At the entrance to the Department of Health and Social Care is a ten-foot timeline of all those who have led the ministry. It is a visual reminder of Labour’s wilderness years: eight Conservative names precede that of Wes Streeting (the last Labour health secretary was Andy Burnham in 2009-10).
I met Streeting, 41, on a warm Friday afternoon in his office on the department’s ninth floor – the balcony of which offers a panoramic view of Westminster. Dressed casually in a navy blazer and open-necked blue shirt, with his ministerial red box in front of him on the table, Streeting looked tanned and relaxed. But he was indignant about his inheritance from the Conservatives.
“It feels like being the fire brigade hosing down the house while the arsonists are heckling you for not doing a good enough job,” Streeting said of his predecessors. “I think they’re appalling, I really do.”
He cited the last government’s handling of the junior doctors’ strike as evidence. When Streeting entered the department on 5 July he was told that outgoing ministers had not met the British Medical Association since March. “I managed to do within three weeks what they had failed to do over more than a year, which was to agree a deal with the junior doctors,” Streeting said. “And now they’ve got the audacity to sit there complaining about the price of the deal at the same time as refusing to apologise for the cost of their failure.”
While the settlement cost around £600m – junior doctors received a 22.3 per cent pay rise (taking their starting pay to £36,600) – the strikes cost the NHS an estimated £3bn and led to the cancellation of roughly 1.5 million appointments and operations. “The Tories were the worst combination of stubbornness and incompetence, penny wise and pound foolish,” Streeting said.
This insight is shaping his approach to the health service. On 12 September, Ara Darzi, the cancer surgeon and former health minister, published his investigation of the NHS. One of its central findings was that while the service has more money and staff than ever – the NHS budget for 2024-25 stands at £192bn and it accounted for 43 per cent of all departmental spending in 2023 – its productivity has stagnated. Over the past six years, NHS spending has increased by 19 per cent but the number of patients starting treatment has risen by just 3 per cent.
Unless this changes, Streeting warned, “we’re going to end up at best with an NHS with a country attached to it, instead of a country that has an NHS” (adapting the description of Prussia as “an army with a country, not a country with an army”). “Or, more likely, an NHS that goes bust.”
Mindful of this, Labour is planning three major shifts: moving from an analogue to a digital NHS; transferring care from hospitals to communities, and focusing on prevention rather than merely cure. When I pressed Streeting on higher funding – the Darzi report identified a £37bn shortfall in capital investment – he insisted that he recognised the need to combine investment and reform (his ten-year plan for the health service will be published next spring).
Labour’s preventative agenda includes plans to restrict outdoor smoking and it will ban junk food ads both online and before the 9pm TV watershed from October 2025 (almost a quarter of English children are obese by the end of primary school). While Streeting told me that “there’s no doubt we need stronger action on smoking”, he sought to reframe the government’s killjoy image.
“My frustration with some of the coverage we’ve seen over the summer is that the argument always lands in the nanny-state place of telling people to stop smoking and giving people the impression that they need to start closing their windows in case I’m peering through of an evening to see what they’re eating and what they’re drinking and if they’re smoking in the comfort of their own home.
“I’m not remotely interested in being the fun police or telling people how to live their lives. What I do recognise is that people are becoming sicker sooner in life and we’ve got to push chronic disease and illness into later life because it’s good for the economy and it’s how we make the NHS financially sustainable.”
Does Streeting – praised as one of Labour’s best communicators – worry that the government’s wider narrative has been too gloomy? In his rose garden speech last month, Keir Starmer warned that “things will get worse before they get better” (an apt description of his approval ratings since).
“I think people mistake honesty for gloominess,” Streeting replied. “It would be quite jarring if we were all skipping around Whitehall singing Sam Cooke’s ‘A Change Is Gonna Come’ or D:Ream’s ‘Things Can Only Better’ at the same as we’re dealing with a £22bn black hole and making some tough choices which are really sticking in the throats of people, particularly on the winter fuel allowance.”
Of Labour’s poll ratings – a recent survey by More in Common put the party on 29 per cent – he said: “We’re not indifferent to public opinion, we’re conscious of the fact that trust in politics and we politicians is at rock-bottom. But the worst thing we could do is just follow the polls rather than following the evidence and making the hard choices now that will leave people happier, not just later in this parliament but for generations to come.”
Streeting recently said that he was “not remotely happy” about the decision to remove winter fuel payments from most pensioners. But wasn’t it a choice, rather than a necessity? (The savings represent 0.1 per cent of annual government spending.) “Well, it’s about £1.5bn towards the £22bn black hole that we face. There will be more difficult choices to come. I understand why the Chancellor had to take the decision when she did because she had to set out the decision far enough in advance of winter for the savings to take effect.”
Notably, Streeting appears to hint at potential cuts to working-age benefits: “I can understand why there will be some pensioners sat there thinking, ‘Well, why us? And what about others?’. Well, there are other choices to come and these aren’t just Rachel’s choices to face up to, these are the choices of the whole government.”
Had 265 people switched sides at the general election, Wes Streeting would not now be Health Secretary. A British-Palestinian activist, Leanne Mohamad, finished just 528 votes behind him in Ilford North (the London seat he has represented since 2015). Was he surprised by how close the result was?
“The backlash on Gaza didn’t surprise me because that was palpable. Contrary to what my independent opponent was saying, I have lived in my borough for over 20 years. I know my people very well, and I knew exactly where people were on the war in Gaza and the Labour Party’s response. I felt that anger on the doorstep and that criticism I can sort of take on the chin. I’ve said the Labour Party needs to respond with humility and rebuild trust.”
But what did shock Streeting was a fake audio recording of him “using the most appalling, foul language about dead Palestinian children” that went viral on WhatsApp.
“I wouldn’t have voted for that candidate. And it was clear to me that many people in my constituency did believe it,” Streeting said. “It’s a threat to liberal democracy and we’ve got to treat it as a national security threat as well as an issue for the Electoral Commission and the police.”
Nearly a decade after he entered parliament, Streeting is invariably described by both admirers and detractors as a “Blairite”. How does he feel about that label? “Well, hopefully off the back of the choices we make, we’ll have our own labels by the end of this government,” Streeting quipped. He added that while he admired Tony Blair’s three general election victories and record of public service improvement, he also has points of disagreement. “My critique of Tony’s leadership, beyond the obvious of Iraq, which I didn’t support at the time, is that he was too quick to declare a classless society, and even in his response to the Grenfell Inquiry I thought he missed one of the central lessons of what was a genuinely distressing and jaw-dropping report, which was a story of working-class people being ignored by professionals in power and treated like their voices didn’t matter.” (Blair suggested in his response to the Grenfell report that some “accidents or tragedies” were unavoidable.)
When the last Labour government left office in 2010, public satisfaction with the NHS stood at 70 per cent – a record high. In 2023, it was at a record low of 24 per cent. Streeting believes he is engaged in a struggle for the very future of the Bevanite model. “Unless we reform the NHS, and unless we reform our approach to public health, this country will not be able to afford a National Health Service in the longer-term. It is an existential threat to the equitable system that Labour created in 1948 and I’m not prepared to duck the difficult decisions.”
This, he insisted, included social care reform (the government is planning a cross-party royal commission on this politically-fraught issue). “If I look back on my time in this office not having grasped the nettle of social care reform, I will have considered my time here a failure, and I’m not prepared to fail.”
Should the Health Secretary succeed, as some commentators have suggested, he could become Starmer’s successor. But Wes Streeting is, for now, grateful to be where he is. “My near-death experience at the ballot box, combined with my brush with cancer a couple of years ago, has made me feel incredibly fortunate to be in the position of doing a job that, for all the challenges, I’m absolutely loving.
“We did something that no one thought was possible after the last general election. Now we’re going to do something that, frankly, lots of people in our country still don’t believe is possible, which is to take Britain from the depths of the crises left by the Conservatives to building a brighter future.”
[See also: What do the Lib Dems want to be?]
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This article appears in the 18 Sep 2024 issue of the New Statesman, What’s the story?