The NHS is “struggling” but “not destroyed”, despite the huge challenges it faces, the head of the health service in England says. In a major speech on Wednesday, Amanda Pritchard urged which ever party won the general election to give the NHS more money, fix social care and tackle threats to public health, such as junk food. Bold government action was needed to stop the NHS becoming “an expensive safety net” that picked up the pieces of people damaged by obesity, mental illness and problem gambling, which was now being exacerbated by people using “unregulated cryptocurrency markets”, she said. In her address to the NHS ConfedExpo conference of health service bosses in Manchester, the chief executive of NHS England acknowledged that maternity care, mental health provision, GP waiting times and patient safety were not good enough. But she rebutted the claim, made in recent years by some politicians and health service staff, that the NHS was “broken”. “It’s important to recognise where we need to do better for patients. But it’s also important that we don’t collude with defeatism,” Pritchard said. “Yes, the post-Covid NHS is damaged, but it is not destroyed. It is struggling, but it is still doing incredible things every day.” Some politicians, such as the shadow health secretary, Wes Streeting, have taken the service’s deepening struggles in recent years as proof that it has been “broken” by 14 years of Conservative underfunding and their failure to grasp the scale of the staffing crisis. Others, such as right-of-centre thinktanks, have claimed that the NHS’s massive waiting list and inability to provide timely care showed the model of a taxpayer-funded service available to all and free at the point of need was no longer sustainable. Pritchard made clear that whoever was in power on 5 July would need to take bold action to help the NHS survive in its current form and cope with an ageing and increasingly sick population. Big expected rises in coming years in the number of people who had at least one long-term condition as well as those suffering mental ill-health would mean “more demand, requiring more capacity”, she said. “More people, more places, more equipment, more drugs. And all of those things add up to more costs” – at a time when population changes mean more people will be paying tax, she said. The next government will need to give the NHS more capital funding to repair crumbling buildings, buy equipment and build new facilities. The cost of addressing the service’s backlog of maintenance repairs has ballooned to almost £12bn. Citing the opening of 30 NHS clinics to help severely obese children, and a recent sharp increase in the number of people in England with a precursor of type 2 diabetes – “a disease driven by junk food and obesity” – she emphasised that “we [the NHS] can’t solve this alone”. She added it was urgent to increase “capacity and quality in social care – a question to which we still need an answer …[which is] vital … to the things everybody wants the NHS to achieve, whether that’s shorter waiting lists or faster A&E care”.