{"id":271368,"date":"2025-11-19T09:19:22","date_gmt":"2025-11-19T09:19:22","guid":{"rendered":"https:\/\/www.newsbeep.com\/uk\/271368\/"},"modified":"2025-11-19T09:19:22","modified_gmt":"2025-11-19T09:19:22","slug":"wes-streetings-gamble-with-the-nhs-is-greater-than-any-play-for-downing-street-gaby-hinsliff","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/uk\/271368\/","title":{"rendered":"Wes Streeting\u2019s gamble with the NHS is greater than any play for Downing Street | Gaby Hinsliff"},"content":{"rendered":"

Everybody has a horror story about NHS<\/a> waiting lists. If it isn\u2019t you, then it\u2019s probably your neighbour, your friend, your elderly parent; trapped in an anxious, miserable limbo for months longer than they should have been, getting passed from pillar to post. The only thing we don\u2019t all know about waiting lists, it turns out, is that actually they\u2019re coming down.<\/p>\n

Barely a quarter of the public in England knew waiting lists had fallen in Labour\u2019s first year in power, according to recent polling for the Health Foundation thinktank in September: more than a third<\/a> thought they had just kept going up, presumably because that\u2019s what we have become gloomily resigned to. Since waiting lists are one of those emotional yardsticks<\/a> by which people judge whether the country is falling apart or not, you would think the government might like to mention this, and indeed this week it planned to. But then someone close to Keir Starmer chose to accuse the health secretary of plotting a coup<\/a> two days before a planned speech on NHS reform, accidentally ensuring that Wes Streeting\u2019s pre-booked stint on breakfast telly<\/a> was mostly spent debating whether the prime minister is toast or not. Streeting emerged a picture of injured innocence, while reminding everyone how much better he is at this stuff than the boss. Well done, everyone, and now back to the bit that actually affects anyone hoping to see a GP this side of Christmas.<\/p>\n

This week, Streeting finally gave the green light<\/a> for axing about 18,000 backroom NHS jobs in England, in a reorganisation that is ultimately supposed to save \u00a31bn a year to be spent on frontline care, but will cost at least that to implement upfront. Nobody wants to hear that they may be losing their job just before Christmas, and the last thing a Labour government wants is to be the one responsible, yet in some respects that was the easy bit.<\/p>\n

For Streeting has embarked on a high-stakes and surprisingly under-discussed reform of NHS England that, if it works, could become the model for rebuilding a crumbling public realm without intolerably high taxes; but if it doesn\u2019t could be the last nail in Labour\u2019s coffin and potentially in the NHS, to boot. And he\u2019s trying to do it in the teeth of a doctors\u2019 strike<\/a>, endlessly delayed social care reforms<\/a> that mean hospitals are still full of people who shouldn\u2019t really be there, and what may be an ominously busy winter<\/a>. Lives depend on whether he succeeds, but that\u2019s not all in an era where people seem increasingly convinced that everything is too broken for conventional politics to fix.<\/p>\n

After finding some way of making people feel better off, cutting waiting lists as promised in its manifesto is probably the single most important thing this government could do now, both for the country and for its own survival. It mattered enough to Rachel Reeves that she used her first tax-raising budget partly to fund 2m extra NHS appointments, and when waiting lists fell<\/a> this May for the first time in 17 years, it looked as though the medicine might be working. Though by August they were creeping up<\/a> again, after a summer heatwave and another strike, they fell once more<\/a> in September: 61.8% of patients currently get treated within 18 weeks of referral and NHS executives are confident<\/a> that could be 65% by next March, on track for 92% \u2013 the target set and met by the Blair government, but consistently missed for a decade \u2013 by 2029.<\/p>\n

Yet progress remains fragile, which helps explain why Streeting\u2019s frustration<\/a> boiled over on Thursday, as resident doctors who got a 28.9% pay rise last year prepared to walk out once more. The BMA, he suggested<\/a>, is only too quick to lobby against doctors paying higher taxes, while demanding the state pay them more out of other people\u2019s taxes. Yet going to war with doctors is another big gamble, because this plan won\u2019t work without them.<\/p>\n

The politics of Streeting\u2019s plan is clear: slash bureaucrats, who aren\u2019t popular, and put the money into frontline care, which is. Merging NHS England back into the Department of Health and Social Care and cutting regional commissioning boards will cut headcount, but will also lead to a devolution of power, with good hospital trusts in theory freed from central control. It has risks but it is a model likely to be echoed across government, with other cabinet ministers exploring<\/a> the use of devolution, digital tools and AI to deliver services differently \u2013 which will mean some painful decisions about the human jobs displaced.<\/p>\n

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Because those NHS staff now anxiously refreshing their CVs weren\u2019t just sitting around looking busy. They will be patient safety officers and infection control specialists, middle managers and unglamorous admin staff with families and mortgages, who worked right through the worst of the pandemic. If it turns out their roles weren\u2019t the best use of taxpayers\u2019 money, that\u2019s not their fault \u2013 they didn\u2019t build the byzantine structure for which they worked \u2013 and like all big changes, this one may be demoralising and disruptive.<\/p>\n

If it works, perhaps the pain will be forgiven. If it means fewer people dying of preventable causes before they ever reach a surgeon, then these reforms will have been life-changing for many families. And if they prove that governments can still make a difference, that paying taxes is worth it, and that life can be better than this, then they will also have done their bit to fight rising political nihilism. Since long waiting lists have made it all too easy to convince some voters that immigrants are the reason they can\u2019t see a GP, rather than the reason they even have a GP, tackling that grievance might even create space for a more reasoned conversation about the skills this country needs.<\/p>\n

Can Streeting pull it off? The jury is still out: on one hand, the last Labour government did it, and the increase in appointments needed isn\u2019t wildly out of kilter with the ones achieved during the Tory years<\/a>. Recent modelling from the Health Foundation<\/a> reckoned Streeting might fall only very slightly short. But making it work still requires going further and faster than the Blair government on a tighter budget, while pushing through a complex reorganisation of an institution that has had more than enough of them, battling mutinous doctors and fighting his own backbenchers over some of the 10-year plan<\/a>\u2019s more controversial ideas around the commercial use of health data.<\/p>\n

If he can do all that and still come up cheerfully cracking Traitors jokes at breakfast, then Streeting probably deserves a tilt at Starmer\u2019s job. If he can\u2019t, then the job may not be anyone\u2019s for long.<\/p>\n

This article was amended on 14 November 2025 to make clear that Wes Streeting\u2019s plans cover England alone and not the whole of the UK. Also it is waiting lists in England that have fallen in Labour\u2019s first year in power.<\/p>\n","protected":false},"excerpt":{"rendered":"Everybody has a horror story about NHS waiting lists. If it isn\u2019t you, then it\u2019s probably your neighbour,…\n","protected":false},"author":2,"featured_media":271369,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[43],"tags":[102,2960,56,54,55],"class_list":{"0":"post-271368","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-uk","11":"tag-united-kingdom","12":"tag-unitedkingdom"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/271368","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=271368"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/271368\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/271369"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=271368"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=271368"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=271368"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}