UK shadow health secretary Wes Streeting: “The NHS is going to have to get used to the fact that money is tight”

In a fluff piece published in the Sunday Times on December 10, Labour Shadow Health Secretary Wes Streeting showed just how little divides the two main capitalist parties in Britain from one another.

Speaking about his recent visit to Singapore—the South-East Asian island-state built on free-market capitalism and political dictatorship—Streeting gushed over the health system there, comparing it favourably to the National Health Service (NHS).

Singapore General Hospital [Photo: Sengkang]

Streeting highlighted Singapore General Hospital’s innovative use of technology, such as robots delivering medicines and patients registering for medical appointments via their mobile phone, noting approvingly that it is “a system that is designed around patients”. Leaving aside the obvious demographic differences between Singapore and the UK (Singapore’s population of 5.4 million is equal roughly to 60 percent of the population of London), the fundamental difference between the two health systems is that while the NHS is free at the point of access, Singaporeans cannot walk into a clinic or hospital and receive treatment for free, as the government imposes user fees for all healthcare services.

Only about 25 percent of Singapore’s public healthcare is funded by taxes. Individuals and their employers pay for the rest through mandatory life insurance schemes. While the insurance covers almost all treatments, individuals still must pay expensive deductibles. Between 8.5 percent and 10 percent of an employee’s monthly salary is deducted to pay for the scheme. While everyone is covered by the insurance, poorer workers are prevented from using it “unnecessarily” by the fact that the deductible must be paid first, before the insurance kicks in. There is a separate fund that fully subsidises the cost of healthcare for those deemed in need of financial assistance, however it only applies to people over 65 and children.

This is not a deal-breaker for Streeting, with the Sunday Times reporting he “believes that replicating the approach of countries such as Singapore… is the key to ensuring that the UK health service has any future at all”. In other words, Labour’s “solution” for the NHS is doing away with a universal health system and replacing it with a privatised or semi-privatised one, a position identical to that of the right-wing Conservative Party.

His comments echo those made by David Cameron and his Health Secretary Andrew Lansley in 2010, before embarking on a devastating campaign of cuts to the NHS. This was part of the government’s “Age of Austerity” that killed more than 330,000 people between 2010 and 2019 (according to the Journal of Epidemiology and Community Health) and which resulted in nearly 500,000 “excess deaths” over the past decade.

Decades of systematic underfunding of the NHS have been exposed during the pandemic, with hospitals at breaking point. In the past two years alone, cuts to the NHS meant 240,000 people died while waiting for hospital treatment.

Unfilled job vacancies extend across the NHS, with waiting lists hitting a record high of 7.8 million this year, and 123,000 seriously ill patients waiting in A&E for over 12 hours. By August, 396,643 people had been waiting over 52 weeks for routine hospital treatment, including 8,998 who had been waiting over 18 months.

Streeting criticises the NHS for not “maximizing” the convenience of patients and being “slow to innovate”, knowing full well that central government cuts have crippled every aspect of patient care. Throughout the Sunday Times piece, he blames “institutional and structural problem[s]” in the NHS for poor results, rather than lack of resources. He condemns “examples of waste and inefficiency” and then shows his contempt to NHS workers by saying, “I don’t think it’s good enough that the NHS uses every winter crisis and every challenge it faces as an excuse to ask for more money”.

Streeting goes on: “The NHS is going to have to get used to the fact that money is tight and it’s going to have to get used to switching spend, and rethinking where and how care is delivered to deliver better outcomes for patients and better value for taxpayers’ money. At the moment, I think we get the worst of all worlds, which is poor outcomes alongside poor value for taxpayers”. Given the catastrophic situation in the NHS outlined above, these comments can only be described as obscene.

However, they serve a definite political purpose: to make clear that a future Labour government will not spend a single penny on the NHS, or any social measure that benefits the working class. At the Labour Party conference in October, Streeting proposed a meagre funding package of £1.1 billion. For comparison, the deficit predicted by NHS England for 2022/23 is £7 billion.

Further deficit reduction would be achieved through “efficiency savings”, such as overworking existing staff, with Streeting condemning the “Monday to Friday culture” in hospitals. He doubled down on these comments this week, telling the Guardian that a Labour government would treat any pay rise for junior doctors as “a journey, not an event” and that it would not match the 35 percent pay rise for junior doctors called for by the British Medical Association.

This is not the first time that Streeting has shown his hostility towards the NHS and its dedicated workforce. Throughout the year, he has ingratiated himself with the pro-Tory Telegraph, repeatedly condemning strikes by junior doctors as “obstacles” to the “unsentimental reform” of the NHS. He has repeatedly shown his support for a policy of running down the NHS with comments such as “We are not going to have a something-for-nothing culture in the NHS with Labour… I’m not prepared to pour money into a black hole” and his recurrent mantra that the health system is “a service, not a shrine”.

In an interview with the pro-Tory Sunday Telegraph, Streeting said, “We are not going to have a something-for-nothing culture in the NHS with Labour… I’m not prepared to pour money into a black hole.” [Photo: screenshot of Sunday Telegraph print edition, December 11, 2022]

This year, NHS workers across all professions took strike action to oppose government cuts and to demand improvements to their appalling working conditions. This included the first ever nationwide strike by Royal College of Nursing members. The junior doctors’ dispute is ongoing, with further strikes set for early January. Throughout, Labour shadow cabinet members, including Streeting and prospective prime minister Sir Keir Starmer, have made clear their hostility to NHS workers, condemning strikes at every opportunity. In March, the right-wing LBC ran an article under the headline, “Wes Streeting: I don’t support the junior doctors’ strike”. More recently, he told BBC Radio 4 that he would be “depressed and furious” if the dispute was not over before the general election.

As the crisis of capitalism worsens, and as NATO powers boost military spending to finance their proxy-war against Russia in Ukraine, and a military and naval build-up against China, Labour and the Conservative Party are united in their plans to cut all social spending. This cannot be achieved without provoking massive social struggles. While Labour would prefer the health union bureaucrats to reach agreement with the government to betray the strikes—repeating a pattern set with the nurses, railway and postal workers—it is not above using the anti-strike laws introduced by the Tories to enforce their agenda of austerity and war.

The defence of the most elementary social rights, including access to healthcare, housing, and education, is bound up with an international offensive of the working class against capitalism. This requires a socialist programme enabling workers to act independently of the trade union bureaucracies which restrain them, and against a hostile pro-corporate and militarist Labour Party.