Re:View 13 June 2025
Research Manager and Head of Health
Quote of the week
“There have been broadly two sorts of reactions to this. The first, mainly from the media and the public – “£29 billion is a hell of a lot of money.” The second, mainly from our think tank friends - “£29 billion is nowhere near enough.” The truth is, both are right.”
Wes Streeting in his speech at the NHS Confed Expo
Happy Friday! It’s been another busy week for Whitehall watchers, and an even busier one for NHS reformers. As surely as the sun rises in the east, the NHS’s funding settlement has vastly outpaced that of other departments.
With the NHS budget now as big as Portugal’s GDP, many column inches will be filled with how to maximise the value from that money. What’s been overlooked in the coverage, but is crucial to see, is the Secretary of State’s speech yesterday at the NHS Confed Expo outlining how they will do it.
But I fundamentally disagree with the Secretary of State. Neither the public, media, or think tank friends are right. It is not volume of money that should be of concern, it is the type of money. As we outlined in our Re:Act snap analysis – what the NHS needs is money to fund reform (mostly capital), not money to fund more of the same day-to-day activity that we know isn’t working (mostly revenue).
The NHS has a unique ability to absorb cash without changing all that much. Increasing revenue spending even more will not incentivise fundamental reform and worse, comes at the expense of other services feeling the pinch.
However, credit is owed where credit is due. While this much-desired cash is limited and would ideally be more balanced, the Government has some impressive ideas for how to spend it. Of course, we would say this because seemingly many of these ideas originated with Re:State.
In the last three days, we have seen the announcement of virtual hospitals (which we recommended in Hospital as service, not a building), a dramatic increase in robotic assisted surgery (which we recommended in A helping hand) and a more instrumental role for local government in the NHS (which we recommended, as a crucial component in the abolition of NHS England, in Close enough to care). These are all enormously positive steps.
Wes Streeting’s emphasis on the role of combined authorities and local government, as part of the shift away from “an ever-growing mountain of bodies, diktats, and targets”, is welcome. Aside from targets being needlessly restrictive, if the Government is serious about prevention, then the organisations who can fix damp housing, dirty air, and poverty need to be given empowered in the health system. Let’s hope this rhetoric translates into reality – perhaps some of the precious £29 billion could head in the direction of local government, and we’ll soon find out in the 10 Year Plan.
Read of the week…
Tom McTague has written a thoughtful long read unpicking Keir Starmer’s prime ministerial style. There is always commentary surrounding the PM that swings between characterising him as technocratic or uninspiring to straight out lacking conviction or political vision. Maybe all of these things are true, or maybe none of them, or perhaps the real problem is how we frame modern British leadership. If you want to answer this question yourself then I recommend this excellent analysis.
(Re:)Meet the team!
Each week, we will be reintroducing our readers to a member of our small but mighty Re:State team. This week, the spotlight is on…
Cory Berman, Researcher - @CoryBerman, @coryberman.bsky.social
Cory, tell us something about yourself that we might not know.
Although you might not suspect it from my mild mannered appearance and generally chill vibes, I’m actually possibly (almost definitely not) the inspiration for 1984’s “The Karate Kid.” I’m a Third Dan black belt in Karate and spent 14 years honing my craft at my North London dojo.
What are you working on?
I’m working across two of our programmes at Re:State. On 'Re:Imagining Whitehall' I will be helping to develop bold and transformative policy recommendations to dramatically improve the effectiveness of the centre of government, whilst on 'Re:Imagining the Local State' I’ll be drawing on my experience of working with local planning departments to work on radical ideas to improve local government and housing and infrastructure policy.
Who is your favourite reformer?
Mikel Arteta. Lots to be learnt from his emphasis on non-negotiable values and unhinged attention to detail.
What gets you out of bed in the morning?
The smooth sounds of Daybreak.