Cowper’s Cut 405: What’s the difference between Wes Streeting and Matt Hancock?
What’s the difference between Wes Streeting and Matt Hancock?
This might just be the health policy and politics version of a Christmas cracker joke. You know the format: ‘ho ho ho!’
Equally, it might not.
Some similarities are evident. Both are energetic narcissists, arriving in the health brief having risen without trace, and doing so with high if undeserved self-esteemed reputations (Hancock as protegé and lingual proctologist of former Chancellor George Osborne; Streeting as former President of the National Union of Students, and boy, does it it show).
Ending the independence of the NHS Commissioning Board (AKA NHS England) is another commonality: Hancock started it with the White Paper that became the 2022 Act, in response to his vexation at constantly being outsmarted by NHSE chief executive and political magus Simon Stevens; and Streeting finished it, in evident exasperation at the continuing gradient of NHSE non-compliance under the CEship of political anti-magus Amanda Pritchard, something compounded by the fact that NHSE did almost nothing very well.
There are also a few practical differences between them.
Hancock thought he was wonderful at the media, but wasn’t.
Streeting knows he is fairly good at the media, and indeed is fairly good (thus standing out a mile in a Cabinet full of people who are almost defiantly bad at doing media, and who show worryingly scant interest in getting better at the wholly learnable skills involved).
See also leadership (party thereof): nobody whatsoever apart from Matt Hancock ever thought he would be a future leader of the Conservative And Unionist Party. His 2016 leadership campaign launch is a triumph of Partridgesque bathos, which amply rewards re-watching.
By contrast, and curiously, Young Master Wesley Streeting is often described as a possible future leader of the Labour Party: even by some people who are not Westminster lobby journalists.
And indeed, the desire to be The Dear Leader is not an ignoble ambition.
Yet Young Master Wesley’s time as Health But Social Care Secretary could not have shown us more clearly that there is no Streetingism, bar some tepidly reheated Blairite mantras which don’t amount to a hill of beans. The presence of reams of old Blairite advisers devoid of new ideas in Team Milburn-Streeting’s era of the Department For Health But Social Care is a strong tell of the intellectual vacuity at work.
Wes Streeting
A person might argue in favour of Mr Streeting’s U-turn piece for The Guardian that his view on mental health overdiagnosis was divisive and ill-informed.
That would of course be to ignore Young Master Wesley’s longstanding penchant for writing endless word-salad opinion pieces for idiot-oriented former newspaper the Boris Johnson Fanzine, such as this one helpfully describing them BMA as “a bunch of moaning Minnies”. (They’re far shitter and worse than that.) Oh, and there was also this week’s particularly infantile and obviously untrue briefed BJF piece about people with hiccups flooding A&Es.
So perfectly does Young Master Wesley think the NHS in England is running that he even has time to argue with the BJF’s batshit-crazy editorials.
Whether Young Master Wesley’s motivation for this BJF media fiesta is being slightly bored in the job, or is rooted in some bizarre tanks-on-lawns fetish, who can say?
Mr Andy Cowper
A chacun son gout: I have previously remarked on YMW’s fetish for shouting ‘reform or die!’ at the NHS (“Mr Streeting’s principal national media activity has been to shout “REFORM OR DIE!” at the NHS and its workforce. No kink-shaming here: to each their own fetish”.)
It is not as if things are getting any better in the English NHS, for which Young Master Wesley has chosen to be explicitly responsible. I have been banging on in ‘Cut’ about Interim Jim’s ‘return to financial balance at all costs’ policy, and repeatedly warning that significant and reliable anecdata suggests that the strained success at doing this of the first half of this financial year may not be sustained.
Zoe Tidman
Guess what?
Health Service Journal reports that “NHS England revealed the trusts furthest behind their financial plans halfway through the year, with some providers off plan by up to 6 per cent as a proportion of their turnover. The trust-level data follows NHS England reporting its 42 health systems were overall only a fraction of a percentage point behind a planned £1.2bn deficit for the first six months of the year. NHSE said systems were £289m behind plan, against a combined allocation of £167bn (0.2 per cent).
“However, this masked broad variation, with nearly a third - 66 out of the 207 providers - reporting that they were off plan at the halfway point of the year.”
Mmmmmm. Funny old world.
Zoe Tidman
Funnier still was NHSE’s deputy chief financial officer Nicci Briggs telling the Healthcare Financial Managers’ Association conference that there are “some basics that we’ve really got to get back to. The multiyear planning is something that, unless you have been a finance professional for more than eight years, you have probably not done.
“How do we get some of those basic skillsets back? How do we have discussions at a board level about finance? How do we look at run rates?”
HSJ’s Zoe Tidman reported that Ms Briggs also cautioned against plans that “suddenly, miraculously” project their run rate is going to improve in the new financial year because “they fed back in a whole load” of non-recurrent income “that recurrently happen[s] every year. We’ve just got to try and smooth out and stop some of that game-playing that happens”.
Say it ain’t so, Shane! For NHS England directors to be publicly decrying the very same NHS financial lying that they have incentivised for many, many years is perhaps the most La Rouchefoucauldian example of hypocrisy being the homage that vice pays to virtue.
So, yeah. What is the difference between Wes Streeting and Matt Hancock?
NICE work if you can get it
Transactional economic threats from President Donald Trump’s MAGA administration have done what inflation alone could not, and seen a raise to the NICE technology threshold.
Populist gangsterism 1: economics 0.
BMA resident doctors’ leadership try to cancel Christmas
The BMA Resident Doctors 2008 Pay Differential Historical Re-Enactment Society really is going from strength to strength.
Their announcement of five consecutive days of more strike action 17-22 December (immediately before Christmas) is a response to the fairly evident erosion in effectiveness of their two most recent bouts of strike action.
This move will have more effect: the cover for those residents who participate will have to be found from the pool of consultants and SPRs already in the firing line for working over Christmas.
It will be a remarkably interesting example of power dynamics once we see what this does to doctors’ attitudes towards further industrial action.
Public opinion appears to have swung durably against these strikes.
Recommended and required reading
Research by Healthwatch England has found that one in seven people in England who need hospital care are not receiving it because the referral by their GP gets lost, rejected or delayed.
The Financial Times asks whether the next big blockbuster drug will come from China. Could be interesting, tariff-wise.
‘Abolished To Perfection’ is an insightful new report from the Nuffield Trust and Institute For Government, which is likely to be completely ignored by Team Milburn-Streeting. Don’t believe me? Have a look at the Nuffield Trust’s ‘Doomed To Repeat?’ report from 2018.
Health Minister Zubir Ahmed told the FT that the UK should “leverage” its new health data service for the “benefit of the Treasury coffers”, as well as accelerating the discovery of new treatments for NHS patients. He was referring to the government’s new Health Data Research Service (HDRS), which will give researchers a single access point to national datasets for the first time and unlock “the power” of NHS data. Mmmmmmm.
Admirable comment piece in HSJ by Andi Orlowski, president of the Association of Professional Healthcare Analysts.
Good Prospect article on the messy history of PFI.
Someone’s leaked The Guardian the Royal College of Physicians’ thoroughly damning report on Blackpool Hospitals. I wonder which Royal College could have done that?
NHS wheelchair services: many are not at all good, apparently.
Another strong ‘Mythbuster’ column in HSJ from Steve Black.
Wexham Park Hospital has removed many of its handwashing sinks: the BJF explores why.
Royal College of Radiologists survey briefed to The Guardian suggests the need for more radiologists.