What next for the new Health Secretary?
Wes Streeting has been given the top job at the Department of Health and Social Care.
With the NHS in crisis, a stretched social care system and staff across both sectors saying they have been pushed to the brink, Wes Streeting has been handed one of the most challenging ministerial roles in Cabinet.
As the new Health and Social Care Secretary, Mr Streeting will start the job with a bulging in-tray.
Commentators have said the new Government needs to “hit the ground running” to address some of the key issues facing the system.
Mr Streeting, who received treatment for kidney cancer in 2021, said: “The NHS saved my life. Now I’m determined to save our NHS. That work starts today.”
Here are some of those issues Mr Streeting will be faced with the moment he steps into his new office.
– Industrial action
Mr Streeting has promised to contact junior doctors in England on July 5, with negotiations expected to resume soon afterwards.
The bitter dispute over pay has lasted for 20 months and seen junior doctors go out on strike 11 times, causing widespread disruption across the NHS.
Meanwhile, Mr Streeting also faces the threat of collective action by GPs across England – with family doctors currently being balloted by the British Medical Association on whether or not they are in favour of staging action amid a row over the new contract for GP services in England.
This collective action could potentially mean GPs limit the number of patients they will see each day to 25, or they may choose to stop performing work they are not formally contracted to do.
Sally Warren, director of policy at the King’s Fund think tank, told the PA news agency that resolving industrial action in the NHS should be the Health Secretary’s “first priority”.
– Staffing issues
This year’s NHS pay award – which was due in April – has still not been announced, which has led to “low morale” among staff, NHS Providers has said.
The representative body for NHS trusts has also highlighted how vacancies across the NHS in England remain “stubbornly high” – at more than 100,000.
Meanwhile, there have been reports of hospitals considering cutting back on posts in a bid to try and balance the books.
– Tackling waiting times
Some 6.33 million patients are stuck on the waiting list for routine hospital care in England, waiting for 7.57 million treatments, operations or procedures.
Labour has pledged to tackle the near-record waiting list with an additional 40,000 appointments each week.
Mr Streeting has also committed to getting the A&E waiting time back on track within Labour’s first term in office.
There will also be pressure for him to get a grip on cancer wait times, with the latest figures showing there has been a rise in the proportion of patients facing longer waits to have cancer ruled out or diagnosed, or start treatment.
– Crumbling hospitals
The maintenance backlog for the NHS stands at £11.6 billion. This is the amount of money that is needed to restore buildings to a certain state of repair.
Health leaders have called the bill “staggering” and said the problems “cannot be allowed to get worse”.
The Royal College of Surgeons and NHS Confederation have called on the new Government to commit to a £6.4 billion annual funding increase to upgrade NHS facilities.
– The smoking legislation
Charities have called on the new Government to revive the smoking ban as a “priority”.
The law would have made it illegal to sell tobacco products to anyone born after January 1 2009, as well as cracking down on youth vaping with stricter regulations on flavours and packaging.
But after the General Election was called at the end of May, the Tobacco and Vapes Bill was not included in the legislation rushed through by MPs when Parliament was prorogued.
– Stopping the 8am rush for GP care
Labour has pledged to end the 8am scramble for GP appointments by training more doctors and updating the NHS app so slots are easy to book and rearrange.
Under the party’s plans, family doctors, physiotherapists, mental health specialists, dentists, district nurses, care workers and health visitors would be brought under one roof as part of a trial of Neighbourhood Health Centres.
– Preparing for winter
It may be July, but NHS leaders will have already started their preparations for winter in earnest. Winter is usually the busiest time of year for the NHS, demand rises sharply as flu and Covid start circulating and the cold weather sets in.
Ms Warren said that winter preparations already needed to be “ramped up quite considerably”, adding: “With the NHS stretched as it is, and social care really stretched, any new government will have to think through what they can do to attempt to shift the dial on social care, on NHS prep for winter generally.”
– Reforming the dental contract
Mr Streeting has promised to contact leading dentists on July 8 to start reforming the NHS’s contract with dentists.
The current contract has been dubbed as “broken” by some, who point out that it does not incentivise staff to stay working in the NHS. This in turn has led to many dentists “going private” – forcing patients to pay for care or leaving some without a nearby NHS dentist, creating so-called “dental deserts”.
– Social care reform
Social care may not have featured heavily in the manifestos or debates but campaigners will be demanding challenges – including low pay, staff shortages and a stretched system overall – are tackled by the new Government.
The Nuffield Trust has said improvements in living standards mean people are living well for longer but there is also a reported rise in complexity of need, with more people living with multiple long-term conditions. The think tank has warned this might see a rise in demand for formal care over unpaid care provided by family or friends, although the need to recognise unpaid carers with more support has also been highlighted.
An adult social care workforce strategy is due to be launched mid-July setting out what the sector needs over the next 15 years on pay, training and career development.
A promise has been made to implement from October 2025 a delayed cap on care costs – limiting the amount anyone in England has to spend on their personal care over their lifetime at £86,000. But the King’s Fund has warned that “given the current state of the public finances, it would take an optimist to believe that will happen”.
The Health Foundation has suggested such a cap could cost an additional £0.5 billion per year in 2026/27, rising to around £3.5 billion by 2035/36 and would likely be the least expensive option in the short-term.
It said introducing free personal care in England, in a similar way to how Scotland operates, could cost around £7 billion annually by 2035/36, whereas an NHS-style model of universal and comprehensive care could cost around £17 billion in additional funding by then.
– Longer-term planning
Ms Warren said that a spending review in the autumn would act as the “starting gun” for financial planning for 2025/26.
Many people in the sector have called for longer-term plans for spending so the NHS can look ahead further than a single year.
