The NHS needs reform rather than more money, the health secretary has said, while admitting that record-high waiting lists will continue to rise before they fall. Sajid Javid said the health service already had the resources it needed and did not require more to care for patients effectively. “The NHS now has locked in the resources it needs. It doesn’t need any more money. What it needs to deliver for more people is not money. It needs reform,” he said. In an interview with the Times, he compared the NHS to the now defunct video rental chain Blockbuster, arguing that it needed to be dramatically restructured in order to continue delivering healthcare free at the point of use. “You want to have a system that, yes, it’s got the values of 1948 but looking at delivery towards 2048,” he said. Javid made the same comparison in a cabinet meeting on Tuesday, saying the country had a “Blockbuster healthcare system in the age of Netflix”, though he later defended his comments by saying he did not mean it should become a subscription-based service. Javid also called for the chancellor’s plans for a 1p cut in income tax in 2024 to be brought forward to next year. “I want to see a small state that focuses on delivery of the things that really matter, and I want to see taxes as low as possible,” he said. The cut would do little to help those bearing the brunt of the cost of living crisis, with 80% of the benefit going to the top half of earners. The health secretary’s remarks on funding for the health service follow a damning report that showed the NHS had lost almost 25,000 beds across the UK in the last decade. The Royal College of Emergency Medicine said the drop had led to a sharp increase in waiting times for A&E, ambulances and operations, and was causing “real patient harm” and a “serious patient safety crisis”. Speaking in the same week that a viral video clip showed a nurse telling patients they faced 13-hour waits at an overcrowded A&E department, Javid conceded that NHS waiting lists would continue to rise. “I’ve been very honest, waiting lists will keep rising before they fall,” he told the Times. “People appreciate honesty. They want ministers to be frank and treat them like adults.” He said people understood that significant challenges remained in the wake of the Covid pandemic. He insisted that reforming the health service was a necessity. “It is absolutely possible to drive change and reform in the NHS and we have to, it’s not a choice,” he said, adding that its budget this year exceeded Greece’s GDP. “We estimate by the end of this parliament it will account for more than 40% of day-to-day government spending.” Javid stopped short of calling for cuts to the NHS budget and said he did not want to see “important health services cut”. “What you can certainly do is reduce the growth of NHS spending and deliver more at the same time,” he said.