Wes Streeting launches defence of NHS reforms amid wider political turmoil

Wes Streeting has launched a defence of his NHS reforms, amid political turmoil over the fallout from Angela Rayner’s resignation as deputy leader and the Mandelson scandal.

The news may be focused elsewhere, with the deputy leadership nominations set to close today, and the sacking of the US ambassador over his close ties to paedophile financier Jeffrey Epstein, but that did not stop the health secretary from trying to pull the agenda back towards the government’s missions.

In a speech to Nesta, the UK’s independent innovation agency, he emphasised the positive role of both the state and private business in improving people’s lives.

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Speaking from experience, he said when he was growing up in the 80s “the prevailing political philosophy was that government was the problem not the solution”.

“That didn’t really reflect my own experience.

“The state helped my mum to feed me, clothe me, house me; to keep me healthy and to educate me.

“I would say that standing here today, as a Cabinet Minister in a Labour government, that I am here in no small part thanks to the wise investment of the British taxpayer.”

The Andrew Lansley-fication of the British state

He said the Thatcherite/Reaganite approach was a response to the post-war rebuild of Britain, led by “an ever-increasing entourage of nationalised institutions”.

Highlighting the escalating healthcare budget, he said: “If you knew in 2010, that 15 years later spending on health would have increased by around £65 billion and on welfare by about £30 billion, you’d be forgiven for incorrectly predicting which party won the four General Elections in that time.

“You might also have wrongly assumed that NHS waiting times would have remained short, poverty would have continued to fall and that Britain had been transformed into an egalitarian nirvana.”

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The right wing analysis of this failure is that the public sector became bloated, and the solution is a British version of DOGE or Milei’s chainsaw, he said.

However, he laid the blame squarely at the feet of former Conservative health minister Andrew Lansley’s reforms.

“An alternative analysis is that too many powers, resources and responsibilities were taken away from the frontline and put in the hands of QUANGOs and arms-length bodies.

“Call it the Andrew Lansley-fication of the British state.

“These centralised, remote and unaccountable public bodies left the people who work in public services disenfranchised and the people who use them disaffected.”

Instead, he said Keir Starmer’s “mission-driven” government was one that “doesn’t turn a blind eye to the failures and limitations of the state but retains our core belief that government can be an engine of progress”.

The third way

Articulating this New Labour style third-way politics, he said the underlying philosophy was one where government action is necessary, but the state cannot go it alone.

“The range, depth and complexity of the challenges facing us demand a different approach from government.

“Unlike the Right, we believe in the capability of frontline staff to drive change, and that markets can and should be shaped.

“Unlike the old Left, we believe that government cannot go it alone.

“This is the promise of mission-driven government: setting audacious targets then using all the levers available to us to achieve them.”

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