Why Wes Streeting’s 6 billion NHS Cost-Cutting Approach Is A Terrible Leadership Role Model.

The NHS is having to cut costs, to save £6.6 billion, but why is the approach of Wes Streeting the Health Minister acting as a terrible role model and leading the health service down a dangerous path?

The NHS Budget Cutting Crisis

This is not political: I’ve no doubt Wes Streeting means well. His intentions to tackle the NHS’s 6.6 billion budget crisis by cutting ‘bloated bureaucracy’ needs clear action. However, his current approach is setting a horrendous role model and that risks leading NHS on a dangerous and potentially destructive path.

In a recent Guardian article, Streeting says: “My team and I are going through budgets line by line, with a relentless focus on slashing bloated bureaucracy.” On the surface, this sounds proactive. But think about this, these decisions are sudden top down, no attempt to learn or understand, no discussion, no collaboration, no understanding of consequences or outcomes. This lacks any genuine understanding of the complex realities within the NHS.

Cuts to Local Systems.

When abolishing NHS England the health secretary talked about moving decision making from the centre to empower local systems. “This will allow us to move decision-making closer to the front line, empowering local leaders and systems to drive improvements in patient outcomes and tackle health disparities.” But the very same week they announced 50% cuts to the Integrated Care Boards. Devastating the very people whose job it is to improve local services. Whilst the NHS 10 Year Plan is still yet to be announced it is hard to understand how this can enable local services to deliver the 3 big shifts as part of the NHS’s New Plan.

• moving care from hospitals to communities
• making better use of technology
• focussing on preventing sickness, not just treating it

A Rotten Role Model of Leadership

Effective leadership demands role modelling. Leaders set standards through their actions, not merely their words. By making arbitrary, spreadsheet-driven decisions about cuts, without consulting local communities, service users, or frontline staff, Wes Streeting is inadvertently demonstrating a terrible standard. His approach risks embedding uncertainty, insecurity, and fear into NHS culture. It also suggest that the best way to save money is to simply cut staff. But as this post argues what happens is you lose the experts and the bureaucrats stay on ready to grow again immitating this very same style of leadership.

Role Modelling Hypocrisy

Moreover, there’s a disturbing contradiction in Streeting’s rhetoric. He publicly criticises centralised, top-down control ““The NHS is far too centralised. Power needs to shift from the top down to the local level so that those who know their communities best can lead the change we need.” (The Independent)

Yet simultaneously insists 

“I need to get my hands on the controls of the NHS so that I can grip the crisis and get the NHS back on its feet” (The Guardian)

Is it one rule for him and another for everyone else. Such contradictions verge on gaslighting: The idea he is making changes ‘for their own good’ and ‘he is here to help us’ 

The Danger of Spreadsheet Management

Streeting’s approach is also a terrible role model for the NHS as it appears to rely so heavily on spreadsheets and budgets. Spreadsheets keep you stuck in your own niche when making decisions. The spreadsheet is NOT REALITY.  Spreadsheets offer an imaginary form of order, but when divorced from real-world understanding, they can lead to chaotic and harmful outcomes. Not everything that really matters appears is on a spreadsheet and so whilst top down bureaucratic change can lead to endless cycles of failure. (Read more here)

A Poor Example to Follow:

Consider a not unlikely scenario six months from now: demand from patients is higher than expected, whilst planned productivity savings will prove illusionary, and NHS services will be losing money. Should healthcare managers followed his role model: whip out their spreadsheets and start announcing job cuts? Their decisions based on control and power: Such knee-jerk reactions only encourage short-termism, panic-driven decisions, and siloed bugeting, saving money in one area by inadvertently harming another. 

Keeping the NHS Titanic Afloat

The NHS is sinking into a funding crisis. The financial challenge of a £6.6 billion of overspend is significant. But Streeting’s approach is like choosing bits of the NHS Titanic to throw overboard in a desperate attempt to keep the broken NHS afloat. It is just panic and increasingly risks breaking something essential. (As Ashby’s Law of Requisite Variety Suggests is highly likely). It is far better to find and seal off the leaking area and repair it.

Why is the NHS Leaking Money?

We need to ask: where’s the real leak? It’s not your likely your local GP surgery or mental health service. Quite frankly with tight contracts it’s hard for them to overspend significantly. Whereas Hospitals account for around 60% of NHS costs. They are almost certainly the leak. You can’t cut a hospital if it spends too much so it is almost certain that they are the financial leak. And while we can’t ‘cut’ a hospital, we can be honest about where the overspend is happening, and how to address it structurally, not politically.

Why Fixing the Leaks Rather Than Getting Rid of People Is the Priority

If the leaks aren’t addressed directly, hospitals will continue absorbing an ever-increasing share of NHS resources. This imbalance harms community-based services, GPs, mental health care, and preventive care as they are cut and hospitals spend ever higher proportion of the NHS budgets. Rather than panic cutting, the focus must be on identifying the leaks, sealing them off, and stabilising the situation.

A Better Path Forward

Wes Streeting still has the opportunity to set a different role model, one rooted in collaborative decision-making, using relationships to empower change, listening, learning, and understanding the frontline realities of NHS staff and patients. Explore what is possible, rather than blindly making top down decisions using spreadsheets, he could lead by engaging those who know best how to work more efficiently and focus on areas that dont damage essential services: entrusting the frontline leaders the clinicians, nurses, carers, and communities who see the problems daily.

If Streeting chooses collaboration over control, he can reverse the current trajectory toward an NHS governed by fear, uncertainty, and top-down micromanagement. It’s not too late to shift direction. It is not his NHS it is OUR NHS.

The NHS deserves compassionate, informed leadership, and the best of role models for it’s leaders, not panic-driven, spreadsheet led chaos. Wes Streeting must choose wisely.

Conclusion

Wes Streeting’s intentions might be noble, but his current top-down, spreadsheet-driven strategy risks setting a bad role model for other leaders and creating a chaotic, fear-based NHS. The solution lies in collaborative leadership, genuine engagement with frontline staff, and careful repair, not reckless cuts. The NHS deserves better; it deserves leadership that heals rather than harms.