FTs and ICBs want me to abolish each other, says Streeting

Speaking at the Royal College of Physicians annual conference yesterday, the Labour health and social care lead repeated his vow not to restructure the NHS, but said: “I also think we need to break down some of the siloed working between primary, and secondary, and community, and build those kinds of multidisciplinary teams”.

Mr Streeting said this would require examination of “how we can make that work operationally, make sure the financial flows work in the right place and in the right way, and to try and, without upending the system architecture, to look really carefully at how we make sure that integrated care boards really do deliver integrated working”.

He added: “How we deal with some of the tension that I can already see between foundation trusts and integrated care boards and systems? The conviction in both places that, ‘it would be working so much better if I just abolished one or the other’.

“I don’t think that is the answer. Actually, what we do need is far more collaborative working and I do think that would make a real difference.”

In answer to a question at the event in London about the need for more hospital beds, Mr Streeting said he wanted to “shift the centre of gravity in the NHS out to primary and community” care; and claimed the NHS spent a relatively large amount internationally on acute care, but less on everything else.

Mr Streeting also sought to reach out to medics, saying he recognised the pressures on their work, and that they would play a big part in developing the 10-year plan Labour would start work on immediately after entering government. 

In doing so he said he was adopting a model from Singapore General Hospital called “Get Rid of Stupid Stuff”, where staff nominated wasteful processes and policies to be axed.

He added: “I am absolutely convinced that the solutions to the NHS crisis will come from frontline staff and it will be my role to take the extraordinary things that are happening in the health service and make them the ordinary, bringing the best of the NHS to the rest of the NHS”.

Mr Streeting admitted he believed the pay dispute between junior doctors and the government would have been resolved by now, and expects industrial action to continue to the general election.

It comes as junior doctors in England voted overwhelmingly to extend their strike mandate for a further six months. The new mandate, confirmed last month, will last until 19 September. Yet-to-be-announced pay proposals for 2024-25 could also lead to further disputes with doctors, nurses, and other Agenda for Change staff.  

The shadow health secretary said: “I am under no illusions that there needs to be movement on pay. We are going to have to negotiate, there is going to have to be some give and take…

“I won’t be waiting years, or months, to resolve the junior doctors dispute. We will have to get them in straight away if we win the next general election and this dispute is still ongoing.

“We can’t afford to lose them. My fear isn’t just that they walk out or more industrial action, which is impacting on health service performance and on patients, I think the real existential risk is that those people walk out of the NHS altogether.”

Mr Streeting also addressed the issue of physician associates – which has become hugely controversial with doctors – saying PAs have a “role to play and a contribution to make”, but should not be substituted for doctors and “patient safety [should be] foremost”.