Will fixing the NHS be enough to save Starmer's government? Maybe. But only on one condition

Fixing the NHS will not be enough to save the Labour Party, experts have said – unless they work out how to sell it to the public.

Keir Starmer and Wes Streeting unveiled the government’s 10-year plan for the NHS yesterday (3 July).
The plan will “fundamentally rewire” the health service, the prime minister said, shifting care out of hospitals and into a new network of neighbourhood health hubs and embracing AI-enabled technology.

“It’s only Labour governments that can do this,” he told reporters. “It’s only a Labour government that can therefore make the NHS fit for the future.”

Read more:

• The NHS is facing an existential crisis. Can Labour’s 10-year plan really save it?
• We all clapped for the NHS during the Covid pandemic. Did it actually do… anything?
• Mental health patients find it ‘impossible to get help’ amid Manchester care crisis: ‘It makes you ill’

His Labour government certainly needs a win. After one year in government, public approval is at rock bottom; Labour trails Nigel Farage’s Reform UK by up to nine points. Earlier this week, a backbench rebellion forced the government to make 11th hour concessions to its flagship welfare bill; on Wednesday (2 July), chancellor Rachel Reeves was visibly distressed during PMQs.

Public dissatisfaction is being driven not just by policy outcomes, but also by perception, experts say. Early scandals and unpopular cuts – such as the now-abandoned winter fuel payment reduction – contributed to what Colm Murphy, lecturer in British politics at Queen Mary University of London, describes as “eroded trust”.

In this context, health service improvement takes on an urgent political dimension.

“The NHS will very likely be critical to the government’s re-election, or eviction, in 2029,” he added.

Measurable improvements to the NHS would be a serious boon for the beleaguered Labour team, says professor Patrick Diamond – former policy adviser to Tony Blair’s Labour government.

“The government has found it very difficult to deliver tangible improvements in the areas that voters really care about, of which I would say the two most important are the economy in the NHS,” he told Big Issue.

“[Improving the health service] would be a major card to play in a general election campaign. Because I think when you look at voter’s priorities, the NHS is always high up the list. It will be high up the list in three or four years time.”

The NHS remains “one of the highest issues that voters cared about” in 2024 – and still ranks in the top three, says Murphy. If performance doesn’t improve, it could “blow a hole in the government’s pitch to voters”.

Will Labour’s 10-year health plan work?

The 10-year plan – analysed by the Big Issue in more detail here – has been broadly welcomed by healthcare unions and experts.

“This government inherited an NHS on its knees, and there are no quick fixes for the deep-rooted challenges it faces,” said Sebastian Rees of the IPPR think tank.

“But by shifting the centre of gravity from hospitals to neighbourhoods, strengthening local services, and seizing the huge opportunities that lie ahead in innovation and technology, ministers have begun to chart a path to long-term renewal.”

But “delivery” will be the real challenge, he continued: “That means sustained investment, tough choices on priorities and meaningful accountability. The plan is welcome – but it must be the start of a decade of determined action.”

Independent think tank The Health Foundation echoed this concern.

“We welcome many of the changes in the plan – more integrated services, boosting primary and community care, harnessing innovation and technology, reducing health inequalities – but these are not new ideas and questions remain about how will be implemented and whether they will be backed by sufficient resources,” said Dr Jennifer Dixon, chief executive.

“Standing back, making the plan happen with the resources on offer will be tough. Health spending will grow by 2.8% a year in real-terms between 2025/26 and 2028/29 – lower than the historic average (3.7%) and much lower than Labour’s last period in government (6.8%).”

Capital investment – in buildings, equipment, and IT – will grow by just 1% a year.

Without sufficient funding, it’s unclear whether the government will make sure voters feel improvements to the NHS. Likewise, the necessary focus on prevention means improvements go on behind the scenes, and aren’t immediately felt.

“The last period when patient satisfaction was rising in the NHS was in the 2000s, and that was the product of a lot more money, but also a really ruthless focus on things like reducing waiting times, clearing backlogs, obviously having targets around the time between diagnosis and treatment,” Diamond said.

“The current focus on prevention is very good and necessary, but it’s harder to make patients feel that immediately.”

To achieve its ambitions for the NHS – and find a coherent political message – the government perhaps ought to consider a targeted ‘health tax’, Diamond suggested.

“If I was Labour, I would consider fighting the next election around a targeted tax increase for health,” he continued. “Because that would create a very clear dividing line with the opposition. You would lose some votes, perhaps, but it would be a principled position on which to fight, and generate needed revenue.”

Labour’s search for a message

Labour has struggled to find a “principled position” since last July, says Dr Richard Johnson, senior lecturer at Queen Mary University of London.

“A lot of the problems of the government began when it was in opposition, particularly actually with respect to its approach to policy,” he told Big Issue. “The message that came out of the Starmer leadership in his four years as leader of the opposition is, let’s not have any policy fights. Let’s not have any big policy debates. That’s quite unusual for Labour. The strategy was, you know, we don’t want to be seen as a divided party. The Tories are making enough of a mess of it. Let the focus be on how bad they are, and will come in by default. Short term, that worked.”

But in government, Starmer’s rigid opposition to ‘ideology’ – exemplified in his claim that ‘there is no such thing as Starmerism’ – comes across as directionless and technocratic. The government has come under fire from its left flank for decisions around the two-child benefit cap and the winter fuel payment. But the main problem is a lack of justifying ideology, Johnson said.

“Labour in government often does things that traditional labour, grassroots, are not so happy with. But thinking back to when Blair came in with a similarly sized parliamentary party in 97 you know, he did welfare reform, and it was very unpopular with a lot of people in the Labour benches,” he told Big Issue.

Blair removed the lone payment premium, a benefit top-up for single parents.

“Blair knew it was going to be unpopular, and he spent months inviting Labour MPs to meet with him, to have the debate, to have the argument, to have a discussion. What’s lacking with Starmer is that he’s not really prepared to almost intellectually defend what he’s doing, because everything is just tactical.”

The success of the government’s NHS plan is not only about the outcomes that it delivers. For Labour, it’s also how they spin it. Without a mooring ideology, that is difficult.

“You cannot allow the policy to speak for itself,” he said. “You have to be able to constantly be arguing and coming back to it. They say, good politics is when people start to roll their eyes when they’ve heard you say it enough times – like David Cameron’s ‘fixing the public finances’ slogan.

“People have such low trust in politicians that if you are not constantly going out there and arguing and showing and demonstrating what changes it is that you’re delivering – then even if that change happens, I don’t think you just get credit. I don’t think people would just go, ‘Oh, I can get my medicine more quickly. I can see a GP – thank you, Labour government.’ I mean I think that gratitude is not automatic now.”

And while the government promises transformation, it is already under growing internal strain. “The need to retain fiscal prudence and invest and reform long-term will clash with urgent, expensive problems,” Murphy warned. Without growth, “the government will continue to fracture.”

Improving the NHS could stave off some of this kind of fracturing – but only if voters feel it.

The stakes are high, Diamond adds: “We could be cratering to a Reform victory, and the first time in a century where we could have a government that’s not led by Labour or the Conservatives.”

Real stories. Real impact. Real change.  

No clickbait. Just trustworthy journalism that gets to the heart of big issues in the UK and beyond. Words drive real change.

If this article gave you something to think about, help us keep doing this work.  

Support independent journalism from £5 a month.