To govern is to choose, so Keir Starmer must choose the NHS first

Editorial: Until people have the fear of ill health lifted from their lives, it is impossible for the nation to progress

The prime minister mentioned the NHS in his speech in Downing Street: ‘We will rebuild Britain, with wealth created in every community, our NHS back on its feet, facing the future...’ (PA)

The prime minister was suitably serious when he addressed the first meeting of his cabinet. “We will be judged on actions and not words,” he said. He knows that one of the causes of his predecessor’s downfall was a feeling that the Conservative government’s words failed to match its actions.

It will be hard to put that right, especially as the Labour government takes over at a time when, as is traditional in the British system, “there is no money”. The most important early decision for the new prime minister and the new government, therefore, is what its priorities are.

Unfortunately, there was little sense of this from Sir Keir Starmer’s words in Downing Street on Friday or after his first cabinet meeting on Saturday. We heard plenty of words, and many of them were the right ones – but words are the easy part, as Sir Keir himself implied. It is the actions that matter, and to deliver effective action a government must know what it will do first.

Sir Keir is trying to organise his government around five “missions”, and on Saturday he announced the creation of five “mission delivery boards”, all of which he will chair. This is a sensible way of structuring decision-making, but five priorities is too many. Unless the new government decides that it will deliver one or at most two things, it will end up failing to decide.

In our view, the top priority has to be to fix the National Health Service. Until people have the fear of ill health lifted from their lives it is impossible for the nation to progress. As a secondary priority, something needs to be done about the prison overcrowding crisis, but that is more like firefighting the recurrent crises that beset all governments most of the time.

Sir Keir has made a good start on prisons, appointing James Timpson, the chief executive of a company with a proud record of employing ex-offenders and a leading prisons reformer, as a minister in the House of Lords. That sends the right signal that the new government is prepared to tackle the underlying causes of the prison crisis – that we lock up too many people compared with similar countries.

But the NHS should come first. The prime minister mentioned the NHS in his speech in Downing Street: “We will rebuild Britain, with wealth created in every community, our NHS back on its feet, facing the future...” But it was but one item in a list. Wes Streeting, the new health and social care secretary, got it right on Friday with a rather unusual statement, declaring: “The policy of this department is that the NHS is broken.”

The Independent welcomes this blunt admission that there are too many patients who are “not receiving the care they deserve”. The word “broken” to describe institutions that are not working as well as they should is usually unhelpful, and there are many parts of the NHS that are in fact working extremely well, but it is essential to be honest about the failings of those parts that are working badly if they are to be repaired. When one in nine of the population is on a waiting list, something is very wrong.

So Mr Streeting was right, as was one of his first actions in the job, to phone the junior doctors’ representatives and to restart negotiations in the next few days to end their strike. He and Rachel Reeves, the chancellor, have a difficult balancing act, in that it is in the national interest both to settle this dispute but not to do so too expensively. But settle it they must. Then we will see if Mr Streeting’s brave talk about using the private sector creatively to deliver free NHS services can be turned into backlog-clearing action.

This will require a significant amount of Sir Keir’s time. But unless the drive to fix the NHS comes from the prime minister himself, there is a danger that it will drift into the muddle of problems that the government is simply trying to manage rather than solve.

To govern is to choose, and Sir Keir should choose the NHS first.