‘Streeting gets the public’s views on the NHS, even if CLPs may not like them’

Wes Streeting’s speech to Labour conference a couple of weeks ago was a memorable one. It was big, bold and unapologetic. It didn’t take any prisoners. It was the Shadow Health Secretary at his best.

If you’ll forgive me quoting fairly extensively, there was one passage that really stood out: “Reform is even more important than investment. Because pouring ever-increasing amounts of money into a system that isn’t working is wasteful in every sense. A waste of money we don’t have. A waste of time that is running out. A waste of potential, because the NHS has so much going for it.

“Labour will never abandon the founding principles of the NHS as a publicly-funded public service, free at the point of use. I make the case for reform not in opposition to those principles but in defence of them.

“I’m blunt about the fact that the NHS is no longer the envy of the world, not to undermine it, but to reassure people that we’ve noticed. I argue that our NHS must modernise or die, not as a threat but a choice.”

Streeting understands the paradoxes of public opinion on the NHS

The NHS “must modernise or die”, shadow health secretary Wes Streeting tells Labour’s conferencehttps://t.co/Phlacdpf28 pic.twitter.com/DL3kdqATH4

— BBC Politics (@BBCPolitics) October 11, 2023

The reason that I think this passage is so interesting is that it shows that Streeting and his team understand what I call the ‘three paradoxes of public opinion on the NHS’ and – even more importantly – that they seemingly want to solve them.

If they seem frustratingly contradictory, that’s because they are. Normal people are very capable of holding contradictory views in their heads, especially in subjects about which they know little but feel strongly.

Each of the paradoxes, which have regularly been witnessed in the opinion research I oversee, are of profound importance as Labour thinks about how to frame its NHS offer running into the next election.

They are:

1. Everyone loves the NHS and yet in focus groups it quickly becomes apparent that absolutely everybody has a personal horror story about waiting lists or botched admin. These stories flow from them like a public policy fever dream.
2. Everybody knows that the NHS is in desperate need of reform – and yet in focus groups almost nobody believes such reform will work. Getting people to imagine a high-performing NHS is very, very hard.
3. Everybody knows that the NHS is in desperate need of investment – they see it with their own eyes every time they visit a hospital. And yet nobody believes it will make any difference to the service they are experiencing.

Streeting’s speech at conference seemed to try to reflect these paradoxes and even solve some of them. This is especially clear in the passage above when he is “blunt” about the fact that most people think the service they receive from the NHS bureaucracy is not good enough.

Labour’s health policies are tangible to voters

I also detect his understanding of the public mood in the concrete policies that Labour announced. This was most apparent in the way that the shadow health team picked very specific areas to announce investment commitments.

Take, for example, the policy, revealed in advance of conference, of focusing on MRI scanners for investment. In this commitment, Streeting is committing to a tangible investment – it is easy to understand how it will directly correlate to performance on waiting lists.

The same could be said for two other big announcements that were made around conference: significant investment and commitment in adolescent mental health services and in NHS dentistry. They are tangible, much more so than big bold ideas about systemic reform. Their limited scope is, perhaps strangely, an electoral net-positive.

It may not be popular in many Constituency Labour Parties, but much of this is also true of the idea of using private health providers to bring down waiting lists. For ordinary people who just want to see their granny’s hip replaced in less than two years, this is a no brainer. It’s easy to understand, and its efficacy is completely obvious. It also implicitly tells voters that Labour gets that the current NHS is no longer capable of delivering what is needed.

Streeting has demonstrated in these last few weeks that he has a good grasp of where the public is on the NHS. Given that its omni-crisis is likely to be among the most salient issues when the election finally comes, that is excellent news for the Labour Party – and, by extension, the country.