A sharp surge in flu cases, ongoing COVID pressures and the long-running industrial dispute with the BMA have combined to hand Wes Streeting a perfect winter storm for the NHS. With confirmation that the Health Secretary has failed to prevent the strikes from going ahead, the NHS crisis has heightened. Streeting has never shied away from saying the health service needs serious change, but the past few months have shown just how steep the climb will be. It is worth acknowledging where he has made progress and where he has stumbled. Delivering improvements in the NHS will be essential to ensuring a Labour victory in in 2029 and so it is crucial that Labour gets it right.
Honesty Without a Coherent Winter Plan
Streeting’s most striking quality is his willingness to level with people. For years, ministers insisted that a little extra short-term funding would keep the NHS afloat. Streeting has broken from that. He has been open about the scale of the problems the country is dealing with: chronic workforce shortages, weak social care capacity, overloaded emergency departments, and hospitals unable to cope with seasonal surges. During this flu wave, his tone is steady and realistic. He doesn’t sugarcoat the pressures, nor does he resort to panic. Instead, he is focused on practical steps such as more virtual wards, better discharge arrangements, and closer coordination across local systems.
But honesty and realism only carry a minister so far. There are plenty of interviews, but no structured plan setting out how the government intended to get through the winter. In a period of intense public anxiety, people look for reassurance that someone is gripping the problem. Streeting understands the issues, but at a time when the Labour government is struggling in the polls against the forces of populism, Ministers projecting control is key.
The BMA Dispute and a Failure to Break the Deadlock
That’s been just as evident in the handling of the industrial dispute. Relations between the BMA and ministers had become bitter and confrontational under previous administrations. To his credit, Streeting’s decision to approach negotiations with a more respectful, less combative attitude was not only welcome but long overdue. Unfortunately, that has not lasted and there will be industrial action over Christmas. The BMA will blame the Health Secretary, and the Health Secretary will blame the BMA. But if there is major disruption to the NHS over Christmas and patients suffer, the electorate will ultimately blame the government and the man at the top, Wes Streeting.
The Health Secretary allowed negotiations to drag on too long without a firm direction or clear parameters and as agreement has slipped from his grasp, Streeting’s tone has taken on the combative nature of his predecessors. The result was predictable: frustration among doctors, scepticism from the public and a sense that ministers were waiting for someone else to blink. His communication with the public is measured, clear and sincere. However, communication with NHS staff has been far less consistent. Many frontline workers say they’ve heard more from the media than from the Department of Health itself. In a crisis, silence breeds cynicism. A stronger, more direct channel of communication with clinicians could have helped build trust at a critical moment. Streeting has been boxed in by the Treasury’s reluctance to further loosen the purse strings for health. But multi-year pay paths, improved career progression, or linking settlements to wider workforce reform could have been put on the table sooner. Instead, the dispute settled into a pattern that suited no one and looks set to rumble on.
From Diagnosis to Delivery: Leadership Under Pressure
Operationally, Streeting is still finding his feet. He has improved oversight inside the Department of Health, pushing for better real-time data and closer monitoring of local pressures. That’s a sensible step forward. But the truth is that ambulance delays, overcrowded A&Es and bed shortages are symptoms of long-term structural failings. Even so, there were moments when a more hands-on, visible approach might have helped. Faster escalation with local systems, tougher expectations on clearing discharge backlogs, and clearer intervention triggers would have given the impression of firmer grip.
To be fair, no health secretary could have solved these problems overnight. Streeting inherited an NHS weakened by years of underinvestment and political churn. His instinct to be honest about the challenges and open to reform is exactly what the system needs. But winter crises are unforgiving. They demand leadership in the most pressured circumstances.
The Health Secretary understands the value of long-term change and isn’t afraid to challenge sacred cows. But this winter has revealed the gap between diagnosis and delivery. If he wants to carry the confidence of the public and the NHS workforce, he will need to sharpen his strategic messaging, quicken his operational decision-making and bring more imagination to the negotiating table and plan earlier. This must be the last winter where the public face disruption through industrial action in their NHS.
There is still time for him to show that he can convert intent into tangible progress. His reform agenda remains credible and necessary. But the immediate test, namely managing a flu surge and ending damaging strikes, has highlighted the difference between calling for change and being able to deliver it in the heat of a crisis.
Labour Future’s message is simple: the direction is right, but the execution needs to be much stronger and more strategic, much faster and far clearer if the NHS is to emerge from these winter pressures with renewed momentum rather than deeper exhaustion.
