Wes Streeting, Please Up Your Game!

The hearts of the wise make their mouths prudent, and their lips promote instruction.

Proverbs 16:23,  The Old Testament

We have just spent rather a lot of money on essential maintenance of our house. I knew that we needed to attend to issues that had been developing over the years. We replaced our roof a few years after we moved in and in memory it is still the “new” roof. But damp in certain spots and actual leaking during a heavy rainstorm this year convinced us that essential maintenance work was due!   Similarly, our external walls were showing signs of deterioration and some  repointing was in order. We were not prepared for the amount of work that needed to be undertaken when the builder came round and inspected the roof and walls! As we thought about it more carefully, we realised that our “new” roof was over thirty years old and that the brickwork on the house is nearing 100 years!  So, we bit the bullet and agreed to all the work. Now that the work has been done, we feel reassured that the house will be good for another 30 years and that what we pass on to the children will be worth passing on.

Wes Streeting, the new Secretary of Health for England, has begun his term by asserting that the problems facing the National Health Service (NHS) cannot be solved by throwing money at it (1).  It’s disappointing to hear a Labour Party Secretary of State still deploying neo-liberal Conservative rhetoric when discussing the problems facing the NHS, even after a huge parliamentary majority has been won by Labour. The facts are indisputable, in every single year of the previous Conservative governments inflation adjusted spending on the NHS has been several percentage points below what is acknowledged as the stand-still spending requirement (2).

Health economics is complex, but we can get some idea of the scale of the cumulative reduction in financial support for the NHS by the 35% pay claim of junior doctors to restore their pay levels to 2010 levels. We can reasonably assume that the overall funding deficit for the NHS must be on a similar scale. What would happen if our own household incomes shrank by a third over 15 years? Well, for one thing, the essential maintenance that my wife and I have just carried out could not be afforded and we would have increasingly significant problems with leaks and damp in our walls as the fabric of our house deteriorated.

Which is exactly what has happened in the NHS. We know that waiting-times in the NHS are getting worse. What we may not understand is that a significant proportion of that increase is because the fabric of our hospitals is failing as timely maintenance could not be afforded (2). Power failures, leaks, unsafe buildings result in cancellation of procedures which increase waiting times. Staffing is, of course, another issue. The falling level of pay over the years means that more and more experienced staff leave for better opportunities elsewhere.  This not only means that more and more very expensive private sector (agency) staff are used to fill the gaps, but that the NHS staff body is becoming less and less experienced and can’t work at the same efficiency as the experienced staff they are replacing. And, of course, the failure to properly fund adult social care means that, at any one time, more than 10% of hospital beds are occupied by patients waiting to be discharged.

All of this is the result of inadequate funding. What Wes Streeting would be right in saying is that increased funding will not result in an overnight fix. There is no fix that could do that. These problems cannot be resolved overnight, or even, in the lifetime of a single parliament. But increased funding is absolutely essential for any improvement at all. To pretend otherwise is simply disingenuous and following the playbook of Conservative neo-liberal-speak. Wes Streeting simply has to up his game if he’s going to make a real difference!

1. https://www.thesun.co.uk/news/27175749/wes-streeting-nhs-major-reform-labour/ acc. 17:52 28.7.24
2. BBC News – More money and staff – so why isn’t the NHS more productive?
   https://www.bbc.com/news/articles/c0dmvdmmv80o  acc. 15:55 29.7.24