NHS restructure is greatest danger to Streeting’s effort to revive service
In the Great Hall at the University of East London last Wednesday, the perennially upbeat Wes Streeting was exuding even greater positivity than usual.After years of neglect under the Conservatives, he said, the NHS was starting to revive thanks to Labour’s medicine.In a bravura performance in front of an audience of health service bosses, policy experts and student nurses in their blue and green uniforms, Streeting reeled off a long list of improvements in his 20-month tenure as health secretary.The NHS backlog: down by 374,000 since Labour took over in July 2024.A&E waiting times: the best last winter for four years.
Ambulance response times for heart attack and stroke victims: the best for five years.There had been 1,000 extra GPs promised but 2,000 actually delivered.Extra mental health staff, NHS dentistry appointments and funding for the NHS in England – £26bn, no less.But he was also buoyed because of the latest statistics on public satisfaction with the NHS, published that morning.Satisfaction across England, Scotland and Wales rose last year from 2024’s all-time low of 21% to 26% – the first rise in seven years.
And dissatisfaction fell from 59% to 51% – the biggest drop since 1998,That was further proof, he added, that “the NHS is on the road to recovery” and “people are beginning to feel that change”,As he spoke, 150 miles away in Cheshire that recovery seemed elusive at Leighton hospital in Crewe,Last Wednesday, and indeed all last week, it was under some of the most intense pressure it has ever faced,Despite winter being over, its emergency department was at one point full to bursting.
At one point it was looking after a near-record 170 patients, while across its wards 110 others were medically fit to leave but still occupying a bed, thus compounding the intense pressures on the A&E.One member of staff said: “It’s been the worst few weeks of my career.I’ve been ashamed to work for the NHS.You could see the despair on everyone’s faces.There were just no answers as there was no space anywhere for patients.
Everyone was really trying their best,People were staying late and missing breaks,”Leighton’s struggles were an example of another thing Streeting said: that while he was “proud of our progress” he was also “often ashamed when confronted with the reality of an NHS that still isn’t there for people when they need it”,But, he added, “the NHS today is better than it was when we came to power – and it will be better in the coming years”,Research published last week by University College London’s Global Business School for Health, based on the views of 850 NHS leaders and senior managers, illustrated why the NHS has a long way to go before it is back to the generally well-performing service it was until 2010.
While staff goodwill remains strong, “people are exhausted”.Relentless demand for care and constrained resources mean “the system is running so close to the line operationally”.And high vacancy rates mean NHS bosses spend a lot of time trying to ensure safe staffing of services.Streeting’s tenure so far has involved three priorities.First, action to deliver on his repeated promises to restore NHS waiting times standards for key areas of care – on A&E, access to GPs, cancer care and planned hospital treatment.
Second, a 10-year health plan that aims to modernise how the service works through “three big shifts”: from analogue to digital, from treatment to prevention and from hospital-based to community-based care.And third, a radical restructuring of the NHS – which he had previously ruled out – including the abolition of NHS England, which he insists will ultimately save money and ensure the service revives faster.Streeting knows that the public cares most about waiting times.At UEL he said that while waits for hospital treatment would definitely be back to 18 weeks by 2029, he could not guarantee the same for the others, such as four-hour A&E care, timely cancer treatment and prompt ambulance callouts after a 999 call.But when he spoke to the Guardian’s Politics Weekly podcast hours later he was more positive, and apparently now confident of success on all the key metrics.
The Guardian sought the views of trust leaders, thinktank experts, senior NHS figures, current and ex-government health advisers, and a former Labour health minister about Streeting’s progress so far.They were also asked about the obstacles Streeting will have to overcome in order to rescue the NHS from the mess he inherited in 2024 and make it once again a service that gives people fast, high-quality care when they need it.On the “three big shifts”, NHS insiders agree that progress is slow.Plans announced far outstrip delivery on the ground.“I can’t yet hear the sound of the machinery of the ‘three big shifts’ clanking into gear,” one senior figure in the service said.
Fulfilling plans for the promised creation of dozens of “neighbourhood health centres” – offering different types of physical and mental health care under one roof – is also important politically.But the greatest danger to Streeting may yet come from an issue that is not much on the public’s radar: the restructuring of the NHS and legislation – still unpublished – needed to formalise NHS England being merged with the Department of Health and Social Care.The last government to reorganise the NHS – the Tory/Lib Dem coalition in 2010 – expended a lot of energy dealing with the endless complications of doing so.“The reorganisation of the NHS has been a total car crash,” said Bill Morgan, who advised Rishi Sunak on health until the 2024 general election and is otherwise impressed by Streeting.“They haven’t introduced the legislation, which shows how little thought was given to it.
”Stuart Hoddinott, an NHS expert at the Institute for Government thinktank, said he could see why the health secretary became so frustrated with a body that often duplicated the functions of his own Department of Health and Social Care (DHSC) and limited his power to order changes,But he said the abolition of NHS England “was an incredibly hasty decision that seems to have been made with little consideration of the wide-ranging impacts,It is creating a lot of turmoil”,There is the human, and financial cost through redundancies, of halving the staff who work for the DHSC, NHS England and its 42 regional integrated care boards,But, Hoddinott added, there was also a risk for Streeting that staff and organisations left dispirited, disengaged and possibly jobless by the “chaotic” restructuring would be too distracted by all that to help deliver his priorities.
Brent crude hits $116 a barrel as Trump threatens to ‘blow up’ Iran’s oil wells and export hub
The price of oil rose sharply to $116 a barrel on Monday as Donald Trump threatened to “blow up” and “completely obliterate” Iranian electricity plants, oil wells and its export hub Kharg Island if it did not agree to a deal.Brent crude, the international benchmark for oil, rose by 1.6% on Monday after Trump wrote on his social media platform Truth Social that if a deal was not agreed and the strait of Hormuz was not reopened, the US would take further action.He wrote: “We will conclude our lovely ‘stay’ in Iran by blowing up and completely obliterating all of their Electric Generating Plants, Oil Wells and Kharg Island (and possibly all desalinization plants!), which we have purposefully not yet ‘touched’ …“This will be in retribution for our many soldiers, and others, that Iran has butchered and killed over the old Regime’s 47 year ‘Reign of Terror’.”The US president threatened to seize the Iranian export hub of Kharg Island in an interview with the Financial Times on Sunday
FCA to release details of UK car finance scandal compensation scheme
Millions of drivers will discover how much can they claim over the car finance scandal on Monday, as the City regulator sets out the final terms of its compensation scheme.The Financial Conduct Authority (FCA) will release the details of its redress programme for 14m motor finance agreements after 4.30pm, ensuring that the information comes out after stock markets close for trading.Regulators want to avoid large price fluctuations in the share prices of the biggest stock market-listed car loan providers, including Lloyds Banking Group, Santander, Barclays, and the specialist lender Close Brothers.The companies have been lobbying against the FCA’s proposals, which were put out for consultation in the final months of 2025, arguing that they amounted to a too-generous compensation bill for drivers
‘Soon publishers won’t stand a chance’: literary world in struggle to detect AI-written books
Recently, the literary agent Kate Nash started noticing that the submission letters she was receiving from authors were becoming more thorough – albeit also more formulaic.“I took it as a rise in diligence,” she said. “I thought it was a good thing.”But then she had what she described as her eureka moment: the letter with the AI prompt right at the top. “It read: ‘Rewrite my query letter for Kate Nash including a comp to a writer she represents,’” she said
‘Our assumptions are broken’: how fraudulent church data revealed AI’s threat to polling
If you had been keeping tabs on the news about church attendance in Britain lately, you would be forgiven for thinking the country was in the midst of a Christian revival.Stories of swelling congregations, filled with young people returning to the flock, spurred on by everything from social media to a rise in bible sales appeared to be confirmed by a 2024 report from the Bible Society.Based on data collected by a YouGov survey, it claimed church attendance was increasing in England and Wales. The findings drove headlines, and the narrative was established.There was just one problem – the survey turned out to be based on “fraudulent” data and has been withdrawn
F1 must find answers to safety crisis after Bearman’s escape but there are no easy fixes | Giles Richards
Oliver Bearman emerging unhurt from a huge accident at the Japanese Grand Prix was considered a lucky escape. Formula One must think it is catching a break given there is a full month to work out how best to mitigate against it happening again. It is going to need every minute of that time given the complexity of the problem.Bearman’s Haas car was travelling at 307kmh (191mph) when he was forced to veer off track as he came up behind the relatively slow-moving Alpine of Franco Colapinto. The closing speed between the two cars was 50kmh, a frightening pace
Worcestershire overseas signing leaves one-day final early to catch flight to England
Worcestershire’s new overseas signing has arrived under a cloud after leaving a one-day final in South Africa in order to catch his flight to England. Beyers Swanepoel was playing for Lions against Titans on Sunday when, according to a report by Times Live, he set off for the airport “around the 43rd over” of the second innings without informing his teammates as to why. It was widely assumed he had picked up an injury.The all-rounder had bowled his full allocation of 10 overs, but because there was no injury, Lions were denied a substitute fielder for the final stages of the match. Titans went on to chase down the target with a ball to spare
‘They feel true’: political deepfakes are growing in influence – even if people know they aren’t real
Sony to hike PS5 prices by $100 as AI and Iran war push up memory chip costs
Wikipedia bans AI-generated content in its online encyclopedia
Number of AI chatbots ignoring human instructions increasing, study says
‘Accountability has arrived’: dual US court losses show shifting tide against Meta and co
New York City hospitals drop Palantir as controversial AI firm expands in UK