There are many better things Wes Streeting could focus on than picking rows with NHS managers, writes HSJ editor Alastair McLellan.

Much has already been said about the influence of former health secretary Alan Milburn on current incumbent Wes Streeting.

And there has been plenty of speculation that today’s “failing managers” speech by Mr Streeting was inspired by his predecessor… and maybe it was.

However, HSJ thinks Mr Milburn’s influence is more relevant in another way.

When the New Labour bruiser found himself in a tight spot, his instinct was to attack. Having a row is sometimes very useful for a politician. It consumes attention and dominates media coverage – because we journalists love conflict.

Mr Streeting took this route many times in opposition, usually to avoid conversations about funding. In government he has found achieving things harder than he expected – as all parties who have been in opposition for a long time inevitably do. So he needs to buy time, while maintaining his reputation as a reformer.

It is also the case that little of what Mr Streeting announced in relation to “failing” managers is new – public “league tables” already exist in the form of the strategic oversight framework, and as for senior leaders being held to account for perceived failure, the high turnover at the most struggling providers speaks for itself. 

Given all this, HSJ will not join the row. Rather we shall simply list the things that we think the health secretary could better spend his time focusing on delivering as soon as possible. A non-exhaustive list includes:

  • A refreshed elective recovery plan, including the mechanism for delivering the promised 40,000 more elective appointments (now not due to be delivered until July);
  • An outpatient transformation plan;
  • Funding allocations for 2025-26;
  • Funding for promised mental health school teams;
  • Deciding the future of the mental health investment standard (Mr Steeting said today he “wanted” to keep it);
  • Speeding up the review of the New Hospital Programme;
  • Mitigating the impact of the national insurance rise, especially on GPs, social enterprises and hospices;
  • Contract reform for GPs; dentists and community pharmacy;
  • Deciding whether to hold a royal commission on adult social care (having heavily briefed it over the summer then gone quiet);
  • Choosing the new chairs of NHS England and the Care Quality Commission;
  • Ruling on the role of physician associates;
  • Deciding on major service reconfigurations, including south London children’s cancer services.

There are many more.

Mr Streeting gave the impression of a man in a hurry during his NHS Providers speech. Good, there is much important work for him to do.

Topics