Institute for Government Warns of “Chaotic and Incoherent” NHS Reform Strategy Under Wes Streeting
A new report from the respected Institute for Government (IfG) has delivered a stark warning about the future of the National Health Service, accusing Health Secretary Wes Streeting of pursuing a “chaotic and incoherent approach” to NHS reform that threatens the government’s ability to meet its own performance targets. The findings raise urgent questions about NHS productivity, the future of primary care, and the long-term sustainability of health and social care services in England.
According to the IfG analysis, Streeting’s first year in office has produced a mixture of progress and deep concern. The report credits the health secretary with securing improved hospital performance, a significant increase in GP numbers, and the lowest rate of hospital staff turnover outside the pandemic period. The pay agreement he struck with resident doctors prevented another winter dominated by NHS strikes and helped stabilise frontline services.
However, the thinktank highlights several major shortcomings that it says now overshadow these achievements. Chief among them is the abolition of NHS England, which the report describes as “abysmally handled,” generating confusion across the health system and diverting attention away from critical reform priorities. The report also criticises a lack of action to halt the ongoing loss of senior GPs, warning that the exodus of GP partners risks deepening the crisis in primary care.
Stuart Hoddinott, Associate Director at the IfG and author of the report, said:
“While there have been some genuine improvements across hospitals and general practice, these gains have been undermined by a disordered strategy for reforming the NHS. Management cuts to integrated care boards proved an unnecessary distraction, and the government still has no coherent plan to stem the long-term decline of general practice.”
He continued:
“Nothing announced so far addresses the structural pressures driving GPs away from the profession, and some decisions may actively damage the adult social care sector. A further collapse in general practice and social care would be a disastrous legacy for the current government.”
The report also reveals that the Treasury has rejected Streeting’s request for more than £1 billion to cover redundancy costs linked to the abolition of NHS England, raising further doubts about the reform programme’s feasibility.
The IfG warns that the government is now unlikely to meet key NHS waiting-time targets, including its flagship commitment for 92% of patients to start consultant-led treatment within 18 weeks of referral. It notes stagnation—or even deterioration—in several core areas of NHS performance, despite widespread promises of transformation.
In addition, the thinktank criticises Streeting’s mixed messaging, highlighting a contradiction between his pledge to shift more care into the community and the proposal for new “integrated health organisations,” which may inadvertently funnel more funding back into hospitals.
With Chancellor Rachel Reeves placing NHS improvement at the heart of this month’s Budget, and with Streeting increasingly seen as a potential future leadership contender, the scrutiny on his performance is only intensifying. The Department of Health and Social Care has been approached for comment.
