Streeting: I’ll end ‘begging bowl’ relations between Health Department and HMT

Katie Neame
Wes Streeting. Photo: Department of Health and Social Care

Wes Streeting has pledged to end what he called the “begging bowl” relationship between the Department of Health and Social Care and the Treasury, arguing that his department must play a role in achieving Labour’s economic growth mission.

Speaking at the Tony Blair Institute’s conference earlier today, the Health Secretary also said he is “optimistic” about talks with junior doctors this afternoon, describing the change in government as an “important reset moment”, though he reiterated that Labour does not believe their pay demand is affordable.

Asked how he plans to fix the NHS that he has described as “broken”, Streeting said: “One of the things I’ve said to my department and to the NHS is we need to rethink our role in government and in our country at large. This is no longer simply a public services department. This is an economic growth department.”

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He emphasised the link between the “health of the nation and the health of the economy”, telling attendees: “We’re going to be a government that firstly recognises that fact and recognises that as we get people not just back to health but back to work, that’s a big contribution to growth.”

Streeting continued: “If we can marry our health and social care system with the incredible life sciences and medtech ecosystem we have in this country, we can be a powerhouse for the life sciences and medtech revolution here in this country… and in the world. And that is an economic growth mission.”

He added: “I’m now responsible for one of the largest workforces in the entire world that have a presence in every community in this country. As anchor institutions, the NHS, the social care system, we can be drivers of economic growth in every part of the country.”

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The Health Secretary said: “That is a major shift in mindset. It’s a rethinking of the role of the department and it also means – and the tough messages I delivered in opposition are not going to change now we’re in government.

“It also means ending the begging bowl culture, where the only interaction the Treasury has with the Department of Health and Social Care is: ‘We need more money for X, Y and Z.’

“The starting point has got to be: ‘We will help you achieve your mission for growth and improve the prosperity and lives of everyone in this country, by making sure that we are with you, lockstep in driving growth.”

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Elsewhere in the interview with journalist Jon Sopel, Streeting said cutting NHS waiting times is his “immediate focus” but that Labour will also be “embarking on a long-term plan for both health and social care”.

He said: “We’ve got to make sure that we keep our eyes on the long-term horizon because if you look not just at the challenge today… but the challenges which I consider to be existential for the future of the NHS, which are growing ageing population, rising preventable chronic disease and rising costs pressures…

“If we don’t make the right reform decisions now, in the medium term, let alone the long term, future generations and future Health and Social Care Secretaries will curse us, because we didn’t take the difficult long-term decisions at the right time and we saddled future generations with a National Health Service that is unsustainable.

“I am optimistic about the future of the NHS, and I think that the same equitable principles upon which it was founded in 1948 can and must survive and thrive in the 21st century. But that is not inevitable.”

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Asked about the NHS continuing to be free at the point of use, Streeting said: “Free at the point of use is about fairness and equity and defending a system that means when you fall ill you do not have to worry about the bill. And I think that is an equitable principle that is worth fighting for.”

He added: “However, people are already making the choice, and what we’re seeing is the opening up of a two-tier system, where those who can afford it are paying to go private and those who can’t are being left behind.

“And one of the reasons I was determined in opposition to take on the left on this issue, is this isn’t simply a pragmatic argument that says: ‘Well, we can get waiting lists down faster if we use spare capacity in the private sector.’ Though that’s important.

“It was also a principled argument that said: ‘Why should those without means wait longer while those who have means are seen faster?’ That’s an affront to my left-wing principles. I don’t know why it isn’t an affront to theirs.”


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