Shadow health secretary Wes Streeting has said he wants the NHS to lean on the private health sector in the short term so it can drastically reduce its dependence in the future, as he rejected New Labour’s “ideological conviction” that competition drives up standards.
Defending what he described as his “unfashionably nuanced” perspective, Streeting said in an interview with the Financial Times: “I can simultaneously want to reduce our reliance on the private sector by making sure the NHS has the staff, the equipment, the technology it needs to treat patients on time, at the same time as recognising that there is currently some capacity in the private sector and we should seek to use it.”
The 41-year-old, who is seen by some as a future Labour leader, said he had received guidance from central architects of health policy in Tony Blair’s government, including former health secretary Alan Milburn and ex-Number 10 adviser Paul Corrigan. They had “rolled up their sleeves” to help his team “prepare in a serious way for government”, he said.
But Streeting sought to distinguish his vision for the role of the private sector from the one developed under Blair whose administration established a new cadre of independent sector treatment centres. Many of these were run by private providers, to compete with, and challenge, the NHS.
The Blair administration also increased the use of private finance initiatives (PFIs) to fund infrastructure projects.
“I’m less persuaded by the ideological conviction of New Labour — even though Tony always says he wasn’t ideological — that competition in public services necessarily drives up standards”, he said, noting that the evidence to support that view was “patchy”.
In the long run he would like no one to need to go private, he said, arguing that the “private sector fell off a cliff under the last Labour government because the NHS was so good that people didn’t feel the need to go private”.
He pointed to significant cuts in waiting times for treatment and increased consultants’ pay for priority operations at the time. “And that’s my ambition again: to make the NHS so good that no one feels forced to go private,” he added.
There are other signs that Sir Keir Starmer’s team is seeking to put distance between the New Labour juggernaut that swept to power 27 years ago and the modern-day party that polls suggest is likely to return to power later this year. On Tuesday, shadow chancellor Rachel Reeves criticised Blair’s administration for presiding over key economic weaknesses that led to the financial crisis.
Hemmed in by tight fiscal rules set by Reeves, Streeting is championing a “ruthlessly pragmatic” agenda for the NHS in which the precondition for additional funding would be reform, including through the rollout of new technologies and partnerships with cutting-edge private companies.
He has committed to using spare capacity in the private sector to offer tens of thousands of patients treatments for procedures such as hip, knee and eye surgeries if Labour comes to power, funded by the NHS.
Asked if he understood why there was resistance from some grassroots Labour members to the idea of handing profits to private providers, Streeting insisted he had won the argument both within the party and the country.
However, he touched on concerns that using the private sector might take staff away from the NHS because they draw from the same pool. He said: “I say to some of those online campaign groups . . . instead of campaigning at politicians saying ‘don’t use the private sector’, why don’t you campaign at your professional colleagues who spend so much time in private practice?”
The FT joined him on a tour of Moorfields Eye Hospital as he learned how technological advances were being used to reduce pressure on the emergency department, improve patient choice and streamline diagnoses. He watched a demonstration of an AI partnership Moorfields had set up with Google’s DeepMind to use millions of retinal images to understand patterns in sight loss.
While its developer, consultant Pearse Keane, made clear that Moorfields’ senior leadership had enthusiastically backed his project from the start, Streeting indicated his concern that not all health bosses were similarly ready to embrace innovation.
He said it was “actually appalling” how slowly NHS trusts were using patient data to improve care, arguing that there needed to be a top-down mandate forcing services to share information to benefit the wider public. “This data doesn’t belong to GPs, it doesn’t belong to the NHS, it’s our patient data,” he said.
Just three years ago, Streeting’s life was in the hands of the NHS. He received a diagnosis of early-stage kidney cancer at the age of 38, while campaigning in a car park in Bury.
Although his pathway was quite straightforward — the affected kidney was removed within six months — he said he endured some “pretty basic diagnostic failures”, including being sent for the wrong type of scan and getting “mucked around” waiting months for test results. “If it had been a bit more advanced, if the tumour was metastasising . . . ” he said, trailing off. “Time matters.”
Streeting and Reeves have committed to spending £1.6bn in their first parliament to pay for 2mn more appointments and surgeries to slash waiting lists. Labour has also pledged to double the number of modern scanners such as CT and MRI machines where the UK lags far behind many other OECD nations.
Streeting would not be drawn on how Labour would pay for these interventions after the Tories nabbed his party’s flagship policy of closing a tax loophole for non-domiciled workers in the UK for use in its own Spring Budget. The party now has a black hole of about £2.6bn to fill to meet its spending commitments.
He said Reeves had “some options available” but could be “forgiven for not rushing to provide the magpies in the Conservative party with some more Labour fruit to swoop down and steal”.
The NHS needed to “put the foot down on the accelerator . . . when it comes to innovation”, Streeting said, suggesting it was often too slow to disseminate initiatives that had proved effective.
“The real innovation and the drive” would come, not from politicians or NHS England but “people on the frontline. And we’ve got to give them that freedom to innovate,” he said.
Despite its purchasing clout as a centralised system covering all Britons, companies are often frustrated by having to deal with multiple NHS entities to get their products or solutions into England’s health service. “It should not be the case that people have to tout their wares from trust to trust, from system to system,” Streeting said.
Instead pioneers and entrepreneurs should have “a single front door” into the NHS, he said. They should be offered “a great proposition which is help with research, help proving the concept, help with regulatory approvals . . . And then in return, we would expect a good deal on price and speed of access for British patients as well as helping you export around the world,” he added.