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Podcast Summary: The Rest Is Politics - Episode 82: Wes Streeting: Labour, Privatisation, and the NHS
Episode Overview In this episode of *The Rest Is Politics*, hosts Alastair Campbell and Rory Stewart interview Wes Streeting, the Shadow Secretary of State for Health and Social Care. They explore a variety of topics related to the National Health Service (NHS), privatisation in healthcare, the Labour Party's approach to health and social care, and Streeting's personal journey and upbringing.
Key Themes and Discussions
- Personal Background of Wes Streeting
- Memoir Insights: Streeting shares insights from his memoir titled *One Boy, Two Bills and a Fry-Up*, highlighting his unique upbringing.
- Family Influences:
- Grandfather "Bill Streeting": A staunch Conservative with a strong work ethic who influenced Streeting’s values of hard work and law.
- Grandfather "Bill Crowley": A more colorful character with a troubled history and a complex relationship with crime, offering a contrast to Streeting's other grandfather.
- Childhood and Identity: Streeting reflects on how his challenging childhood shaped his political views and moral compass, emphasizing the importance of social justice.
- Politics and the Labour Party
- Political Journey: Streeting's rise in politics began at Cambridge, where he became politically active and focused on social justice issues.
- Labour's Trust Issues: He points out the need for the Labour Party to regain trust on issues like economy, law and order, and national security.
- Generational Change: He highlights how his father's potential vote for Labour in the upcoming election signifies a shift within traditional Conservative demographics.
- The NHS and Health Policy
- Privatisation Debate: The episode delves into the contentious issue of whether privatisation could save parts of the NHS, with Streeting advocating that the focus should be on enhancing public services rather than privatising them.
- Challenges Facing the NHS:
- Funding and Resource Allocation: Streeting discusses how a significant portion of the NHS budget is consumed without improving outcomes, arguing for a shift in funding toward primary care and community services.
- Mental Health Services: He emphasizes the importance of improving mental health services, advocating for earlier intervention and community support to prevent crises.
- Social Issues and Personal Beliefs
- Faith and Sexuality: Streeting discusses his experiences reconciling his faith as an Anglican with his sexuality, describing a journey fraught with internal conflict but ultimately leading to acceptance.
- Cultural Impact: He reflects on the societal expectations surrounding faith in politics and how they shape public perception and personal identity.
- Future of Health and Social Care
- Plans for Reform: The conversation touches on Streeting’s vision for the future of health services, focusing on:
- Increased funding for mental health services.
- A more patient-centered approach to healthcare that includes better support systems to reduce hospital admissions.
- The significance of community care in enhancing patient outcomes.
Key Takeaways
- Wes Streeting's personal and family history deeply influences his political values and vision for the Labour Party.
- The NHS faces significant challenges, particularly in resource allocation and service delivery, necessitating a reevaluation of how funds are spent and where services are directed.
- There is potential for Labour to reshape its image and regain trust by addressing practical concerns around healthcare and social justice.
- The integration of personal beliefs, such as faith and identity, plays a crucial role in shaping the narratives of public figures in politics today.
Conclusion This episode of *The Rest Is Politics* provides a multifaceted look at Wes Streeting's journey from a complex childhood to a prominent political figure, intertwining personal anecdotes with pressing national issues regarding the NHS and the Labour Party's direction. The discussions offer listeners a deeper understanding of how personal experiences can shape political ideologies and the challenges faced in the current political landscape.
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Transcript
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1:37Welcome to The Restless Apologies Leading with me, Anastar Campbell. And with me, Rory Stewart. Joined by Wes Streeting, who, if the polls are right and Labour win the general election, will be Secretary of State for Health and Social Care. and a bit like some of our earlier Labour interviewees with a very interesting backstory but probably the only one aged 41 who has already written a memoir title One Boy, Two Bills and a Fry-Up about his rather extraordinary childhood. I think he will definitely be the only member of parliament whose mother was born whilst her mother was chained to a hospital bed because she was on release from prison where she shared a cell with none other than christine keeler who will be well known to older it's the star of the profumo affair profumo scandal yeah along with mandy rice davis yeah it's amazing how those two women their names kind of resonate through the years and they will and what was the great catch line they produced uh he would say that wouldn't he he'd say that yeah yeah let's say we don't have too many he would say that it wouldn't be moments uh the thing about wes that you have to understand is relentlessly political uh very working class background went to cambridge university became very politically active there president of the national union of students then a counselor bit of work in the private sector but pretty much has been a politician and political all his life and will be is one of the most important labor figures in the campaign and will be one of the most important figures in the government if there is one so wes thank you for being here Thank you very, very much for joining us.
3:16Thank you for having me. Can I start then with your memoir and your book and do give us a bit of a sense of the different dimensions of your childhood. Father's family, mother's family, how you grew up, what those different traditions were, how they fed into who you are today. Yeah, it's captured in the title. So the one boy is obviously me. The two Bills are my two granddads, both of them called Bill, who I think epitomise two very stereotypical East End families, but wildly different stereotypes. And which part of the East End were you from? Stepney. So Stepney Whitechapel, Stepney Green, that's my stomping ground.
3:54And on my dad's side of the family, he had Bill Streeting, served king and country in the Second World War in the Royal Navy, as his father had in the First World War. He was very big on law and order, very much a monarchist, loved the Queen, worked all of his life. And, yep, he was what I would call a sort of pull-yourself-up-by-your-bootstraps working-class, thatcherite Tory. In fact, the only time he ever voted something other than conservative was Liberal in Tower Hamlets to keep Labour out. So he was a staunch Tory, an Anglican, and probably the most influential person in my life and the closest relationship.
4:33Would he have been a Brexit voter? Would that have been the way he probably would have gone? I bet he would have done, yeah. I think he probably would have voted to leave the European Union. Interestingly, my dad, who's also been a lifelong conservative, he voted remain narrowly on economic grounds. Right. As my dad works in the car, he's a car salesman. But you said that was the most important relationship. Yeah. Your granddad, your mother or your father? We were so close. He was like my best friend growing up. And when there was a lot of turbulence and chaos and instability at home, you know, when I'd go to stay with my granddad, that would be, those would be the best moments of the week.
5:07And give us a sense of him. What was he like physically? What made him somebody that, was he good at dealing with young people? Was he fun to be around? He was, despite his politics and traditions, he was definitely a soft touch as a granddad. He was the one I'd go to if I wanted to borrow chocolate. My dad said no. He used to do these crazy things for me, like on a Saturday morning, I'd ask what I'd want for breakfast and I'd say beef burgers and potato waffles and he'd make them. I think this is kind of crazy, by the way. Did he enjoy playing with a child? He read to me all the time. He would indulge any interest I had.
5:39He would pretend the sweets I made out of pure icing sugar were delicious. I was a granddad's boy. it and um but you know he's he's also very traditional like i don't think he ever owned a pair of jeans in his entire life whenever he picked me up from school um on a friday he'd arrive early to join us at church and he'd be suited and booted but he'd be suited and booted to go to the square market on roman road on a saturday he might not wear a tie on a saturday but he would be there with his big laundry bags full of shopping um sort of carrying them down the road he used to occasionally have a string vest on um if he was in you know at home casually but other than that, he was very well turned out.
6:16He'd be horrified that I sometimes use one of those shiny sponges to shine my shoes rather than a proper navy boot polish. And given that he was in many ways quite an old-fashioned conservative person, did you have a chance to discuss being gay with him? How did he deal with that? No, he sadly died when I was 11, which was without doubt the worst day of my life. so I wonder I always wonder how how he would react I think his reaction would have been the same as my dad's which was taking a bit of time to get used to it but unconditional love so I feel I feel fairly confident about that we'll talk about the other bill the more colorful bill yeah I can put it like that in a minute uh the one who hung out with the craze and stuff but you see your grandfather was important to you and clearly I think I think I'm right I've heard you say this, I think to me before, that he was very important in the development of your Christian faith, but doesn't seem to have influenced your politics in the same way.
7:12To an extent he has, albeit, you know, when I was growing up and I used to talk to my granddad about politics, even at that young age, not least because there was very left-wing firebrand politics on my mum's side at the family. I've always had a strong commitment to social justice, and particularly given my childhood and upbringing, I might not have described it as that when I was growing up, But that basic fairness always kind of had ingrained. Where I've kind of got to over time is a frustration that when I talked to my dad or my granddad about why they were conservative, and it would be things like trusted with the economy, law and order, national security.
7:50As I've grown up and as I've looked back on Labour history, you know, I loved history growing up, read history at university. I don't think that those are or at least should be conservative issues but the Labour Party is too often surrendered that ground to the conservatives and I think we've under Keir's leadership and I promise I'm not going to do loads of lines to take throughout this conversation but I do think that one of the reasons for where we are today is when you look back at Lee, Wilson, Blair they all answered the three questions that stop Labour winning power. We always have to answer those three questions.
8:26And if we answer any of them with a no, we lose. So can we trust you with our money? Can we trust you on law and order? Can we trust you on national security? And your grandfather and father would answer no to that for Labour? Yeah. Although my dad's vote is hanging in the air at this general election. What, even this one? This could be the first time my dad votes Labour at the general election. He doesn't live in my constituency. He's always voted for me. But my dad, when I stood for a council by-election in 2010 and I was still living with my dad, he said uh he said i'm voting streeting i'm not voting labor but dad's moved i mean he voted labor in the london elections for the first time ever without streeting being on the ballot paper okay that's good so his votes are he's leaning labor for the general election so let's just just before we move on to uh more politics give us the sense of your your mother's side yeah it's completely different family my granddad granddad pops bill crowley um he didn't serve king and country but he did serve at her majesty's pleasure he was in and out of prison throughout his life in fact his early experiences of the criminal justice system were in ball stalls approved schools um from a very young age and he grew up in the east end as well yes well south london originally then they moved to the east end and he had a string of convictions for armed robbery and was that basically his job yeah um apart from i mean he had a couple of other jobs he can never help himself even when he was doing kind of straight jobs he would come home that was He was a delivery driver.
9:51He'd come home with huge pallets of fresh fish that would then fill the freezers of every house in the family. Some really thick, high-quality doormats that then adorn the doors across the East End. I like thick, high-quality doormats. Absolutely. Very posh for the East End. One of the stories I tell in the book was when he was doing work as an official receiver. He couldn't believe his luck because as far as he was concerned, he was being paid to legitimately steal from people and he would turn up to all these people in debt and he didn't mind doing businesses but it was when he was knocking on doors looking into the eyes of and it was usually women who answered the door and having to take what little they had he would just sort of say it's all right you weren't in I didn't see you and walk off and and he would and it's a bit like his work as an armed robber you know he wouldn't steal from his own as it were.
10:44In the end, he quit that job because he said being an armed robber was more honest work than being a bailiff. To be a little serious for a moment. He's your grandfather and you have a deep affection for him. He obviously had many virtues. You just give an example of him being generous and compassionate to people. Armed robbery is a terrifying, violent, horrible imposition on the victims. I guess your other grandfather who believes in law and order would be like, you do not minimise what the hell it means to be an armed robber, however glamorous that sounds. Yeah. And actually one of the issues I address in the book is this issue of the glamorisation.
11:23And I enjoyed some of those kind of gangster films as much as anyone else. But when I sort of take a step back and you think, is this really right that we hold people up in this way and we sort of particularly glamorise the craze and My granddad's often appeared in newspaper headlines as an associate of the Krays. Actually, he wasn't particularly. He knew them, but he wasn't an associate. He was with the Richardsons and one or two others. I'll tell some colourful, not suitable for work jokes in the book about some of his gangster associates. But there was a serious point. I mean, there's one story my mum told me, which he burst in one evening crying with laughter, just saying, only a woman, only a woman, only a woman over again.
12:13And my mum was saying, what's going on? And he'd gone into, I think it was a shop or a post office. He'd held a shotgun up in the face of the person behind the counter, the woman behind the counter. And she'd gone to press the panic button. And he said, you press that button, I'll shoot you. And she just looked him deadpan in the eye, pressed the button and said, go on then. And he burst, because he was never going to shoot her, burst out laughing, ran off and said, only a woman would have done that. and it's sort of and me and my mum talked about this saying well I think one thing I can be pretty sure of is that she didn't go home laughing that day and who knows what impact that might have had on her for years to come it's completely terrifying did she even go back to her I mean it sounds like she was hard as nails but there's a you know there are no crimes without victims the courage to look down the barrel of a gun gun and say go on then and I would also count my own family among his victims because his relationship with my nan was a very abusive one.
13:07I mean, my nan herself was incredibly strong, but my mum grew up in an environment with violence where my granddad was at home and not home. It was a very unstable childhood. It affected my mum's education and her life chances. You mentioned my nan giving birth in prison. She was only in prison because she got caught up with my granddad's work. And yet my nan was this warrior for social justice. She was very active in the Tenants Association in the East End, campaigned against Murdoch when he moved to News International. Sometimes when I'm going into work to do an interview with the Sun, I sort of look up and say, I'm really sorry, Nam, but we've got to talk to everyone.
13:46I think she could have been a great Labour councillor or even a Labour MP. In fact, she was asked to be a Labour councillor and she said no because she was ashamed of her criminal record and she didn't want to bring herself, the family or the Labour party into disrepute. So it had a big consequence for my mum, for her brothers and sisters, for my nan and what she was able to do. Where do you think your kind of moral compass comes from then? Did your mum and your grandmother on that side of the family, on the labour criminal side of the family, did they sit you down and talk about right or wrong?
14:17Did the other bill sit you down and talk about right or wrong? I mean, how have you got a kind of that sense of what's right and what's wrong and the moral compass that it gives you? I think from both sides of the family. I mean, my mum's never justified my granddad's criminality. I mean, in the book, I explain it in that it was only not long before he died when he finally revealed to my mum and my aunt that he'd been both physically and sexually abused by his father growing up. And suddenly it all made sense. It doesn't excuse, but it does explain. And you can then see, well, despite having a really loving mum and a brilliant relationship with his sisters, you can understand why Ball Store or Approved School might feel like a safer place and why the institutions of prison and that routine felt like a safer place.
15:06And of course, he had status in prison as an armed robber and as a getaway driver. He had friends. And so life was actually better for him in prison, which I think is a huge tragedy. Did you know him well as a child? What was he like to deal with as a grandson? Well, that's the sadness for me. When I was very young, I remember him being in and out of prison. I went to visit him once in prison and I didn't want to go back. Which prison was it? I think that would have been Wandsworth. I remember getting on a train down to South London and I didn't like seeing him there. I said to my mum, I didn't want to go back afterwards, which upset my granddad, but I just didn't want to go back.
15:45When he eventually came out and came out for good, I found him to be loving, but also to be living quite a sad and solitary life. I felt sorry for him. When I spent time with him, and it goes back to the suddenly all makes sense point in terms of his childhood. I used to sit there thinking, because we used to have fierce debates about politics, about religion. He was like a Dawkins-style atheist before Richard Dawkins became a big thing. He had read all of the major religious texts, the Bible, the Quran, the Torah. and he was really well read. And I used to think, and he used to be incredibly funny.
16:17He used to raise a sharp wit and he absolutely encouraged me to aim high. I mean, you know, he was so proud when I made it to Cambridge and I used to sit there thinking, how is it that someone this smart, this funny, this well read could have led such a wasted life? You turn up in Cambridge. Were you confident when you were 18? sharing these stories with other people that you were at university with? No. In fact, even when the book came out, it came as a surprise to lots of my friends at university. So how did you, I guess like most of us at 18, we're a little bit self-conscious. How do you think you sort of presented yourself to people when you were 18?
17:01I've always had a... I'm trying to find a better way to describe this because I always describe myself having a bit of a working class chip on my shoulder, but I don't mean that in a resentful or sort of aggravated way. What I mean is that I'd sort of been brought up with this idea, well, you know, anything you can do, I can do. And I've always had this sort of sense of, well, I'm not going to let my background hold me back. So I arrived in Cambridge with a precocious, actually precocious is probably about - So a positive ship. I had a precociousness, yeah. And I arrived, I remember having some arguments with some of my friends from independent schools.
17:36I never met anyone from private school before I went to university, of trying to say, well, you've earned your place here. We've all earned our place here. But I've earned my place more because I've had to clear more hurdles. And the way I describe it now, talking to kids from backgrounds like mine across the East End when I go and talk in schools is, you know, I actually often compare myself to Jacob Rees-Mogg after I was elected to Parliament, which is, look, we are sat here in Parliament. We've got an equal vote, an equal voice, and we're sat around the Treasury Committee, one of the most influential committees.
18:05And Jacob was that opposite me for a good few years. And I used to say, look, Jacob and I do the same job. We've got the same weight, not quite the same voice, but notionally, we've got the right to speak. We've reached the same destination, but I've had to clear hurdles to get ahead. Actually, that's made me the stronger athlete and it's built resilience. I don't look back with it, and it's certainly not a misery memoir I've written. I don't look back with a sense of pity. We mentioned the one boy, the two bills, the grandparents, the fry-up. and this is probably where the maybe maybe the precociousness was born in the womb because my mum was pregnant as as a teenager i think i'm sort of what's technically known as an accident it was not a planned pregnancy and everyone including my dad my granddad my mum my nan my mum's mum all agreed the best thing to do is my mum to have an abortion but she decided in a run-up that she wasn't going to go through with it she knew that my formidable nan might well frog marcher to the hospital to go through it so on the morning of the of the appointment she did the one thing she was explicitly told she couldn't do or the procedure couldn't go ahead which was to have breakfast so the fry up is literally the fry up that saved my life and i think that's where the precociousness was born in the womb i think listen we talk rory and i talk a lot on this podcast about prisons because we both go into prisons and and you know you rightly say they're pretty horrific and you had that experience as a child i think we both are a little bit disappointed that there's no sense of prison reform being on the political agenda right now.
19:35We're just going to live with these terrible prisons. Is that not something you think that a Labour Party ought to be focused on? I think we do have to look at the whole issue of kind of criminal justice in the round. I would argue, for example, that my nan should never have been in prison, that her offences weren't serious enough as a pregnant woman to find herself giving birth with all of the consequences that would involve. Because my mum was separated from my nan for a while at the beginning and we now know so much about those first thousand days. That was a terrible thing to have done and I think there are probably too many women in prison today for offences.
20:14Can I maybe push it one more stage? Both Alistair and I would agree strongly that there are far too many women in prison and most of the women in prison shouldn't be in prison, but it's also true that our prisons are horrible. Filthy, violent, drug-ridden, unsafe, horrible places. None of these parties, I'm afraid, neither Labor nor conservatives nor Lib Dems, are really focusing on this campaign on the most vulnerable. I'd like to see a party say, if we get in, we're going to look after prisoners properly, we're going to look after the homeless properly. We're going to look after the very poorest in society properly.
20:53People who don't vote in case prisons aren't even allowed to vote, but that a basic mark of our civilization is to massively improve conditions. Look at Sweden, look at Netherlands, make humane conditions in prisons absolutely central to the manifesto. I don't think it's a surprise that when money is in short supply and when you're fighting an election on the issues that matter to voters and you're trying to kind of hit voters on the nose with the messages that speak to the issues that they care most about that prison and prison reform is not going to be a centrepiece of the election campaign um i didn't think it would cost you votes oddly i mean i i was thinking about it yesterday i mean i agree with you it's not maybe something that's going to excite the daily mail voter but it would be completely on brand for a compassionate labor party it would be something that you could do where people could be like okay i get it you've got a moral compass all right maybe it's not our priority but this is showing your values it's a i think it's something you could do that wouldn't cost you votes and might actually give people certain kind of even as you say that i can hear the tories going soft on crime soft on crime soft on crime and also like you know and then and then there's a question of the money and you know what you know we've got a fierce competition for resources at the moment because they're in short supply and would you start here i do think there's a more fundamental question though about why how we got to this state and why is it that criminal justice and prisons feature so low?
22:19You were a prisons minister. What made your job the most difficult to achieve change? What's interesting to me is that I came into that job and my predecessor, Sam Gimas, said, you've got to be hard on crime. I completely disagreed. I came in and I thought, this is a total disgrace. I said she was inspired by Tessa Jal. Tessa Jal said to me that the big question she asked herself whenever she went into a hospital is, would I put my mother in this hospital? And I thought, would I put a relative in this prison? The answer is absolutely not. Terrifying, disgusting, filthy place. And so everything I did was going out saying, these are complete disgusting disgraces, and we're going to try to make them safe for prisoners, safe for prison officers, safe families.
23:05Paradoxically, I found that actually the public responded very favorably. The newspapers weren't that brutal to me, and all the conventional wisdom, which was, you know, you'll be punished for it, wasn't true. People do have a conscience in Britain and you can awake it. So I feel sad that people aren't leaning into this. I think we're being too cowardly about this. I don't think it's so much a conscience issue, but I do think it's a resources issue. I mean, the prison estate is an absolute mess. But then would you prioritise prisons over our schools and hospitals? I wouldn't. And I don't think that's an immoral choice.
23:38I think I probably would because they are so bad. I mean, so much worse than a school. A bad school is a very depressing thing. But 30 ,000 assaults a year in prison. I mean, prison men, people are getting their heads chopped off in the exercise yards. They're getting, I mean, that's not happening in schools. I mean, this is something hidden from society, which is so much worse than you can imagine. Can I ask you something else about your earlier life? What did you learn, first of all, in student politics? And then as a councillor, that maybe you're trying to apply today as in, I think, what's your first election as a key campaigner, as they're called.
24:16Yeah. Well, politics is fundamentally about change at any level. And I had a wry smile this week because I think Varsity, one of the student newspapers at Cambridge, they run a sort of feature looking back sort of 20 years. And 20 years ago was me. and this week they mentioned a certain West Streeting campaigning successfully to save the university's architecture department from closure. And that wasn't just me, by the way. It was a huge team effort. The architecture society leadership at the time deserved the lion's share of the credit, but that's what politics and political change is really about, the saviour.
25:00If ever it's about the saviour, it is about a collective effort, a team effort to affect change. And we did. And I'm incredibly proud that that architecture department is still there today, still thriving. And I can say, hand on heart, that I was part of that achievement and legacy. And similarly, in local government, I mean, it's made me a committed devolver. I believe that power is better exercised when it's closer to the peoples and communities. It's there to serve. and Andy Burnham has been a trailblazer for the mayoral model and we're seeing others now follow using those levers of power. I might not be happy with the result for lots of reasons, but Ben Houtrin up on Teesside, the fact that he is still there despite the tsunami that swept away other conservatives, says something about the fact that people judged him as a mayor, not simply as the political brand.
25:54And so I'm very committed to devolution. and also again it's about how you affect fundamental change and sometimes really practical change you know i was i was in a rush the other day i was going from one thing to another as you do during the election campaign and i stopped it i was got stopped at these traffic lights around the corner from where i live um on horns road in barking side and i was in a rush and i said to the person driving the car i was like this is my fault i've got these traffic lights installed because we've got the the new development behind me and the school in front of me and we put the crossing in because we were worried about children's road safety and we've probably saved some lives and prevented some injuries so even really practical things like getting in a pedestrian crossing it's quite bold to tell a voter that you've just made his life more difficult well done well you know and it's good and i mean i love my time and and you know the one year i had as deputy leader of the london borough of redbridge for i was elected as as the mp for ilford north I got so much done in that one year and I can point to things around my constituency and around my borough that I delivered as deputy leader of the council in the last nine years as a as most you know a backbencher and then as a member of the shadow cabinet and a member of the front bench I can point to things I achieved that are consequential I saved King George Jackson emergency department that was the A &E department that found my kidney cancer and saved my life I can point to things I've done in Parliament to make a difference, albeit on issues like Islamophobia, where I work with Saeed Avarsi.
27:23We made some impact, but not the fundamental change I really wanted to make. The point you're making is you've got to be in government. Yeah, and that's why this election for me is incredibly exciting, so we might pull it off. It's also, I mean, for listeners to the show, it's a kind of reminder of one of the weirdnesses of being a backbench MP. Because as you say, a lot of what I certainly felt as an MP, that a lot of what our voters want us to do are quite practical local issues. And a lot of that is actually the job of the local council, not the MP. Local MP doesn't actually have a budget, doesn't have legal powers.
27:58So even when we say, And of course, I did this like you. I got the dueling of the A66. I got the lift in Penrith station. And you're saying you saved the hospital. Well, yeah, up to a point. But obviously, you're an opposition backbench MP. So that thing wouldn't have been saved unless, presumably, some conservative minister signed off on it. So the most you're doing as an backbench MP is having some sort of, you hope, some influence on the process. You're not actually in power. You're not doing it yourself. You're asking for something. You're lobbying for something. you're pushing for something, you're making the case for something.
28:33I think that's one of the things that can make politics quite depressing. I felt a lot of my colleagues who'd come out of business or the military or even running local councils when they became backbench and peaceful, struggling to really feel that impact. They never said it to voters because, of course, you've got to keep saying to voters to get them to vote for you. I'm delivering change, I'm delivering change. You never say to them, listen, I'm pretty powerless and this is a bit embarrassing and I'm not actually achieving very much every year. But there is a sense in which that is a bit true.
29:02Maybe that's one of the things that makes you commit to devolution. Yeah, I mean, there's a lot of truth in what you say. A few things I'd say, though. Firstly, Parliament really matters and our role as legislators really matters. And there are things that you can achieve even as a backbencher. I mean, that was certainly true in the Brexit parliaments where, I mean, we kind of seized control of the order paper in quite unprecedented But what did you actually achieve? What you actually achieved? Not the outcome we wanted. No, what you achieved was Boris Johnson pushing through an even harder Brexit by destroying Theresa May's deal.
29:33Again, there's some truth in that. I think the role of parliament, though, matters and holding the executive to account matters. Can I push that words for a second, though? Because given the way the whips work, given the way the majorities work, you're basically trooping through the lobbies day in, day out, losing, losing, losing. and it doesn't matter what you say in the debates, the other side isn't really listening. That's the thing I noticed when I became an MP. They're not really debates, are they, to be honest? I mean, you stand up, you ask your question, you get some sort of stupid synthetic answer from the dispatch box.
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30:06Half the people are looking at their phones. The people doing the speech are reading their speech. I mean, it's not really a debate in the sense that this is a debate where we're actually listening to each other and exchanging ideas. No, there are some exceptions. I mean, on issues like assisted dying or if there are particular abortion reforms where I think the free vote debates, you do have more of a debate. But there's an awful lot of influencing going on behind the scenes. And there are often groups of MPs who are able to affect change to shift their parties. And that's a process. I think, and this speaks to a piece you've just written for The Guardian, Rory, about your experience and frustration, some of which you've already mentioned.
30:43I think the one that worries me more is some of your reflections from government and the chopping and changing of ministers. In the last two and a half years, I've been shadow health and social care secretary. I've been up against five secretaries of state for health and social care. Now, that's just not serious. It means even when you've got good people occupying those jobs, they can't actually make a difference before they're moved on. The thing that I am optimistic about is one of the things about Keir's character as a political leader, which is underestimated. Because often his late arrival into politics is often debated as if it's some sort of weakness, whereas I think it's his superpower.
31:21Because I think he sees the pitfalls and shortcomings of the way our political system currently works that gives me some hope and confidence that he's going to change it. I mean, it's not just special pleading when I say to Keir, you really shouldn't chop and change your ministers every five minutes. And by the way, it's going to take me at least a term to get NHS waiting standards to where we'd want them to be. And this is going to be a decade of change and reform that's going to be needed to really get NHS moat. You nearly said that to renewal then, didn't you? The talking point was slippy and I could feel it.
31:51I thought you'd mock me if I said renewal. So I'm glad you're following the script, Alastair, to identify the lines. But I think there's a real opportunity. And similarly, I mean, this is not really a retail offer for the voters, the sort of the mission driven government that Keir's talking about, although I think it will speak to some highly engaged voters. But this idea that government can't solve everything and that we have to work in partnership with business, with civil society and all of us as citizens, I think is really powerful. and similarly and I think this is the antidote to the sort of the the laissez-faire hands-off small stateism of the of the conservative party traditionally there are lots of things we can't do without a good enabling government so we've got to see this as a more mature dynamic partnership and so beyond the sort of the specific pledges and how they're funded and the ground on which the election is for I think there's something fundamental about how Keir Starmer wants to reshaped government which if we pull it off will be really quite radical and transformational and make government look a lot different in the future than it has been in the past now i want to come on to the national health service which is and social care which is your brief but just briefly to close off as it were on you personally two tiny issues to discuss being gay and your faith so first of all tell us about the you know i've heard you talk before about coming out and sort of dealing with that your background and so forth tell us a little bit about that but also whether your faith helped in that or whether there was a conflict that you felt within oh the faith was the biggest hindrance um i really wrestled with my faith and sexuality for years and years and often i'm asked you know do you choose to be gay or were you born gay is it nature is it nurture and i don't i don't have a scientific answer to the question when did you the answer um when i came out of university and and i the best answer the nature versus nurture debate is well i tried really hard not to be gay and i think that did me an awful lot of damage and i think it damages a lot of people who try to be someone they're not and then live with the consequences because you realize when you have this weight lifted off your shoulders and i felt this genuinely liberating experience when i came out you realize how much time and emotional energy is consumed, living a lie and trying to be someone else.
34:17And the highest compliment I can pay Cambridge, by the way, because I often get asked, what was it like being a working class kid at Cambridge? Could you fit in? The highest compliment I can pay the university and sell in college, my college, is not only was I happy at Cambridge, it was the first place I felt was so comfortable that I was able to tell people I was gay. And I received a very good reaction and that was 20 years ago. It's even better now, I think. Much, much better experience at Cambridge than Alistair had. we don't need to go into my i'm so sorry don't worry about it that was a long long long long time ago thanks yeah i think i'm 26 years older than you i shouldn't have said that before you move on to my brief and now you get the knives out yeah you know as long as you deliver on mental health we'll come on to yeah i'll definitely come on to that but no and and on the faith point i mean i had this this conflict consumed me and actually in the end i came out and accepted myself for being gay and then there were and then it really I mean the it created a distance between me and the church that's never fully recovered in that you know I even though there was literally a chapel in the middle of my college at Selwyn that I could have just walked to 30 seconds every Sunday morning I didn't attend chapel once during my time at Cambridge until the end you're an Anglican yep and I feel much more at home in the Anglican church than I did and and And just give us a sense.
35:38I mean, do you believe in the virgin birth? Do you believe in the resurrection? Yeah. Yeah, those are the sort of the central tenets of our faith.
35:51And is that because you've had a sort of personal, intense religious experience that helps you towards that? Yeah, I think going back to when I was baptised and confirmed, which is when I was 10 years old, I had to fight my parents to be baptised and confirmed. What? You didn't want to? No, I wanted to be. And they didn't. I mean, my mum actually is now a Christian, but my parents at the time were kind of atheist, and they thought I was too young to make the decision. And I begged and pleaded and begged because I used to go to church every Sunday. And what was going on when you were begging and pleading?
36:25What did you think you were begging and pleading for? What was the thing that was going to give you that you felt you needed? Well, these are rites of passage in the faith. and I was already aware that I hadn't been baptised as a baby and so I already felt I'd missed out on something. And also the confirmation was about me making a commitment to my faith. And there was a bit of me that thought, what the hell has it got to do with you, my parents? I've made this choice. This is my faith. This is my commitment. It's got bugger all to do with you. And so at that age already you had a strong belief in God, which has wavered at times or just stayed with you constantly?
37:02My belief in God has not wavered. my connection with my faith has and i've now managed to reconcile those two things and have reconciled that but you retain a strong belief that there is a god yes very very very strongly um and but and a belief that jesus christ not only lived and existed but he's the son of god and was sent to sent as our savior so that's those those are the sort of central tenets yeah i can't remember what age you were when i came out with we don't do god but you was that a tactical or a strategic error i was making do you think No, I think there are definitely people out there, and this is for me the great sadness, there are definitely people out there who when you talk about your faith, they instinctively worry about.
37:47And actually, interestingly, I think this applies to an extent to politicians of other faiths. But there definitely seems to be a fear of Christians in politics. Because I think people think, well, if you're a legislator, does that mean... And this is for me the sadness about how people view Christianity is they think, well, that means you're going to take away my right to choose. That means you're not going to respect my right to marry. And it suddenly becomes this sort of, they associate Christianity with social conservatism and they fear that if we're religious that we're going to impinge on other people's rights.
38:23That's never been how I've cast my vote as a legislator. But you're right that it is also a challenge for people of other faiths too. So if you were sitting opposite me, I mean, we've interviewed a lot of Muslim MPs who've talked proudly about the faith, the fact that they're Muslims, but they never quite go as far as you've done. They never quite lean into the microphone and say, there is no God, but God and Muhammad is his prophet. So I would say that actually as a Christian, you're able to go a little bit further. You can put the tenets of your faith out there without pushing people back. I mean, at the moment there is a very ugly toxicity about Islam.
38:58I mean, we saw this this weekend with the demonstration on the streets of London where kids were chanting, you know, Allah, Allah, who the beep is Allah? And you just think, hang on a second, we would be up in arms if there were protests that were so... I mean, I'm not one of these people who'd be protesting against the life of Brian. It's one of my favorite films actually, come to think of it. I love the fact that when I went to see the Book of Mormon, which is outrageous, in the program is an advert from the Mormons saying, you know, you've seen the show, now read the book, which I just thought was wonderfully self-deprecating humour.
39:34I just think, hang on a second, one of the great things about this country is we are a Christian country, but we are a multi-faith democracy. and whatever disagreements I have with Rishi Sunak and his politics, I love the fact that this country has a Hindu prime minister. I love the fact we've got a Muslim mayor of London. I love the fact until recently we had a Muslim first minister of Scotland. And I look at the way sometimes people of faith are treated in politics and it makes me feel sad. And there are legitimate questions. It is entirely right to ask Kate Forbes, would you vote to protect my rights?
40:11Would you vote to roll them back? If there's a vote to extend my rights, how would you? It's totally legitimate. But I feel that at times, particularly in the case of Kate Forbes, and I think it's applied to other politicians, there's been a degree of ridicule that I wouldn't tolerate if that person were ridiculed for being gay or for being trans or for having an identity that is not considered to be the norm, the mainstream. So, Wes, this has been great. We're coming to the halfway point. And we're going to move on after the break to do health, social care, mental health, and some of the policy issues.
40:43But thank you very much. Take a break.
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41:22Welcome back to The Rest of the Problems, leading with me, Anastair Campbell. And me, Rory Stewart. And Wes Streeting. So Wes, we've talked about you a lot. Let's talk about the National Health Service. And let's again try and do it as you did admirably in the first part of the discussion without slipping into election talking points and i'll i'll spot the bile off just to ward you so we are just over a week into the general election campaign this is a hard ask i accept it i will try and deprogram my brain and i'm not going to start by say list the six first steps because i know that got you into trouble not on another interview but never mind uh can we start actually can we start with can we start with mental health yeah so you talk about if i can give you one of the talking points 10 years of national renewal let's say at the end of 10 years of national renewal what do our mental health services look like how different are they how much better will they be my hope than um than they are now well firstly i'd hope that we're and this applies to physical health as well but i'd hope that we're intervening a lot earlier and we are doing a lot more on the prevention side getting people access to support services treatment far earlier there's a reason why we use the cliche prevention is better than cure and it particularly applies in medicine and mental health is no different to physical health in that respect.
42:39We've got to make sure that at the acute end of the spectrum the services are high quality. That's a far cry from where we are today. We see far too many people detained and far too many people hitting crisis points because we don't get there early enough and it's one of the reasons why and I'm really proud of the actually some of our mental health policies have been around for years. There were some of the earlier policies that Keir announced as leader of the Labour Party, which I think says a lot about where he is on this. But if we're able to put mental health support in every primary and secondary school in the country, I think that gets to young people a lot earlier, both in terms of preventing mental ill health and promoting positive wellbeing and helping young people to cope with this extraordinary range of pressures that didn't exist when I was growing up.
43:27community mental health hubs in every community eight and a half thousand extra mental health support workers we've deliberately gone at the kind of the earlier end of making sure that people avoid hitting crisis point and even on the crisis point i'm really sad actually genuinely sad that we reached the end of this parliament without reform of the mental health act because there was a bill that went through scrutiny among both the commons and the lords we were waiting for the government to introduce it formally and they didn't. I don't understand why. It's wildly out of date. Those will be the first steps we take on mental health.
44:01But ultimately, I want to make sure, and I've avoided actually on the campaign trail saying, we're going to deliver parity of esteem. I think, do you know what? People have heard this all before. Let's just do it rather than say it. It doesn't exist. Before we get on to the solutions in your policy, just to dig a little bit into the problem that we face. You wrote, I thought, quite a good piece in, of all places, the Daily Telegraph on this, where you pointed out that four out of every 10 pounds of our normal current spending is now going into the NHS. We're spending on whatever is 165 billion pounds a year.
44:37The costs of running a health service keep going up above inflation. If you just kept spending at an inflation level, you wouldn't keep up because we're getting older all the time, because the drugs are getting more expensive. We're in an odd position where, oddly, Theresa May did put a bit more money into health, Boris Johnson put a bit more money, and then NHS transformation plan under Rishi Sunak is promising more money in the future. Quite a lot of money going in, but still a real sense that the whole thing is creaking. You explained how long these waiting lists are in treatments, A &E bust, morale very low, nurses, doctors, GPs.
45:16So just before you get on to what you're going to do to fix it, sketch where you see the problems. If you were going to be grim about the situation, give us the negative picture of what's wrong with the NHS. I'm so glad you entered the discussion through that kind of prism because I'm always asked, well, where's the extra money going to come from? And people always rush to talk about the spending. And as if the question is, is it an extra two, four, six, eight, ten, twenty billion rather than where's nearly£170 billion of our money going and why are we getting such terrible outcomes compared to other OECD countries?
45:51And when you look across other leading economies and why their health outcomes are better, it's actually not to do with the model of funding and the fact the NHS is a single payer system free at the point of use. It is to do with the fact that when it comes to spending on hospitals, we're pretty much top of the table. But then you look at primary care, community services, mental health, social care, diagnostics, where either near the bottom, out the bottom, or seriously lagging behind. And you think it's got nothing to do with the funding model? No. And I think in a nutshell, we've got an NHS that gets to people too late.
46:23And therefore we do late diagnosis. It gets them in hospital rather than earlier on before they get to hospital. Yeah, and too late in the, the later you get to people, it tends to be far more expensive to do the treatment and you're less likely to be successful in terms of the outcome. Give us an example of a particular case or disease or something where you can illustrate this point about if you leave it too late to get to hospital, it's far more expensive to do it. I mean, mental health is one, obviously, but like cancer is also, you know, the obvious example where, you know, your outcomes at stage four, you're so much more likely to die with lung cancer than if you're caught at stage one or two.
46:58My own experience with kidney cancer, you know, caught at stage one, the one thing, there are two things I didn't have to worry about. One was dying because I knew enough to know that I wasn't going to die. And that was relief, put it mildly. But secondly, you know, not having to worry about the bill is important. And that's important to me. and you know and even before you get to like the worst fatal outcomes if someone can't get a gp appointment which would cost the nhs about 40 quid they end up in a and e which would cost 400 so you can see how inefficient resource allocation is across the system can i just um i mean this it's such a complicated system isn't it i mean just give us a sense if you as i'm sure you will become such a state for health in six weeks time how many people work in the national health service roughly how many hospitals are there, how many GP clinics, how many patients are going through the system?
47:46Yeah, we're looking at about one and a half million. And that's the NHS, you've got social care on top of that. So one and a half million people that you're sort of responsible for in that. Yeah. And look, part of my thinking about what kind of health secretary I would want to be and how we deal with this challenge is recognising the role and responsibility you bring to bear. and understanding the systemic change that you can help to drive. And it goes back to the earlier question you asked me, Alistair, about what have I learned in politics previously. I do not have a messiah complex and I'm under no illusion that just by changing one person behind one desk in DHSC, Department of Health and Social Care, that we're going to fix everything.
48:35This has got to be a whole team effort. and it would be my job if we win the next election to put in place the right system support to enable people at every level of the system to deliver the outcomes and you know if we if we look at our hospital-centric system for a moment and we look at the queues of ambulances outside the front the busy a and e departments the chock awards the best hospital leaders in the country have recognized that the solutions to the crisis in our hospitals are systemic and they lie beyond the hospital So if we've got better primary care and community services, we're less likely to see people arriving in ambulances.
49:13We're less likely to see people walking through the front door of A &E. And social care, we're less likely to see delayed discharges. So the throughput of people through hospitals works so much better if you deliver the right solutions, the right system changes outside the hospital. Just trying to put it in the simplest terms. So one thing this might mean is shifting a bit more money from the hospitals towards GPs, for example? Certainly I want to see thousands more GPs trained up, cutting through the red tape that holds them back. But also over time, I want to see primary care as a proportion of the NHS budget grow.
49:44Explain what primary care is. Primary care is your GPs, your pharmacies, those sort of first points of access in the community. And alongside that, if you've got the right community support, care in people's homes, that's where you can do, in the jargon, secondary prevention. or what we might say, stopping people from ending up back in hospital. So a member of my family had a series of mini strokes last year. Fortunately, she recovered well. She was discharged back home and in an outcome that will surprise very few people who work in the NHS within days of being at home because there wasn't the right community nursing in place, the right care in the home.
50:25She fell, fractured her hip, was back in hospital and on a pretty horrible orthopedic recovery pathway as well as a stroke recovery pathway. That's where having the right support available to people in the community and people's homes can prevent people from needing the very expensive hospital care, which costs thousands in terms of bed occupancy. I was in hospital recently, and like you do, you talk to all the nurses and all the doctors and what have you. And this very, very strong feeling I got was that they desperately want to change the government, but also that they feel you will pay them more.
51:01Well, they can judge us on our record and that's absolutely accurate. In 1997, we had the same pressure on pay restoration. Will you restore pay to where it would have been if it had kept up in line with inflation? and in 1997 very much like now we had a shadow chancellor and a leader who said hang on a minute the promises we make have got to be promises we can keep and the country can afford so we're not going to promise to deliver full pay restoration because we can't spell out exactly how we will pay for it and by when but that Labour government did deliver full pay restoration and I'm very confident if we get the economy growing that we can improve people's not just pay but their working conditions too I'm not going to say the obvious, which is that that's a big bet on growth.
51:47The reason Gordon Brown and Blair were able to do it is the economy grew and they inherited a growing economy and you're inheriting an economy that's in bits. And we did a bit of hypothecated taxation. A bit of hypothecated taxation, yeah. We won't get into that. We can talk about that later.
52:04What sort of manager you think he'll be? How are you going to think about... Alan Milburn is one of my great heroes in the world. He's a great believer in the fact that You can't run all the things from the centre. He said the problem with my former colleague, Steve Barkley, as he was trying to get into the details of what was happening on the wards. Yeah, it was crazy. And his view is you needed to trust hospitals. Tell us a little bit about that. And that's then over to Alistair for his last question. Yeah, actually, I don't really think of myself as a manager, but as a leader. And I think that's the responsibility of the Secretary of State for Health and Social Care.
52:32It's not to micromanage. It's to make sure that at every tier of the system, you've got the right people with the right skills, delivering the right kind of change. and the thing that gives me great hope and confidence about what the future of the NHS could look like are the incredible people who are showing us what that change looks like already albeit in pockets and if all I did was to take the best of the NHS to the rest of the NHS we would see enormous productivity gains vast improvements in patient outcomes and better use of taxpayers money Anna Milburn is one of my heroes too and one of the advantages that I've got is I've got Alan and a whole bunch of successful former Labour health secretaries in my corner giving me advice.
53:11I work really closely with them to learn from both the things they got right and also the things they got wrong. And one of the things I loved about your conversation with Alan on this podcast, and I'd encourage people to look back at it, is for someone who I remember when he was in government, it was like, you know, Alan was like just this huge character, very confident, very self-assured. He is so much more humble in person than I would ever have expected to be when who was in the cabinet. And maybe that's what kind of cabinet office does to you. But he is one of my, I think Alan's hugely impressive.
53:41And I'm really glad that I can draw on his advice frequently. Well, listen, Wes, you're a busy man. You're on the campaign trail. You've got thousands of interviews to do. So we will definitely have you back if you get back. But you don't look tired, which I'm surprised at. I'm running on caffeine and adrenaline. And honestly, I mean, just over the first week of this campaign has been one of the most fun weeks of my life. I'm enjoying this campaign, absolutely loving it. In fact, I did a mammoth 6am till 3pm media round the other day and absolutely loved it. Thank you very much, Wes, for coming on.
54:15I'm now doing the V sign at Miss Kirsty O 'Brien, who's trying to get you out of the studio. Listen, let me tell you, Wes, and let me tell Kirsty as well, you'll have more people watching this than watching this daytime telly. Thank you, go ahead. Wes, thanks again. I really love the conversation. Hopefully come back. Cheers. Thanks a lot.
54:33Well, that was a slightly sort of odd interview because where suddenly his people appeared at a glass screen behind us explaining that he needed to leave half an hour earlier than we were expecting. So we didn't actually get into the details the NHS much we wanted. I think we did some lovely stuff in his early life, but we're going to have to get him back to really get into the nitty gritty of the policy stuff. In a way, I think that given he is one of the key campaigners, he's going to be talking an awful lot about the National Health Service. And I think people will enjoy listening to him to talk about his, not just his family background, but I was also quite, I was impressed by the way he came straight out on the God stuff.
55:09That was good. That was good. That was really interesting. Normally when people talk about the faith, I'm afraid this is true of me as a sort of wobbling Anglican. Yeah. You know, he was pretty clear. These are the tenets of my faith. I believe in the virgin birth. I believe in the resurrection. I believe Jesus Christ, the son of God. And he's also right that, because I argue with my sister, who's pretty much, you know, she's a very committed Christian. And she's always saying to me, she thinks it's really bad the way that Christians feel that they cannot talk about their faith in politics. So, yeah, he felt no compunction at all.
55:40And the other thing I did say to him before the interview is, you know, no talking points, no electioneering, proper conversation. And it was definitely that. It was definitely that. And it must be lovely for you to know you've got a shared hero in Alan Milburn. Yeah, absolutely. And a shared hero in his grandfather, who's exactly my kind of person. Not the armed robber, the soldier, the monarchist. Yeah, yeah, yeah. He's exactly my kind of... So you like the right wig, Bill. I love the vision, because he's also... I love the fact that he was a really kind, compassionate grandfather. I thought that told me a lot about him.
56:17I think you can see why people do look at Wes and think he's got something a bit special. And joking aside, but I was expecting by now that he'd be looking a bit sort of baggy. I mean, I'm not even campaigning and I'm feeling exhausted by this campaign already. But I get the feeling that just as he enjoyed Cambridge and I didn't, I get the feeling he really enjoys election campaigns, in which I found them. You hate it. I didn't hate them, but God, they're hard work. And of course, it's even harder at his level. I mean, the ones that I enjoyed were when I wasn't that senior. So when I was running, because the elections were always in May and June for me.
56:55And it's Cumbria at its most beautiful. The gorse bush flowers there. I'm going through every village. I try to cover 100 villages in each campaign. And it was just beautiful. Really amazing. You get every excuse to be out in the fresh air. You're on the back of trackers. Whereas if he goes to his constituency, he just has to look at traffic lights and step in the orphanage. Good. Well, we're getting back if and when. Labour in power. Thank you Alistair. Bye bye. All best, bye.
From the publisher
Could privatising areas of the NHS save it? How easy is it to reconcile one's faith and sexuality? What is Labour's plan for health and social care?
Rory and Alastair are joined by the Shadow Secretary of State for Health and Social Care, Wes Streeting, to discuss all this and more.
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