The Labour government has been in office for almost a fortnight, and one message is being emphasised with an efficiency and discipline which would make Lord Mandelson hug himself with joy. It is a simple one: everything’s broken, and the Tories broke it. And it’s all worse than we thought.
Wes Streeting was first out of the starting gates. On 5 July, only hours after his appointment, he told the world that ‘the policy of this department is that the NHS is broken’. Keir Starmer, holding a press conference the following day, repeated Labour’s NHS mantra: ‘It’s broken and our job now is not just to say who broke it – the last government – but to get on with fixing it’.
The Prime Minister’s diagnosis ranges more widely than Streeting’s. Having appointed retail chief James Timpson as prisons minister, he turned his attention to the prison system. His verdict was familiar. ‘We’ve got too many prisoners, not enough prisons. That’s a monumental failure of the last government… prisons is another obvious example of how parts of the system are broken’.
The Justice Secretary, Shabana Mahmood, drilled the message home on Friday at HMP Five Wells in Northamptonshire.
‘Our prisons are on the point of collapse. If we fail to act now, we face the collapse of the criminal justice system. And a total breakdown of law and order’. The guilty men and women were obvious. ‘It was the most disgraceful dereliction of duty I have ever known. The last government left us with a timebomb’.
Even John Healey, the measured, undemonstrative Defence Secretary, added his voice. His department will undertake a strategic defence review (SDR) – new governments always do now – which will take less than a year, but it will not be a bed of (Labour) roses, with ‘difficult decisions that need to be taken’.
We should not clutch our pearls too tightly. There are traces of George Osborne’s relentless narrative on taking office as Chancellor of the Exchequer in 2010: ‘Thirteen years of a disastrous Labour administration… brought our country to the brink of bankruptcy’, he told that year’s Conservative Party conference. ‘They failed to fix the roof when the sun was shining. And left this country defenceless when the storms came’. This is party politics at its rawest, with bloodied knuckles and no holds barred.
The next step is how Labour will deal with the landscape of catastrophe it has depicted.
On defence, Healey has been hinting at a review since 2021 and had made a firm commitment to a new SDR early last year, and he has downplayed expectations as much as he possibly can. The Prime Minister promised breezily that spending on the armed forces will rise to 2.5% of GDP, which the previous government had pledged by 2030, but Starmer refuses to set a timescale. Healey knows the purse strings will not loosen significantly in the next 12 months.
Mahmood announced that some prisoners would be released after serving 40% of their sentences rather than the current requirement of at least half, and will review the situation in 18 months. She has also promised a 10-year strategy on prison supply, reflecting, one assumes, her party’s manifesto commitment to ‘build the prisons so badly needed’ and provide 14,000 additional spaces.
But Streeting’s reaction has perhaps been the most dramatic. He wants a ‘raw and honest assessment’ of the challenges facing the NHS, and warns that ‘hard truths’ will be revealed. To deliver this, he has ordered an independent investigation into the state of healthcare to conclude by September, the findings of which will inform the government’s ’10-year plan to radically reform the nation’s health service’.
To conduct this investigation, Streeting has appointed Professor Lord Darzi, a consultant who currently holds the Paul Hamlyn Chair of Surgery at Imperial College London and is co-director of the Institute of Global Health Innovation. Darzi, a brilliant clinician and charismatic leader, seems ideal: he was a health minister in Gordon Brown’s ‘government of all the talents’, and wrote reviews of healthcare provision for NHS London in 2007 and the NHS as a whole in 2008.
Reviews are a valuable part of the process of governance. But they can present unexpected dangers to the unwary politician. If you outsource responsibility for policy to those beyond government, you place yourself under an implied obligation to accept their conclusions.
The Health Secretary has said he ‘trust[s] Lord Darzi will leave no stone unturned and have told him to speak truth to power’, and has long talked the language of radical reform. But he has self-confessed ‘red lines’, and says he will ‘die in a ditch’ to preserve the principle of healthcare free at the point of use.
He knows his openness to engagement with private health providers and pharmaceutical companies is poison to the Left of the Labour Party. Hackles have already been raised by his close relationship with arch-Blairite Alan Milburn, by some distance the most able health secretary of the past 30 years. In September we will find out just how radical Streeting is willing to be.
The Starmer government was always likely to tell a story of Conservative ruination and painstaking Labour reconstruction. Without tangible change, however, that narrative will age like milk on a hot summer day. Streeting, Mahmood, Healey and other ministers have a limited window in which they must balance tight financial strictures, impatient public expectations and major structural challenges. When their reviews conclude, they will find themselves subject to the old adage: don’t ask a question if you don’t want to hear the answer.
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