May 17, 2026 11 min read

Cowper’s Cut 428: The misfiring timing and inevitable exit of Young Master Wesley Streeting

‘Oh the Grand Old Duke of Ilford North,

He had eighty-one men:

He marched them up to the top of the hill …’

“We arrived in government underprepared in too many areas and lacking clarity of vision and direction.”
Ex-Health Secretary Wes Streeting MP, speech to Progress event, 16 May 2026

“We know very little (other than headlines and vibes) about Labour’s detailed plans for NHS reform. This is probably because they don’t have any, but if they do, they have been subjected to zero public scrutiny or consideration. That omission is probably going to be important.”

Andy Cowper, ‘Cowper’s Cut’, June 30 2024

pic.twitter.com/9qI2Bj35ZK
— Wes Streeting (@wesstreeting) May 14, 2026

In politics (as in comedy), timing is almost everything. Your basic material matters significantly in both games, but the art of timing is crucial.

And in politics, former US President Lyndon B Johnson famously proposed that the iron law for its practitioners is the ability to count.

You wouldn’t know Wes Streeting’s 81 nominators: they go to another Parliament

I wrote two weeks ago that it seemed unlikely that Young Master Wesley Streeting had the 81 nominations from fellow MPs that would enable him to trigger a leadership challenge within the Labour Party.

Ahem.

I’m old enough to remember when Young Master Wesley had 200 backers who were ‘absolutely solid’. Though in fairness, that Times article does not relate of what material they were absolutely solid. I will leave you to your own view on this.

These imaginary friends of Young Master Wesley sadly failed to show up with their nominations, just when he really needed them. Boo, imaginary friends! Boo!

And so my last column’s prediction that “no meaningful challenge to Starmer will start this week” came to pass. Young Master Wesley indeed lacked the numbers to trigger the Labour leadership challenge that he so unambiguously wants.

Furthermore, The Young Master’s few fellow MPs with government jobs whom he could persuade to try imitating the ‘momentum resignations’ tactic that ultimately did for ex-mayor-turned-shit-PM Boris Johnson were too few in number and too insignificant in influence.

Remember LBJ, Young Master Wesley: he might not have been a likeable politician, but he was a highly effective one.

We shall shortly return to the subject of mayors with Prime Ministerial ambitions in the person of The Mascara Kid, ex-Health Secretary Andy Burnham.

First, though, let us detain ourselves briefly with a summary of young Master Wesley Streeting’s durable and differentiating impact and influence on English health policy and politics.

A summary of Young Master Wesley Streeting’s durable and differentiating impact and influence on English health policy and politics

OK, do you want me to repeat that?

It’s not as if we have recently lacked Health Secretaries whose names may as well have been written in water, for all their actual positive impact. You can rank Therese Coffey, Victoria Atkins, Steve Barclay 1, Steve Barclay 2 and Sajid Javid in any order of insignificance that you like (and I just did): the point is that the NHS is broadly considered to be a Labour issue, and Mr Streeting had a long time in opposition before coming in as a Labour health secretary to take charge of a system that was demonstrably struggling and poorly-led.

It would have been helpful if Team Milburn-Streeting had brought with them some form of meaningful plan.

But there was no plan, as the Ten-Year View made amply clear.

And the planned delivery chapter was removed before its publication.

In this sense, you might argue that Mr Streeting has been the anti-Lansley. Dear old Lord Lansley at least arrived with a full plan for patient choice, clinical commissioning and competition overseen by managerial independence to turn the English NHS into a self-perfecting machine. (Andrew Lansley never got his plan through intact, as Nick Timmins’ magisterial book ‘Never Again?’ rightly observes: indeed, if anyone out there reckons that choice, competition and commissioning drove anything at all in English NHS reform post-Lansley, then I’ll have some of what you’re smoking.)

Mr Streeting is an able communicator, but what have been his achievements?

The triple shift and the neighbourhood health service are concepts awaiting a means of delivery. The extent to which both of these are a set of questions waiting plaintively for answers to the all-powerful issue of ‘how?’ is almost impressive. But not quite.

Is there a meaningful plan for achieving the sole quantifiable 2024 Labour manifesto NHS promise of a return to 95% achievement of 18 week RTT?

There absolutely is not, because there is no clarity about the path to funding the required increase in activity - nor have we seen moves towards seriously reshaping provider activity to establish readiness to deliver, if credible cash were on display.

This week’s announcement of further slight progress and achievement of the 65% RTT target, with which Young Master Wesley burnished his resignation letter to the Prime Minister, has drawn analysts’ attention.

The excellent Dr Rob Findlay points out in his regular analysis for Health Service Journal that “most but not all of the waiting list improvement was achieved by validation”.

Rob’s analysis notes that “the waiting list shrank faster than the current recovery trajectory, meaning the NHS was briefly on track to restore the “18 weeks” standard in 2029 …

“The current trajectory towards restoring “18 weeks” in 2029 required the NHS to overcome seasonal growth in the waiting list of around 35,000 in March, and shrink the waiting list by a further 43,000 patient pathways. It achieved that and more, overcoming seasonal growth and shrinking the list by a further 110,000 pathways – a substantive improvement of around 145,000 patient pathways.

“But something else happened in March: unreported removals from the waiting list spiked from the usual 250,000 per month to a whopping 350,000. So most of the 145,000 improvement was accounted for by the extra 100,000 unreported removals.”

HSJ’s James Illman gives a clear explanation of what is meant by the significant level of ‘unreported removals’ from the RTT list in the achievement of 65% - assuming that an achievement has indeed taken place.

This is debatable: Rob Findlay observes “when there is a huge spike in unreported removals, as in March, it is legitimate to question whether all of those patients were removed for the right reasons. Were so many patients really on the waiting list in error, after 12 months, when validations have been specifically encouraged and incentivised?

“If some of those patients were removed from the waiting list unjustly, they will surely reappear on it when they are re-referred. That would undo some of March’s apparent success, but it would also mean that their care has been delayed, and they may be at clinical risk as a result.” This issue will be worth watching.

As for abolishing NHS England …

Even by the time of Mr Streeting’s arrival in government, NHS England had long since become a hugely overstaffed and under-effective organisation. National system leadership as the incarnation of ‘meh’ was never likely to be durable.

Once the ‘more Matt Hancock’ plans that became the 2022 Act made explicit the effective end of NHSE’s independence, it was never going to attract a leader with the political weathermaking capacities and capabilities that Simon Stevens had displayed over his tenure.

Without Simon’s political skills, NHS England’s senior leadership team were remarkably foolish in their efforts to push back against ministers’ caprices and directions. Not only was NHSE now legally no longer meaningfully independent, the telescopic arm of its being at arms-length from the minister just kept getting shorter and shorter as ministers’ confidence in delivery from the version of NHSE led by Amanda Pritchard diminished exponentially, and so their tolerance for ‘pushback’ dwindled to nothing.

An NHS organisation that doesn’t have powerful leaders and influential friends is actually not that hard to abolish.

There remains a case to be made for the NHS leadership cadre to have some independence from the ministers of the day, which we will see in full focus with the arrival of new Health Secretary James Murray causing the usual upending of the policy carousel.

It remains a matter of curiosity that Young Master Wesley Streeting told HSJ on 31 January 2025 that he would not abolish NHS England, only to ensure that was what happened on 13 March 2025. The Young Master’s later post-hoc rationalisation about keeping the news of NHSE’s abolition from being leaked to HSJ emphasises Mr Streeting’s obsession with the media.

Now he is standing down as Health Secretary, Mr Streeting’s will be able to spend even more time briefing Westminster lobby journalists stories for attribution to ‘sources close to Wes Streeting’. This will make both parties very happy.

Towards leadership?

In Mr Streeting’s resignation letter to PM Sir Keir Starmer, Young Master Wesley wrote, “where we need vision, we have a vacuum. Where we need direction, we have drift. This was underscored by your speech on Monday. Leaders take responsibility, but too often that has meant other people falling on their swords …

“It is now clear that you will not lead the Labour Party into the next general election and that Labour MPs and Labour Unions want the debate about what comes next to be a battle of ideas, not of personalities or petty factionalism. It needs to be broad, and it needs the best possible field of candidates.”

The irony of Young Master Wesley calling for vision and direction, in the wake of having delivered a ten-year plan long on the former but devoid of the latter, and indeed of any concept of how they are to be delivered.

This is, in short, the clearest warning possible for Labour MPs, affiliated bodies and party members about what kind of a party leader Mr Streeting would be.

Aside from the political shrewdness of announcing the resident doctors’ big pay increase loudly and repeatedly early doors, Young Master Wesley Streeting’s tenure in charge of the NHS has been profoundly unexceptional.

Leading Labour

So what kind of leader does the Labour Party believe that it needs next?

The huge kicking that Labour received at the local elections indicates that many people across Labour’s traditional strongholds believe that Reform and Green councillors will do marvellous jobs of filling the potholes and emptying the bins. (Or should that be the other way round?) Good luck to them: you reap what you sow.

But obviously, it sends signals that are hard to ignore for national politics.

Clearly as regards communications skills, Young Master Wesley would be a big upgrade on Sir Keir Starmer, but then again so would a toaster. Yet despite the poverty of Sir Keir’s achievements as a national leader (internationally, he is generally more sure-footed), it is worth noting that less than a quarter of his MPs came out in public opposition.

Little Mascara

The surest sign of a leadership contest was the declared aspiration to return as an MP of devoted Mancunian and Westminster politics-hater, The Mascara Kid himself: Andy Burnham. This aspiration has (this time) won the approval of Labour’s National Executive Committee.

And of course The Mascara Kid is known to us, as a former health minister and indeed tail-end Health Secretary under Gordon Brown, and then shadow health secretary under Labour leader Ed Miliband. Two of his signature policies when in office as SOS were the NHS ‘preferred provider’ offer to trades unions, and the proposals for a National Care Service funded by a 10% levy on estates, which the Conservatives criticised as ‘Labour’s Death Tax’ (before themselves bringing it back as part of Theresa May’s 2017 general election manifesto).

Health policy history fans: guess which lead non-executive director of the Department For Health But Social Care had a big, public go at Burnham in 2009 for his NHS ‘preferred provider’ plan?

Yep, there’s no love lost between Alan ‘Bouncer’ Milburn and The Mascara Kid.

As to Mr Burnham’s political views? He has some: indeed, a multitude of them. The classic political joke about him goes as follows: a Blairite, a Brownite and a Corbynista walk into a bar, and the barman says, ‘what’ll it be, Mr Burnham?’

Nevertheless, The Great British Public appear to dislike Mr Burnham less than the other available options to lead Labour.

It is far too early to get excited about The Mascara Kid’s possible Second Coming: it might be as disappointing as The Stone Roses’ was. There is the small matter of his needing to win a by-election first.

Deeply honoured to be appointed by the Prime Minister as Health & Social Care Secretary.

Huge thanks to @RachelReevesMP for my time as part of her fantastic team.

Can't wait to get started and continue @wesstreeting's brilliant work on such a critical mission for our country.
— James Murray (@jamesmurray_ldn) May 14, 2026

So now, for however long it will be, our new Secretary Of State For Health But Social Care is 2019 intake and Oxbridge PPE graduate James Murray MP. He joins the roll call of Alan Milburn, Andy Burnham and Steve Barclay as Treasury ministers promoted to Health Secretary.

You can find out about his voting record here. His Parliamentary maiden speech is here, in which he mentions his diagnosis with the rare, long-term neurological condition myasthenia gravis.

Good luck to Mr Murray. He inherits a system that is not on course to deliver its targets, and the legacy of a glib, self-promoting predecessor who was only interested in his next move towards being Prime Minister. There is much room for improvement.