Keir Starmer has said Labour is prepared to reform the NHS to prevent it dying, as he said the current system of GP visits “isn’t working”. The Labour leader said his party was going to tackle “bureaucratic nonsense” in the NHS and argued people should be able to self-refer themselves to a physio for back pain or to order a test for “internal bleeding” rather than having to see a GP. Starmer set out his views on the health service in interviews with the BBC and the Sunday Telegraph, saying: “If we don’t get real about reform, the NHS will die.” In the wide-ranging BBC interview, Starmer also said: He had “concerns” about Scotland’s laws to allow people legally to change their gender without medical diagnosis, saying he did not agree that those aged 16 should be able to do this. The UK government is considering whether to block the legislation in a constitutionally controversial move. He had never dreamed of wanting to be prime minister when younger or when he first entered parliament, but his mission as Labour leader was now motivated by “duty”. He could not guarantee his leadership pledge that Labour would abolish tuition fees because the political landscape had changed after the Covid pandemic. Labour would not take the UK back into the EU or the single market, and he resisted the idea that Brexit was to blame for the country’s financial troubles. After his shadow health secretary, Wes Streeting, proposed an overhaul of the GP system, the Labour leader said he would “look at all sorts of reform” for the NHS but stressed it would always be “free at the point of use”. Starmer told BBC One’s Sunday with Laura Kuenssberg that the risks of not reforming the health service were greater than doing so. “The reason I want to reform the health service is because I want to preserve it. I think if we don’t reform the health service, we will be in managed decline,” he said. However, some doctors were sceptical about the idea that patients with conditions such as internal bleeding should be advised to skip seeing their GP, with Dr Rachel Clarke, the doctor and writer on the NHS, describing it as “monumentally stupid and insulting on multiple levels”. Starmer’s plan was also criticised by the Socialist Health Association (SHA), Labour’s affiliated socialist society for healthcare and medical professionals, which three years ago endorsed him for leader. An SHA spokesperson said: “Keir Starmer is right that the Tory-damaged NHS is in urgent need of repair, but his solutions are all wrong … The Labour leadership is offering bromides and dangerous false solutions. “For Keir Starmer to advocate self-referrals for internal bleeding is a recipe for disaster that will waste resources and cost lives. The emphasis on private sector involvement in the NHS will do nothing but accelerate a two-tier health system – one for the rich and one for the rest of us.” With waiting lists at record highs and people struggling to get GP appointments, Starmer appears to have made a calculation that voters will back NHS reform and may trust Labour with this more than the Conservatives. “It’s time for us to think about a new, sustainable system, one that allows GPs to focus on caring for patients rather than the admin that comes with effectively running a small business,” he told the Sunday Telegraph. “We also need to be ruthless with the bureaucratic nonsense you encounter every day in the health service. Why can’t people with persistent back problems self-refer to physio?” He added: “Ambulances queue outside A&E with stroke victims left in the back; cancer patients wait to see specialists; people are stuck on hold at 8am every morning, desperate for a doctor’s appointment. “The idea that the service is still ‘the envy of the world’ is plainly wrong.” Streeting said last month that the NHS was in “existential crisis” and proposed employing GPs through the health service, instead of them being independent contractors running their own practices. Starmer later summarised his proposals for NHS as “self- referrals for patients, doubling the number of graduating doctors and district nurses, increasing training places for nurses and midwives and freeing up GPs to focus on patients”. Rishi Sunak, the prime minister, has made reducing waiting lists one of his five key pledges but he is facing problems on many fronts with the NHS, from long ambulance waits to people struggling to see a GP and health workers planning a raft of further strikes over pay and conditions.