
Rachel Reeves has bet all our money on Wes Streeting saving the NHS
The thinking behind Rachel Reeves's spending plans for the next three years was revealed in her statement on Wednesday. It is crude and probably correct. Of the government's three priorities, there is only one that ministers can control so she will throw money at that one.
The voters care about the cost of living, immigration and the NHS. There is not much the governmen t can do about the first. It has to talk about growth and hope for the best. We are at the mercy of Donald Trump, various wars and the bond markets.
Nor do ministers think, in their heart of hearts, that there is much they can do about the Channel crossings. They have to talk about falling legal immigration, a trend they inherited from the Conservatives, while getting cross with the French for not doing enough to stop the small boats – but not so cross that the gendarmes shrug and fold their arms.
That leaves the NHS. The chancellor has put all her chips on the blue and white oblong on the casino table. The health service received the most generous settlement on Wednesday, planned to grow by three per cent more than inflation over this parliament.
There are those – and Nigel Farage is one of them – who will mutter 'bottomless pit' and 'good money after bad'. Those of us who are a bit more sophisticated will mention the NHS productivity crisis. Before the spending review, for example, I pointed to figures from the Institute for Fiscal Studies showing huge increases in the numbers of doctors and nurses in the NHS over the past five years, and small increases in the number of patients seen.
But I also cited evidence that NHS productivity was improving after the one-off shock of the pandemic and now there is more hopeful news to share. Reports are beginning to emerge about what is in the 10-year plan for the NHS to be published by Wes Streeting, the health secretary, next month. It sounds like a good and ambitious plan to shift incentives so that patients are kept out of hospitals and needless in-person appointments are abolished.
Speaking to The Times, Streeting said: 'Much of what's done in a hospital today will be done on the high street, over the phone, or through the app in a decade's time.'
It might seem a bit slow. He has been in government for nearly a year and is only now coming up with a plan?
Government is slow – Keir Starmer has taken to asking repeatedly, 'Why not today?' – but it is important to get big changes right, and Streeting has thrown himself at a lot of the less visible work in his first 11 months, including abolishing the NHS England bureaucracy and taking the NHS back under the direct control of his department.
He has learned the lessons from the last time Labour saved the NHS under Tony Blair, including bringing back some of the key people who did it: Alan Milburn, Blair's health secretary, and Michael Barber, the head of his delivery unit.
The blueprint is all there in a new book, The Art of Delivery by Michelle Clement, my colleague at King's College London. It is based on Barber's diaries and is the fullest account of how the public services were turned around in Blair's second term as prime minister.
The book makes clear what ought to be obvious, which is that it takes time for the combination of more money and reform to start to change measurable outputs, and even longer before the general public notices an improvement. Nor is improvement a steady upward gradient, because there are policy mistakes and personality clashes along the way.
One of Barber's greatest strengths was his ability to manage relationships put under strain by politicians' impatience for delivery. When one permanent secretary ranted at him for giving his department a traffic-light rating in a note to Blair without consulting him, Barber said: 'This has always happened. I'm just telling you.'
Now it is happening again. The good civil servants and NHS managers will realise that it helps them to have objective performance indicators and stretching targets if the whole service is starting to move in the right direction.
Barber had to persevere for two years before the indicators started to shift, but in the NHS the momentum of change gathered pace thereafter. By 2004, Barber told the cabinet that an episode of EastEnders showed Ian Beale complaining that 'people spend at least five hours in A&E', to which Jane, his wife, responded, 'It's a lot better nowadays.'
Barber began to talk confidently about how the changes in just three years were becoming 'irreversible' – a claim that was mocked by the parsimony and incompetence of the Tory years, which managed to reverse the Labour gains eventually.
The point is that the NHS can be changed in a single parliament. The challenges are different now, and so are the technologies. But the principles are the same: more money accompanied by devolution of power to successful managers and aligning staff incentives with the interests of patients.
Time is already running out for this government, and the stakes are high. Most cabinet ministers understand that. One of them was quoted anonymously by The Times today. If it wasn't Streeting himself, it was someone who thinks just like him: 'The truth is there are a lot of people whose lives have been shit for a long time. They rolled the dice with Brexit, they rolled the dice with Boris and then they rolled the dice again with us. They need to see results otherwise they will roll the dice again with Reform.'
Time is running out, but Streeting is one of the few cabinet ministers to have made good use of it so far.
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles


Daily Mail
31 minutes ago
- Daily Mail
Wealthy families desperate to fill shelves so they appear well-read are snapping up books by the metre
Bookshelves in luxury homes are being filled with envy-inspiring collections – which will never be read by their owners. Specialist wholesalers have long sold books intended only for decorative purposes to hotel chains and film set designers. But these companies have seen a growing trend in wealthy homeowners buying vintage and award-winning books by the metre in a bid to make their homes look more sophisticated. Experts say a well-stocked bookcase has become a symbol of a 'luxury lifestyle' and being well-educated. It comes amid a growing trend driven by social media, with 11.8 million posts across Instagram and TikTok under the hashtag #bookshelf. Lauren Giles, founder of Curated Books, told The Mail on Sunday: 'So few of us have time to read any more, so having a well-stocked bookshelf has become a way of signalling that you have the luxury of time. 'It's an indicator of a high-end lifestyle, as well as giving people credibility and making them appear intellectual.' Her business, based in West Sussex, sells everything from vintage Pelican paperbacks for £79 per metre, to antique leather-bound tomes costing between £330 and £990 per metre. She has seen a 'huge shift' and now around a third of her customers are interior designers working for private buyers, including celebrities and MPs. Ms Giles said: 'Only about 5 per cent of my clients are actually interested in reading the books. For most people, it's about the aesthetics or to help create a good impression.' Sue Williams, co-founder of London-based Books By Metre, has also seen a rise in requests. Her company covers old books with new dust jackets to match a colour scheme. She said: 'More people like the idea of having lots of books around. But it's about filling the shelves to match a scheme, usually [our customers] are not intending to read them.' Interior design lecturer Hannah Soulsby, who founded design firm Anima & Amare, regularly buys books to improve the aesthetics of a room. Ms Soulsby said: 'Being able to buy a bulk load of books that match a specific colour scheme makes life much easier. 'Only you and the [home] owner know the books aren't going to be read, but when people walk into the room they are pleasantly surprised because books make a space look much more aesthetically pleasing.'


Daily Mail
38 minutes ago
- Daily Mail
Fantasist who invented claims of a VIP paedophile ring at Westminster set to have jail term cut by three years in Labour's sentencing review
Carl Beech, the fantasist who invented claims of a VIP paedophile ring at Westminster, could soon be freed from prison thanks to Labour's sentencing review. The serial liar triggered a high-level investigation in 2014 into lurid allegations of child sexual abuse and murder involving politicians, generals and senior figures in the intelligence services. Those falsely accused, including former home secretary Leon Brittan and retired field marshal Lord Bramall, had their properties raided, and one of them - ex-MP Harvey Proctor - lost both his home and his job. Police only referred to Beech, a former NHS paediatric nurse, using the pseudonym 'Nick' to protect his identity. His claims that he and others had been sexually abused by a 'VIP ring' in the late 1970s and early 1980s, and that he had witnessed three child murders by members of the same group, featured prominently on BBC News and other outlets. The investigation - known as Operation Midland - cost £2.5m but by the time it was wound up, not one arrest had been made. The Met police force later had to apologise and pay compensation over its handling of the allegations. After his arrest and trial, Beech was sentenced in July 2019 to eighteen years in prison. The sentence was made up of 16.5 years for fraud and perverting the course of justice and 18 months for possession of child pornography. While his sentence for child abuse images is unaffected by the recent changes, the bulk of his sentence will be cut by as much as three years. Under the sentencing policy of the Conservative Government he was due for release on 1 Oct 2027. Under changes announced last year by Labour that date was brought forward to 8 Feb 2026. But under the latest proposals Beech, now 57, became eligible for early release on good behaviour on 11 Dec 2024. Commenting on the prospect, former Tory MP Mr Proctor, the only direct living victim of the fraudster's lies, said: 'I'd very much regret Carl Beech being released early from his sentence. I think there must be some discretion, it shouldn't be automatic. 'Those who take this decision should take into account the extraordinary damage he did to a lot of people. The punishment needs to fit the crime. 'If he's released I hope he leads a productive life and rejects any attempt by publishers to write a book – that would be very aggravating to the families of those he falsely accused and to me.'


The Herald Scotland
42 minutes ago
- The Herald Scotland
Procurement rules set to be overhauled as ministers lay out infrastructure plans
The Treasury has promised hundreds of billions over the next decade for projects such as roads, railways and homes. Under proposals put forward in a Cabinet Office consultation, public bodies would have to give more weight to firms which can prove they will boost British jobs when they are bidding for contracts. Chancellor of the Exchequer Rachel Reeves delivered her spending review on Wednesday June 11 (Stefan Rousseau/PA) The change is set to apply to major projects such as transport, as well as other schemes including hospital and school building. Firms looking to work on public sector projects could also be rewarded if they can show benefits they will bring to a community, such as apprenticeships, opportunities for care leavers, or helping people into work. Pat McFadden, the Chancellor of the Duchy of Lancaster, has said that the proposals will reward firms that 'put money in working people's pockets'. 'Whether it's building roads, railways or schools, we want to open up opportunities on major infrastructure projects for firms that boost British jobs and skills,' he said. 'The new rules will deliver on our plan for change by rewarding companies that put money in working people's pockets as we invest in the country's future.' According to the Treasury, the infrastructure strategy will lay out Government plans on prioritised policy areas such as upgrading transport networks, building new homes, modernising public services such as hospitals, and assisting the transition to green energy. Ministers are pledging that at least £725 billion will be spent on infrastructure over the next 10 years. The Chancellor outlined a raft of infrastructure investment as part of last week's spending review. According to Wednesday's announcement, there will be £39 billion over the next 10 years to build affordable and social housing, and spending is due to reach £4 billion a year in 2029-30. There was also a £30 billion commitment to nuclear power, including £14.2 billion to build the Sizewell C plant in Suffolk and £2.5 billion for small modular reactors, as well as £15 billion for public transport projects in England's city regions and a four-year settlement for Transport for London worth £2.2 billion. Ms Reeves said: 'The British people voted for change – and this is how we deliver it. For too long, our infrastructure – our schools and hospitals, or our roads and bridges – have been left to crumble, holding back communities and stunting economic growth. 'This was a dereliction of duty by previous governments overseeing an era of managed decline, but it ends with this one. 'We are investing in Britain's future, brick by brick, road by road and track by track.'