Wes Streeting, the new Health and Social Care Secretary, takes office under incredibly challenging circumstances. With waiting lists totalling over 7.5 million cases, junior doctors on strike and a social care crisis continuing to impact frontline services, Streeting has one of the toughest jobs in government on his hands. With 50% of the country seeing the NHS as one of the most important issues facing the country (YouGov), Streeting’s performance is likely to impact the impression of overall government performance. Early progress can be made, but it will be challenging.
Declaring that the NHS was broken in his first day in office was an honest, bold, and frank assessment of the gravity of the situation facing the health service. There have been positive noises from early negotiations with junior doctors regarding strikes.
However, these immediate and pressing challenges serve as a stark reminder as to how difficult it will be to achieve significant NHS reform in the coming years, particularly whilst firefighting immediate NHS crisis along the way. It is unclear where any funding for ending the strikes will come from, sparking rumours of tax rises or additional borrowing in the autumn.
Streeting’s ambitions for NHS reforms are well intended – with additional appointments, a preventive healthcare model and a greater focus on primary care – yet all of these things will take time, resource, and immense political drive.
Shared learning across the NHS, such as Leeds Teaching Hospitals NHS Trust touring the country to upskill wider NHS staff on how to replicate the success of their evening and weekend services over the coming weeks, is a small step in the right direction. Yet, this could be viewed as performative by other parts of the system, where challenges will be specific to their particular set demographics and funding needs. It remains questionable as to whether the 40,000 additional appointments per week will significantly impact the NHS backlog given its scale.
Pledges to make greater use of the private sector to reduce the backlog whilst controversial, are necessary to tackle the scale of the problem. Streeting’s signals to highlight the benefits of diagnostics as a means of prevention has been received warmly within the MedTech sector and the life sciences sector. Rumours of the return of former Health Secretary and NHS reformer Alan Milburn into the Department of Health and Social Care or the central NHS, would help to provide practical advice and experience on the utilisation of the private sector in a bid to reduce the backlog.
Within the ministerial ranks, there has been both continuity from the opposition benches in the form of Karin Smyth and Andrew Gwynne, with change being brought in through Stephen Kinnock as Minister of State and Baroness Merron, a previous health minister. Political weight has been thrown behind NHS Chief Executive Amanda Pritchard, blaming the previous administration and not NHS personnel on NHS failings- a sensible move to not
damage NHS staff morale ahead of reforms. Lord Darzi will conduct a “frank assessment of the NHS”, a shrewd appointment.
Outside of domestic issues, respite will be provided through the UN General Assembly High-Level meeting on Antimicrobial Resistance in September, and the G20 Health Ministers’ meeting in Rio de Janeiro in October. Streeting would be wise to utilise these international engagements to build relationships with other health ministers, learn what works well, and forge collaboration on global health challenges such as pandemic preparedness, prevention and response amongst others.
With little money, the next few months will be challenging for the government, particularly on the monumental task of improving services in the NHS, with quick wins unlikely given the large ambition on NHS reform. As one of Starmer’s best media performers, Streeting will need to communicate effectively to the NHS, politicians and the public to help bring them with him on his journey of reform. Whilst difficult, he will be hope that the new government, with a mandate for reform and a different tone, will be able to make progress on many of the issues that have previous seemed insurmountable.
