How the strike-blighted NHS is faring under Starmer

NHS resident doctors outside Leeds General Infirmary, as thousands go on strike across England in a pay dispute. PA Wire

It was dark and wet on the first morning of the UK doctors' strike, the latest trouble facing Keir Starmer’s government.

Just over 500 days in office and Mr Starmer's woes include a stalled economy, services such as the NHS and schools stuck in perma-crisis and the impossibility of getting a grip on migration.

Somehow I had dodged the worst of Friday's rain and there was no line of pickets when I crossed into the hospital for a long-planned appointment in the strike-blighted NHS. So what did my experience say about how the system is performing under Labour?

The non-specialist cadre of resident doctors who are striking until Wednesday have a long-running grievance about pay not matching 2008 levels in real terms. They have been on strike for more than 50 days since 2023. Their orange banners and beanies have become a familiar sight at the UK’s main hospitals.

Mr Starmer’s health secretary, Wes Streeting, is openly advising their members not to join the latest action. They have had a 29 per cent pay rise and are now demanding another 26 per cent.

The doctor’s strike shows how precarious these reforms are and how important Wes Streeting's work is to the country’s finances

Going into the clinic where my operation was scheduled certainly felt pretty normal. Mr Streeting’s managers had demanded that the hospitals deliver 95 per cent of scheduled procedures and I didn't worry it would get cancelled.

So far so good. But I was invested in the process. I’ve just checked my records and the treatment was first discussed with the specialist team last December.

As a rising member of Mr Starmer’s government, Mr Streeting has a central role in maintaining faith in the system. The doctors' strike won’t help his ability to claim he can cut waiting time, improve productivity or transform healthcare services.

This matters because the health system represents more than 10 per cent of GDP and the Resolution Foundation think tank estimates that it received 90 per cent of the additional spending committed by Labour since the election. In fact, it says that half of all the spending by UK government departments will be made by the health system by 2029.

Small wonder Mr Streeting is pushing heavily back against the orange uniform-clad doctors, calling on them to defy “deaf union leaders” who instigated the strike.

Indeed, The Times newspaper reported on Monday that about half of the resident doctors had defied the strike call, changing their minds about staying away from work. According to another think tank, Institute for Government, the number of rescheduled operations had already fallen from two for each doctor on strike to 0.7 by the last round of strikes in July.

For anyone outside the UK the NHS is a globally significant player in health care. As it is free to use (mostly) in the UK, it operates by strict systems of timetabling necessary treatment.

Treatment by choice is a rarer thing that mostly falls outside its scope.

The emergency and acute functions are provided across the country and can lead to horror stories of days-long waits in Accident and Emergency or patients waiting in hospital corridors at times of stress.

The bulk of treatments are long, slow processes of logging a condition and waiting for the system to come around and produce an appointment.

There is a welter of plans available to Mr Streeting that promise to boost productivity and transform health care in the UK. The first thing that I, like many other patients, take away from the experience is how the staff is composed of talents from many countries.

On Friday, I was triaged by a nurse from Africa, with a European anaesthetist, ward staff from Asia, surgeon from a south Asian background and finally discharged by staff from Caribbean origins.

This is taking the best of the world to provide me with the care I need. But there is another aspect to how the hospital is run. When the NHS was first set up it relied on demobbed Second World War army personnel to set its organisational rhythms.

You can see the legacy of the layers of staff functions and even the demarcation by different uniforms today.

Mr Streeting has a 10-year transformation plan that would dilute this legacy and that is probably a good thing. To get the ball rolling he has resourced the service. The system has responded, for example, in the strike by trying to deliver that 95 per cent target of uninterrupted service despite tens of thousands of doctors suspending their work by five days.

Yet another think tank, Re:State, says Mr Streeting's battle is largely about boosting patient handling or "flow". It wants to see the hospital of the future rethink the patient journey with a digital passport carrying those needing treatments through the system and unlocking the army-like loyalty to unit that can been seen at various stages of the operations.

For more than a year, the Labour government has pushed changes in this key area. It is clear there is a plan to re-engineer the system. The doctors’ strike shows how precarious these reforms are and how important Mr Streeting’s work is to the country’s finances.

With gloom and doom dominating the UK's headlines ahead of next week’s budget, it is important to remember that Labour can have an impact where it matters. It's just that the headlines can sometimes point to the opposite conclusion.