Wes Streeting is a political heavyweight – good. Now he needs to enact real reforms
Health Secretary Wes Streeting, February 2026 (PA Images / Alamy)
4 min read
Marking the homework of your successor is the political equivalent of backseat driving. So, with apologies in advance to the Health Secretary, how do I rate his success so far in the role?
Being health secretary was by far the most challenging job I did in government. Instead of the red-carpet treatment laid on for the foreign secretary, or the raw power of a chancellor, you must deal with a constant stream of anger and controversy about things going wrong every day in the NHS. That is made worse by the fact that it is the most centralised healthcare system anywhere. Nye Bevan deliberately built a system which, in his own words, meant that “if a bedpan is dropped in a hospital corridor in Tredegar, the reverberations should echo around Whitehall”.
But that’s not the only challenge. It is also because the issues you deal with are literally a matter of life and death. The emotional punch of the decisions you make stays with you for the rest of your life. Being responsible for 1.5 million people in the world’s largest health system requires a pretty unusual combination of emotional intelligence, policy grasp and leadership ability.
It feels like the only priority is to bring down waiting lists, often mechanically through list-combing
And to his credit, Wes Streeting has much of that. He is one of the best communicators in the government, engages empathetically with staff and patients, and has the intellectual agility to understand the need for reform. In his pay battle with the BMA, he managed to do something I never did: swing the public behind the government’s position in a bitter dispute. Looking at the rest of the Cabinet, it is difficult to see anyone who could do better.
But if I were to be critical, I would like to have seen more far-reaching reforms by this stage. Abolishing NHS England is fair enough – it had become a huge and unwieldy bureaucracy. But where are the reforms to bring back family doctors with their own patient lists, as existed before 2004? We know it would lead to happier patients, more motivated GPs and far fewer people going to hospital. NHS hospitals have 18 separate monthly targets, more than anywhere in the world – where are the reforms that replace top-down micromanagement through national targets?
The system we have turns patients into numbers. It also stifles the decentralised autonomy that has made our state schools some of the best in the world. Despite the NHS’s good electronic health records and its track record in inventions that have transformed health globally, we are not turning heads with innovations in the way care is provided. People are knocking at our door to understand how school reforms have worked, and it could be exactly the same for health if we removed the dead hand of centralisation. Wes Streeting understands this, but we have yet to see any decisive change.
From my own experience of patient safety reforms, I know that big changes need to happen early. You have to win your argument with the system and with the public. You make mistakes that need correcting. But a Labour government with a smart health secretary and a large majority can do just that. Instead, it feels like the only priority is to bring down waiting lists, often mechanically through list-combing rather than through real increases in activity. It feels like a big opportunity is being squandered.
Wes Streeting is one of the few people in the Cabinet with the intellectual and political ability to push major reforms through. Some worry that leadership ambitions could be a distraction, but I believe it is good for our biggest public service to be led by a political heavyweight who could become prime minister. My concern is that time is running out for the real reforms the NHS desperately needs.
Jeremy Hunt is Conservative MP for Godalming and Ash and former health secretary
