On 14 May, Wes Streeting walked out of the Department of Health. His resignation letter said he had "lost confidence" in the Prime Minister. He is the latest in a string of departures that has gutted Keir Starmer's cabinet. But the damage here is not just political — it leaves the National Health Service rudderless at the worst possible moment.
22 Disputes and Nobody to Negotiate
The British Medical Association has put it bluntly: the change of Secretary of State has come at "a critical time". Every major group of NHS doctors in England is currently in dispute with the government. Resident doctors. Consultants. SAS doctors. GPs. That is 22 separate active negotiations now sitting on the desk of… nobody.
Industrial action has already cost the NHS an estimated 171,776 appointments and operations in 2025–26. Without a Secretary of State with the political authority to do a deal, we are heading for a summer of strikes that will dwarf last year's. Patients pay the price. People in Preston East tell me every week about cancelled hip operations, postponed cardiac procedures, hospital appointments shunted to October. None of that gets better with an empty chair at the top of the department.
The Spin About the 18-Week Target Doesn't Survive Contact With Reality
Labour briefed loudly that the NHS "hit" the 18-week target in March. Read the small print. The headline waiting list still stands at 7.11 million people. Over a million people have been waiting more than 18 weeks for treatment. Cancer waits have not improved. Diagnostic backlogs sit at 1.68 million. The "win" is one interim measure on one metric, taken on a falling tide. Treat the spin with the contempt it deserves.
Worse, the modest improvements that have happened are largely a function of NHS staff working themselves into the ground. Record sick days. Record burnout. Record numbers of nurses leaving the profession. None of that is sustainable. None of it is being addressed by the people in charge — assuming anyone is, in fact, in charge.
A Health Bill Mid-Passage and No One to Steer It
Streeting's resignation came the day after the King's Speech, which contained the legislation needed to restructure the health service. That bill is now without its champion. Whoever takes over the department will inherit a half-built reform programme they didn't write, with a Commons in chaos, with backbenchers in revolt, and with no political capital to push it through. It will either be quietly dropped or watered down beyond recognition. Either way, patients lose.
This is what happens when a government collapses from within. The country still needs to run. The hospitals still need running. But the machinery of government has seized up because Labour MPs are spending their days plotting against each other rather than doing the jobs their constituents elected them to do.
What Reform UK Would Do
Reform UK has been clear about the NHS: protect it as a free-at-the-point-of-use service, but reform how it is run. We would settle the pay disputes with a binding independent arbitration system so industrial action cannot be used as a political weapon. We would scrap the layers of NHS England management that absorb billions a year before a single nurse is paid. We would publish hospital-level performance data in real time so patients can see where the best care is delivered.
We would also stop the practice of using the NHS as a backdoor labour market for unsettled migration. The asylum-worker-rights policy this site has covered repeatedly is symptomatic — solve the workforce problem with British training places, fair pay, and proper conditions, not with a permanent revolving door of staff whose immigration status is unresolved.
The NHS needs leadership, honesty and reform. Labour has none of those things to offer. That much was clear the day Wes Streeting walked. It will be clearer still by the end of the summer.