
When the Sunday Telegraph emblazoned "Labour vows war on health unions", the shadow health secretary tweeted about it not being "the headline I expected." In that case, Wes Streeting is more stupid than I thought for supposing the Tory party's house journal would treat him fairly. Thing is, I don't believe his protestation. The headline was an accurate reflection of his comments about doctors and the NHS. And as the piece put distance between Labour's front bench and the militant mood of nurses, there will be Leader's office spinners satisfied with a job well done. Making capital unafraid of a Keir Starmer government remains Labour's main strategic objective, and the weekend's intervention on health matters ticks that box.
Streeting's interview had all the subtlety of a sad trombone at a wake. He attacked the British Medical Association and GPs specifically for voting to reduce their working day from 8-6.30 to 9-5. What he failed to mention was practices would flex their hours and schedule GPs to meet local demand. Nor did he address that the move intends to help the retention of doctors. If Streeting had bothered with his briefing notes, he'd know 45% of junior doctors were considering leaving the medical profession, which means a recruitment crisis for GPs. Someone might be "living on a different planet", but it's certainly not the BMA who are looking at stemming the bleed of doctors.
Pouring more petrol onto the fire, he said the BMA were "hostile" to his plans (what plans?) to increase GP access and enforce better standards. Streeting said he wanted to end the "something-for-nothing" culture, and this would be contingent on making extra cash available. There is indeed a something-for-nothing culture in the NHS. It happens daily in every clinic, walk-in centre, and hospital in the land - that is nurses and doctors come on shift and end up finishing long after their contracted hours. They donate something - their unpaid labour - in return for nothing to cover staffing shortfalls and budgets cut to the bone. This is very obviously not what Streeting is talking about. Instead he's playing to his audience, who imagine money is lavished on the NHS so nurses can dance around doing TikToks on the ward, and doctors nip off to enjoy long liquid lunches. And if Streeting-style change isn't accepted by the health unions, what then? Is he going to deny hospitals cash to speed up waiting times and securing more beds because health workers won't show the necessary subservience?
Ah yes, beds. Streeting did the Sunday round of politics programmes defending his plan to use private health capacity to ease the crisis in the NHS. This was him being "bravely" pragmatic, arguing that if people are in pain then using empty beds is the right thing. Patients won't care as long as they're treated and they don't pay a penny. Okay, in a pinch I could imagine any Labour government doing this as a stop gap. Including the one we never got led by Jeremy Corbyn. But to make a song and dance about it? After all, it wouldn't make much of a difference. Between 2001 and 2021, the NHS lost just over 80,000 beds with the steepest falls registered when Labour was in government. Meanwhile, with 6.8m who awaited hospital treatment in September, and the number of beds available in private health are just 8,000. It's but a drop in an ocean, suggesting Streeting's posturing on this issue is less about clearing backlogs and more to do with virtue signalling at wealthy donors and for-profit health interests.
Save perhaps Starmer and Rachel Reeves, the shadow health secretary is the most right wing member of Labour's front bench (putting aside this summer's dalliance with rail nationalisation and backing strikes). The only thing he can be reliably trusted with is ensuring capital finds more profitable outlets in the NHS, while continuing to underwrite it with state money and sustaining the ruinous role played by markets - so dysfunctional that NHS institutions had to find work arounds, until the government kyboshed their efforts. The NHS is in need of serious reform, but one that unleashes the creative power of its staff, throws off the strait jacket of commoditised relationships between its components, introduces proper democratic functioning and accountability, and enjoys budgets that meet clinical demand and staffing needs. This is diametrically opposite to Streeting's arrogant, briefcase-and-sharp-suit managerialism. And that is why when Labour win the next general election health workers and all who support them have to be ready to take on a Labour government as surely as they're fighting the Tories.
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