Wes Streeting is right – if Labour delivers on NHS reform, that’ll be its legacy

Editorial: There’s no denying that the past six months have been rocky for the new government – but if it pulls off NHS reform, the pain will be worth it

Challenged by Laura Kuenssberg on breakfast television about why the government had failed to explain itself very well, health secretary Wes Streeting gave the only response a politician of his stature could: he dodged the question.

He was, in fact, right to do so. The government’s “presentational” shortcomings have been so crashingly obvious it wasn’t worth Mr Streeting trying to prove the opposite. Choices have been made but not justified; and the broad narrative about why the sacrifices now being asked of the public will yield better outcomes has scarcely been developed.

Mr Streeting wasn’t going to try and remedy six months of failing communications in one 20-minute segment on TV. He’s far too clever for that.

Instead, at least so far as his brief, the NHS and social care, is concerned, Mr Streeting offered a more candid and useful message: “The only thing that really matters in the end is delivery.”

Useful, that is, because, in his case, getting waiting lists down, as promised, gives the voter at the next election cause and evidence to conclude that, yes, indeed, things did get better under Labour; patients are in a better place, and the extra taxes were justified.

Real-life experiences are normally more persuasive than three-word slogans (as Boris Johnson eventually discovered). As in the operating theatre, so in the cockpit of politics – results matter. As Mr Streeting stresses, it takes time to change things in health and social care, but his linking of funding and reform is an excellent place to start.

The prime minister, Sir Keir Starmer – a less natural communicator than his health secretary – is at least giving Mr Streeting the high-level backing he needs in his drive to fulfil the manifesto commitment. Which, if you need reminding, was that “patients should expect to wait no longer than 18 weeks from referral for consultant-led treatment of non-urgent health conditions”.

Sir Keir has now interposed a new interim target: “Sixty-five per cent of patients will be treated within 18 weeks by the end of next year. Based on the size of the current waiting list, that would mean a fall of more than 450,000 people waiting more than 18 weeks for treatment.”

The way to do that is to link staffing and working practices with new technology, and already some long-overdue modernisation and new thinking is being applied.

Presented with a patient who is plainly seriously ill with a potential cancer, and in need of urgent further investigation, a general practitioner should have the freedom to refer them immediately for an X-ray or a scan. The patient would then not have to wait to see a consultant for an initial assessment, and then that further wait for diagnostics.

Mr Streeting is also right to want to see more minor complaints treated outside the large hospitals – in GP surgeries or medium-sized community clinics or diagnostic hubs – with qualified nurses and the expertise and equipment to deal with, for example, ear, nose and throat conditions.

Though they should be deployed with more care than is sometimes said to be the case, physician associates and senior nurses can also play a role in giving the public faster attention to their needs. The earlier people are able to see any kind of health professional when they are in pain or anxious, the better their outcomes will be, the sooner they can return to work, and the less likely they will feel forced to burn through their savings to go private.

Where more serious intervention is required, encouraging hospitals to share waiting lists is another reform that can speed up the system. Taking blood pressure readings in the age of smartwatches and relatively inexpensive home monitors shouldn’t ordinarily take up time in surgeries.

Reminding people by text message about appointments should reduce waste. Digitising records will help emergency teams and aid medical research. The research and diagnostic teams have already shown how artificial intelligence can more rapidly and accurately detect tumours than the human eye.

Breakthroughs in drugs to treat Alzheimer’s and Parkinson’s promise revolutionary reductions in the demands made on the NHS and on families, as with HIV; and safe and effective vaccines do reduce the incidence and severity of disease. One of the more worrying alerts of the present flu crisis on the wards is that it may be because of anti-vax propaganda reducing take-up of the flu jab.

There are, in other words, many relatively inexpensive reforms that can be carried out which, taken together, will make people feel that the service they get from the NHS is comparable (in a good way) to that received from their bank or supermarket.

That said, Mr Streeting will need to find more funding for social care – the lack of which is still keeping too many patients in hospital beds who have no wish nor need to be there, but who cannot be discharged because they need extra support, at home or in a care setting, and no support is available. The first report of the Casey review is due mid-next year, and it cannot come soon enough as a basis for a necessary political consensus to be formed about future funding.

Given that some NHS trusts are declaring critical incidents – that the service has been under strain for many years, and the obvious challenges of an ageing population – it is easy to be pessimistic about its future and idly conclude it is incapable of improvement. That is to give too little credit to the “patient” – even if it is 76 this year.

As recently as 2010, it was enjoying excellent ratings and outcomes. To borrow a phrase, the NHS has the right principles, the dedicated staff, and spirit to be great again.