Joe Robertson: Streeting’s NHS plan offers up a dose of déjà vu

Joe Robertson is Conservative MP for Isle of Wight East and a former solicitor

Health Secretary Wes Streeting is calling his Plan for the NHS the “10-year health plan” because that is apparently how long it will take to implement.

It should be called the 25-year health plan because that is how long it has taken to write. It is simply a rip-off of Tony Blair and Alan Milburn’s year 2000 NHS plan, and with nothing new to say.

Fit for the Future is splashed on the front, but in truth it is Streeting’s Back to the Future vision of the NHS already a quarter of a century older. We needed a modern-day Florence Nightingale to sort the post-Covid mess and instead we got Doc Brown and a second-hand DeLorean.

It is hardly surprising that Streeting has dusted off the old Milburn manual and given it a shiny new front cover. He even put the very same Alan Milburn and his old advisor from the time, Paul Corrigan, on the payroll to help him out.

When I challenged Streeting about déjà vu at the Health and Social Care Select Committee earlier this month he said he was “proud” of New Labour reducing waiting times in the 2000s. But that was the decade when Labour increased health spending by an average of 6.8 per cent a year. Not when the Reeves funded overhaul will see a real terms spending cut. Nor was it at a time when resident doctors were planning another mass walkout despite being handed a bumper pay rise just a year before.

To call the Milburn rehash a plan would be generous. It is more like a travel brochure – full of tantalising destinations with absolutely no details about how to get there.

I challenged Streeting on that, too. I asked him to set out how we get to these exciting sounding places. Where could we find “the how” written down so we could be sure it is not all still in his head? It turns out that was optimistic; the delivery plan is not even in his head. He is going to work with stakeholders, he said.

Putting to one side the fact that the so-called plan contains no plan, no new ideas and no funding – is there anything we can pin some hopes to?

The continued emphasis on increased community-based care and getting people out of hospital is obviously welcome. Not new, but entirely the correct objective when around one quarter of hospital beds are occupied by people with no medical reason to be in them and who do not want to be there.

So too is the continuing emphasis on preventative health rather than just treating sick people with illnesses that could have been avoided. Both were the focus of the previous Conservative Government, as well as appearing in the year 2000 plan. Streeting’s ideas include asking shops if they would kindly hide the crisps because they are a bit fatty.

Telling shops to rearrange food displays is actually new but it won’t help the near million people facing dementia that are about to get hit. For them he’s abolished the national dementia diagnosis target and quietly dropped his “national care service”.

The technology shift using AI is actually to do with the future, although one wonders how long it will take to “scale the use of AI” when some NHS Trusts are still using clinical recording systems that predate the computer mouse. Some doctors are even left to overcome GDPR data sharing rules by printing notes on paper and asking the patient to show it to the nurse.

The Health Secretary is keen on his “neighbourhood health centres” delivering care and support “in every community”, but there seems to be little difference between them and multi-disciplinary GP surgeries. Thanks to the last Conservative Government they received additional funding to employ nurses, pharmacists, physiotherapists, mental health practitioners, paramedics and more. They are already well-established places for the delivery of “neighbourhood” care – and more money should be diverted to GP surgeries from hospitals. With the plan silent about funding, we have no idea whether this will happen.

The NHS is bursting with strategies and the 10-year health plan is really just another. No one takes responsibility when things go wrong; too often, underperforming NHS executives are shuffled from one trust to another, failing upwards while services decline. That must stop. Success should be rewarded. Failure should have consequences. We must ensure that the same bloated layer of senior NHS management – those which ran up deficits and oversaw declining performance – are not simply handed the keys to drive any future changes in health care by default.

What health professionals are telling me — including the GP Practice Managers I hosted in Parliament earlier this month – is that the 10-year health plan has lots of nice ideas, but we’ve heard them all before. The back to the future plan is just a summary of good intentions from past governments of various colours which have never been fully realised.

Where Mr Streeting can succeed – and I hope for the good of the country that he does – is on the delivery. I told him as much when I asked if he would tell us about the delivery plan currently in his head, but it turned out to be on a waiting list along with everyone else.