The NHS will not be turned around in one budget, the health secretary, Wes Streeting, has warned, saying measures to be announced on Wednesday would “arrest the decline” amid significant reform of the health service.
Streeting told broadcasters new efficiencies in the health service would be the key quid pro quo for significant investment. The government is expected to announce a spending boost of at least 4% to the health budget.
Reeves said on Monday new cash would continue to drive down waiting lists, delivering more surgical hubs and radiotherapy machines – with the aim of an extra 40,000 appointments a week.
Streeting said on Tuesday he was confident there would be substantial improvements to the NHS over the course of the parliament. “I think people are realistic, you don’t fix the NHS overnight,” he told BBC Radio 4’s Today programme.
“You don’t fix it in a single budget, but over the course of this parliament, you will get the NHS back on its feet at the same time as making the right long-term decisions that will make the NHS fit for the future.”
Streeting also said he would not guarantee that the funding would make a difference in time to avert a winter crisis this year. “I will always face up to the challenges. I will not stop the difficult decisions or the fact that there are still problems to be solved, and you will see me on the frontline this winter, where there will still be challenges, because you can’t just wave away the pressures,” he said.
Streeting accepted that social care reform remained a significant challenge to be tackled, admitting “you cannot fix the NHS without fixing social care”.
He declined to set a specific direction on social care in the short term, saying he hoped to try to build “a cross-party consensus” on how to find a solution. “We are also thinking about, as we build the long-term plan for social care, how best to create a degree of national consensus around the national care service in a way that we have done over the last 76 years with the National Health Service,” he said.
Amid challenges from the Tories about how to define a “working person” who would not be hit by tax rises, Streeting said he considered himself to be one – but also said he was not the kind of person the chancellor, Rachel Reeves, had in her “mind’s eye” when it came to the budget.
“What I will say is that in our manifesto we were very clear about the steps we were going to take to protect working people, which was ruling out increases in income tax, national insurance and VAT, and despite all the pressures that we are under and the scale of the black hole in the public finances, we will honour every single one of those commitments,” he told Sky News.
He told Kay Burley: “With the greatest respect to you and I, and the jobs that we do and the salaries we’re on, and I know you work hard doing your job, I don’t think the chancellor’s worried about whether you or I are going to get by. She is worried about people on low and middle incomes.”
He also defended the decision for Reeves to trail some aspects of her budget early – including changing the rules of borrowing – saying it was vital not to spook financial markets. It came after criticism from the Commons speaker for briefing too much of the budget before it came before MPs.
Streeting said: “It was important for the chancellor when she was in Washington last week to explain the context in which she’s making some big reforms to our economy and the way that she handles investment in our national infrastructure. That was important to make sure that this budget lands in the right context with the financial markets.
“We saw what happened with Liz Truss and Kwasi Kwarteng when they ignored the Office for Budget Responsibility and sidelined them, when they took the markets by surprise, they ended up tanking the economy, and we are still paying the price for it.
“But we do take the speaker seriously. We take parliament seriously. We are members of parliament first and foremost, and we’ve all heard very, very clearly and plainly what Mr Speaker said yesterday, and we will certainly be taking that into account in terms of our conduct in the coming days, weeks and months.”
