Keir Starmer and Shadow Health secretary Wes Streeting want to play it both ways. On the one hand Labour has been posting on social media claiming: “The longer the Tories are in power, the longer patients will wait. Only Labour has a plan to cut NHS waiting lists and get patients treated on time again.”

Of course no serious plan exists: the promise to cut waiting lists hangs on a wing and a prayer, with a a large side order of wishful thinking and lashings of down-right delusion.

That’s because at the same time as this empty promise is made, a totally contrary message is being conveyed by Starmer and by Streeting in news studios, articles and interviews in the right wing press, insisting that – if elected – a Labour government will certainly “not turn on the spending taps.”

This even implies, as the Financial Times concludes, that Labour might feel obliged to contemplate further cuts in public services – while of course blaming the situation on the economic mess that will left behind when the Tories eventually lose office.

Starmer and Streeting seem keen to keep promising the right wing of the Tory electorate that there will be no increases in taxes (even on the super-rich and windfall profits in the energy companies) and no increases in spending.

If they stick to that promise, Labour can’t offer even a glimmer of light at the end of the tunnel for 1.4 million hard-pressed NHS staff.

The NHS workforce have to cope as best they can with crumbling hospitals (backlog maintenance bill now £11.6 billion), clapped out equipment, 120,000 vacant posts, too few beds, and gaps in social care, community health services and overstretched GP services.  This winter, deficit-laden hospital trusts are also facing impossible demands for yet more “efficiency savings,” with some managers warning “nuclear service cuts” are needed to balance the books.

To make matters worse Streeting, with his private sector donors to keep happy, and effectively echoing Rishi Sunak, also keeps calling for the NHS to make more use of private providers, while giving no evidence to show how this would improve matters.

He has also been taunting NHS leaders, arguing they should “learn lessons” he has drawn from the superficial impressions he has gained from his recent tour of Australia, accompanied by the paywalled hard right Telegraph’s health editor Laura Donnelly.

She duly served up adoring articles trumpeting Streeting’s nonsense, not least the ridiculous claim that “Australia has the answer to fixing the NHS … spending less but achieving more.”

Anyone who bothers to check OECD spending figures knows Australia doesn’t spend less: it spent 17% more per capita than UK in 2022 (equivalent to an extra £27 billion this year for the NHS).

Nor is there any direct comparison between the two populations: the UK has a much higher proportion of older people (21% more aged 65+ per 1,000 people, 23% more 80+).

And Australia’s health system is notoriously complex and wasteful, with hefty government subsidies for private health insurance, money which experts argue could be “more cost‐effectively invested in other programs, such as public hospitals and chronic disease prevention in primary care.”

Streeting clearly doesn’t understand the NHS, or the systems he is visiting: and even where he has seen some potentially relevant ideas, not one of the ‘innovations’ he is now touting from Australia or Singapore could be implemented in England’s NHS without more spending.

Starmer and his shadow cabinet already seem to be showing the same fundamentalist zeal to boost private provision as Tony Blair’s government displayed in the mid 2000s.

But team Starmer are much more conservative on public spending than New Labour were in 1997, when they insisted on sticking within Tory spending limits for three miserable years. Only in 2000 did Blair announce the historic decision that the UK’s health spending would be increased over a decade, to raise it closer to the average of comparable European countries.

Had that funding not been invested the NHS would almost certainly have virtually collapsed on a number of fronts.

Now, after 13 years of austerity and real terms cuts in funding since New Labour lost office in 2010, the NHS is already in a much worse state than it was in 1997. A Starmer government won’t have three years to tread water and postpone the necessary investment.

Every additional contract for private providers will only worsen the plight of NHS providers … while lining private sector pockets. Nor will Streeting be able to deliver any of his fancy ideas for primary care without spending more: instead the shortages of GPs and gaps and delays in services will only get worse.

NHS staff, battered and bruised by successive Tory governments, are desperate to see Labour’s leaders commit to positive changes and investment to enable them once again to deliver speedy, safe, high quality services as they did back in 2010, rather than face a continual decline.

Patients too and the wider public need some hope that things might change for the better in our most popular public service. Many of them need persuading that Labour does offer a genuine alternative rather than the same old arguments we hear each day from Rishi Sunak’s ministers. Promising none of the resources needed for change may please the Tory right, but it will dismay all of Labour’s natural supporters.

Once again the real danger is that even if they do get elected – if there is no change of line – a Starmer government could preside over a real collapse of the NHS that was established by Clement Attlee’s far from leftist government 75 years ago.

And nobody will forgive them for that.





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