In a speech delivered earlier today, Sir Keir warned the Health System must reform or die as working people cannot afford to pay more to revive the institution. He also blamed the previous conservative government for the situation. Let s take a look at some of the findings in that report. It found that if you turn up to an Accident And Emergency department it s likely that One Hundred people could be in front of you waiting for treatment. It also found that there are around Fourteen Thousand avoidable deaths a year. And the last time the nhs met the Cancer Treatment Target which is 62 days was nine years ago, in 2015. Sir Keir Starmer says some of their changes won t be universally popular, but he says he will do the right thing for the nhs. Lets take a listen to some of what he had to say. We ve just got to be more ambitious. Like children s Mental Health or children s dentistry, you know. And look, i know some Prevention Measures will be controversial, but i m prepared to be bold, even in the face of loud opposition. So, no, some of our changes won t be universally popular. We know that. But i will do the right thing for our nhs, our economy and our children. Our political Corrrespondentjoe Pike gave his assessment of Keir Starmer s speech. As with the public finances, he wants to make it clear there will not be a quick or easy fix, and he wants voters to give it ten years to sort it all out. But from my conversations with government, there are a couple of other things he was trying to do in that speech. One of the things waS Making a plea to those within the nhs to change their culture. We have seen stories in recent years of things going wrong in hospitals, in some cases being covered up, Senior Manager being accused of not taking the wrap. As one source told me today, we need the nhs facing up to things going wrong, sounding the alarm when it does, and shock the nhs out of that Cover Up Culture for the sake of patient safety, of course. The other thing that i m told Sir Keir starmer wanted to do was try and set the landscape for the battles ahead, make it clear that the diagnosis is bad because the prescription will not be easy. Those within government think there could be significant battles over further public health interventions, restrictions, battles with unions, battles over the complexities of social care, and also potentially battles over a larger role for the private sector, and therefore Keir Starmer wants to make it clear how bad things are before those battles begin. The report, was the result of a nine Week Review by the independent Peer And Nhs Surgeon Lord Darzi who has this response when asked how long reform would take. It s a difficult question because we need to deal with the prescription next. Once we know, how are we going to fix it, that is when we start thinking how long would it take to fix it. My guess will be somewhere around five years, up to eight years to get the nhs back on its feet based on the previous work. As you remember around the millennium when the nhs plan came out in 2002. So how does the nhs compare to other Health Services around the world . Here s our Health Correspondent Nick triggle. There are at similar challenges. The pandemic was a huge shock, a once in a Century Event that disrupted its services, lead to longer waiting times, and in all of these countries. There are similar challenges, but the scope of them are perhaps arguably greater in the nhs. Notjust in england, this Report Today is about england, but across the whole of the uk. That is largely because the nhs has in comparison to many of these places fewer hospital beds, fewer doctors per population and fewer nurses. It s run on a much tighter shape and there was less capacity in the system to observe these shocks. So, as Lord Darzi pointed out today, the nhs ended up cancelling more non probated treatments during the pandemic than any other comparable country. Let s speak to Dr Sonia Adesara a General Practitioner based in london. I want to ask you first of all, you are on the Front Line of the national health service. Just give us a flavour of what it s like on a daily basis where you work. Its like on a daily basis where you work. Its like on a daily basis where you work. Its like on a daily basis where ou work. . where you work. Yes, im a gp. Its difficult. Where you work. Yes, im a gp. Its difficult. Weve where you work. Yes, im a gp. Its difficult. Weve seen where you work. Yes, im a gp. Its difficult. Weve seen in it s difficult. We ve seen in the nhs the situation get worse and worse year on year. In general practice we re sort of at the raw edge of it. We re seeing our workloads increasing, we have patients who are left months sometimes years on Waiting List for that they keep going back to us because their conditions are getting worse, their pain is getting worse, their pain is getting worse. And throughout the just staff shortages and is quite low morale. Burn is high in general practice, i know recent lead three out of five gps planned to leave the profession within the next five years. And across the Country Gp practices are closing, about A Hundred every year. The situation in the nhs is not good for them is not good for people working, not of the patients. I think the binding two findings of your reports, anyone who s worked in the nhs, will be quite familiar with what was discussed in that report. It feels as if nhs workers, we have been talking about this for quite a long time, the worsening conditions in the nhs. I guess it feels every time this comes up we hearfrom governments every time this comes up we hear from governments that they all would make changing, reformed, i think we re waiting now for those reforms to come in place so that i don t agree have ten years to wait for the we never form sooner than that. Keir starmer has said there no funding without reform. He is talked about things like transitioning the nhs to digital, moving more care from hospitals to communities, focusing efforts on prevention over sickness. To those elements sound like Common Sense to you . Do you think there are other parts of reform that are more urgent . It absolutely sounds like Common Sense. Money is needed, funding is needed to. If you just go to your local hospital you will see that there is outdated equipment. Still two buildings are in Disarray Gp practices use very outdated equipment. To ensure we have a Modern Nhs and to digitalize our nhs will need money. I think it s frustrating for those who work in the nhs when you have different systems, different It Systems not working together. We need to digitalize our nhs. Second to digitalize our nhs. Second to that, bringing more care into the community is really important. We ve been saying that his Health Workers and gps for a long time for the patients want to have their care in the community. They absolutely agree with the prevention, talking about prevention. This doesn t geT Talked enough about the Waiting List in the situations getting worse in the hospitals. I think we don T Talk enough about the health of our nation also has been getting worse. We ve been seeing more and more people getting preventable Health Conditions at a younger age. We need to be seeing more action from our government to tackle that for the we have to be open, we need to think about policies outside of the nhs to improve the health of our nation. That s an absolute priority for this government. Doctor adesara, thank you. History has again been made in space. After Neil Armstrong walked on the moon the first nonprofessional astronauts have walked in space. It looks like a perfect world. This is the moment where. 41 year old Jared Isaacman stepped out of the Resilience Spacecraft to start his spacewalk 435 miles above earth. Isaacman paid for this using his own money to buy the mission from company spacex. As the hatch fully opened, there were celebrations inside spacex hq. A good seal. Cheering. And a short time after isaacman stepped out, the engineer Sarah Gillis followed afterwards stepping outside as the spacecraft flew over new zealand. There are still two days left of the Polaris Mission before they return to earth on saturday parachuting into the ocean in a spot off the coast of florida, where a ship will retrieve the spacecraft and crew. Former Nasa Astronaut and the youngest person to pilot a Space Shuttle Susan kilrain told me more about this new key moment in space history. I m excited about all Space Travel, but this has been an impressive mission that spacex is doing with the four civilians going higher than we ve been since we went to the moon and now doing the first civilian extravehicular activity. It s been pretty exciting to watch. And i m and i probably as they were relieved when everything went off without a hitch and the hatch closed properly. And it s repressurized back up again now. Absolutely. And, you know, looking at a spacewalk, you think, well, it doesn t look like much, but explain to people who may not understand what it takes to do this, how difficult it is and how much training these guys have had to go through. Yeah, these guys have trained for more than two years on this mission. And the unique thing about this is that they had to depressurise the entire vehicle. And so basically, all four of the astronauts were under the vacuum of space during the time they were peeking their heads up above and testing out the spacesuit. This hasn t been done since back in the Apollo Gemini days, when we did ourfirst spacewalk, because there s no airlock, so they can tjust put a couple of people in, depressurise it and send them out. So it is extra risky because of that. But it had been tested in a in the vacuum here on earth many times before they launched the other day. And you know, how common do you think commercial Space Travel is going to become now . Well, it seems to be as common as military Space Flight right now. Or not military, but government Space Flight. It s, uh, they re launching all kinds of missions. Some arejust tourist missions up and down, and some are actually completing relevant science to bettering life here on Earth Or Science to help us go further into space someday. So i see nasa working Hand In hand with these civilian companies to explore space. Still to come on the World Today three days of mourning in peru, after the death of the former authoritarian president alberto fujimori, who s died at the age of 86. And the incredible Moment Rock Starjon bonjovi talked a distressed woman off a bridge. Around the world and across the uk. This is the World Today on bbc news. To the us now, where the Swing State of pennsylvania will be critical in the race for the white house. With polls putting Kamala Harris and Donald Trump at 50 50. The state s biggest city, philadelphia, votes democrat . But the counties surrounding it, are closely contested. Sumi has been talking to the owner of a restaurant in doylestown. We ve been talking to voters really all day about what matters to them, and especially to Small Business owners, because in this county, you have a lot of Small Business owners who are struggling with the costs of doing business. And we re here at coaches, which is a Speciality Place for Philly Cheesesteaks and hoagies. And we re here with the owner, eddie, i want you to meet eddie here because they re making some of their specialities back here right now. This is eddie s son, 0wen, who s working on . I think he S Making a a hoagie. He S Making a cheesesteak right now, a cheesesteak. All right, well, we ll talk to you while he S Making that cheesesteak. Sure, sure. So, eddie, just tell us a little bit about the fact that costs have really been going up. You were telling us that it s been harder and harderfor you guys to do business. Everything. Yes, everything, um, gets a lot harder trying to catch up. So we try to get a Profit Margin with prices and everything else, and items move like, i ll give you an example, like steak could be 1. 80 more a pound this week and then it would drop next week. And then we can t always get a certain kind of steak, like we use a sirloin here, that they re out of a certain brand, the other prices of the other brand of steak like an angus, it seems like it moves up. So i have to keep a standard price on stuff of what happens with me is when the price goes up, i would have to make money. I would literally have to move the prices up that week and then move it down. And you can t do that in business, you know, with your customers. So it gets difficult. Yes it does. And it sounds like, you know, from a lot of people we ve talked to, they re not feeling that optimistic about the way things are right now. How do you feel about it . Not very optimistic. Not right now. I want to be optimistic. I m, you know, but right now, it s it s it s everything is it s a grind right now. Um, so, yeah, i m not very optimistic about it right now. Um, hopefully soon we will be, you know. Well, you know, you told us actually that you also actually care a lot about policy, and you ve been watching what s happening with politics in the country right now. There s an election in november. Uh, how do you feel about the options out there, the two candidates out there . Um, not great with it right now. You know, we went off the debate the other day and i didn t i was hopeful that, like both of them, because that s, you know, that s how you want to look at it. And i didn t i didn t take away anything great from that debate from, from from either of them. You know, it was the same old stuff with trump. And it seemed like the Gotcha Question with harris, which i don t know if it was time or place when she got into his rallies and thatjust that s all that man cares about is numbers and rallies and stuff. And thatjust set him off with the whole debate to a different level where it didn t really tell us anything. You know, when we re looking at these things, we re looking for actual concrete, like policy. We didn t get that. And i didn t feel the even the people running the debate with the questions, we i took away nothing from it. Um, you know, that must be frustrating. I mean, we were talking about the fact that you re looking for answers from those. Correct. What is it that you want to see from Donald Trump, Kamala Harris, as they re trying to get your vote . I want to see what they actually are going to do to obviously, inflation is a big thing. Um, they talk about they can fix it, but they don t actually tell you how they can fix it. You know,with that said, i don t know. I m looking for, like, have some peace of mind. 0kay. We re okay if i m going to put my vote somewhere. They have a clear path, like, Um Direction of where they re where they re where they re going to go into it. Now, i can buy into that or not. That would give me. I m like, the perfect Swing Voter you re trying to get. And they didn t get me. How s that perfect Swing Voter . 0kay. So i am right there where i have no idea who i m voting for right now. Oh, i hope Kamala Harris and Donald Trump are watching this. I hope they are watching. What would you say to them if you had them standing across from you . For me personally, give me some actual concrete, Hard Policy what you are going to do and let me decide if i m. I could agree with it or, you know, agree or disagree and say, okay, that was good. That s all. JusT Talk to us. Justjust don t do talking points. JusT Talk to us and then, you know, give us some hope to make it this. Make the decision tough. How s that . All right, eddie, thank you so much for talking to us. It s been really great. Of course, we re here in the heart of doylestown. And this is really one of those restaurants that a lot of people come to for lunch. Again, for those specialities, the Philadelphia Cheesesteak and also the hoagie sandwiches as well. But i ve got to say, you know, what we heard from eddie is something we ve been hearing from Small Business owners really all morning who say it is getting increasingly difficult to do business. It is notjust the cost of goods, but also the cost of groceries, the cost of Gas Prices and housing. That s a Big One that we ve really heard that whether you re a renter or trying to buy a home, that that s becoming increasingly prohibitive for them. So we re hearing from more and more voters as we re moving around doylestown, and we re going to keep you updated right here on bbc news. If you want to read more about the act two election you could go to the Bbc Website Plenty of information they are from our reporters. The head of the United Nations has described an israeli Air Strike, that killed six un workers in gaza as unacceptable. The Hamas Run civil Defence Agency said 18 people were killed in yesterday s strike on a school in nuseirat Refugee Camp. Israel s military said it carried out a precise strike on terrorists planning attacks from the school and released a list of nine alleged hamas members from among the those killed overall. 0ur Correspondent daniel de simone has the latest and a warning, this report contains some distressing images. In clear daylight, death from the sky. The united Nations Agency for palestinian refugees says the israeli Air Strike on this school in a gazan Refugee Camp is the deadliest of this war for its staff killing six meaning at least 220 employees have died since the conflict began last october. This man says people distributing aid were killed and asks, what are we supposed to do . What is happening to us . Translation sudde