Health and social care secretary Wes Streeting has spoken of his shock at the lack of joined-up working between his department and the NHS.
Upon entering government, Streeting was struck by “a real silo mentality” separating Department of Health and Social Care officials on the one hand and the health service on the other, he told an Institute for Government fringe event at Labour conference on Monday.
Responding to a question from IfG director Hannah White about whether his department was fit for purpose, Streeting was first at pains to contrast the new Labour government’s approach to the civil service with the official-bashing rhetoric that has characterised Conservative governments over the last few years.
“Contrary to some of the narrative, Whitehall is full of dedicated public servants who want to make a difference to our country,” he said.
However, he went on to say that he had also observed a real separation between DHSC and NHS England.
“I hadn’t realised that when I addressed officials from the department and NHS England at the same time on the Monday after the general election – alongside the chief executive of NHS England who was speaking next to me – that this was seen as a revolutionary act,” he said.
He went on to describe how he and NHS England chief executive Amanda Pritchard were sharing a platform in order to make their pitch as a leadership team for the coming parliament, which included “trying to drive far more joint-working to reduce duplication of effort” between their two organisations.
Continuing with the theme of his first impressions of the department, Streeting lamented how old-fashioned some of DHSC’s processes still were, likening them to those that existed when the NHS was founded in 1948.
“If [former prime minister Clement] Attlee were alive today and wandering through the corridors of Whitehall, he would probably find it familiar. Too familiar. The world is changing around us, it’s changing fast, and government and the way we govern and the way we do public service reform isn’t changing with the times,” he said.
“And I’ll just gently say if Ara Darzi can do such a comprehensive report in eight weeks, we should ask why sometimes the system takes such a long time to move.”
After a few days in the job, the health secretary commissioned eminent surgeon Lord Darzi to produce a "warts and all" report on the NHS ahead of the government's 10-year plan to bolster the health service.
Among its conclusions, the rapid investigation said that waiting times for hospital procedures had ballooned, A&E was “in an awful state” and cancer care still lagged behind other countries.
The report also identified management structures and systems as one of four “heavily inter-related” factors that the review says have contributed to the “dire state of the NHS”, along with the Covid pandemic; lack of patient voice and staff engagement; and austerity in funding and capital starvation.