Wes Streeting takes NHS mandate 'back to basics' as health secretary wages war on overspending

“The culture of routine overspending without consequences is over”, Wes Streeting has warned, as he unveiled a new, trimmed-down mandate for the NHS. The health secretary, who said he will bring the health service “back to basics”, warned that the “NHS must learn to live within its means”. His new targets include cutting waiting list times, improving access to GPs and dentists and improving urgent and emergency care.

In a foreword to the 2025 mandate, Mr Streeting said the approach will put “the NHS on the road to recovery”. “The last Labour government delivered the shortest waiting times and the highest patient satisfaction on record. It won’t be easy, but together we’ll do it again”, he said.



“We recognise that this will mean tough decisions need to be made and local systems should feel empowered to make them”, Mr Streeting warned. "The culture of routine overspending without consequences is over." While the health secretary has insisted it will “deliver on patients’ priorities”, health bodies have expressed concerns that the new mandate will sideline important programmes, risking patient and staff health and wellbeing.

“We are telling the NHS to go back to basics and focus on the fundamentals. It needs to deliver on patients’ priorities – shorter waiting times, being able to get a GP appointment and ambulances that arrive on time”, he told The Telegraph on Wednesday. The Royal College of Surgeons (RCS) of England noted there were still no national targets or deadlines for the NHS to implement sexual misconduct policy, but argued it should remain a top priority.

Professor Vivien Lees, vice president of RCS England and Council lead for sexual misconduct, said: "While we support the secretary of state's push for focused NHS priorities, including waiting times, we argue that addressing significant cultural and workforce issues, particularly sexual misconduct, is crucial for improving NHS working conditions. “We want NHS England to deliver a detailed roadmap for implementing the National Sexual Misconduct Policy Framework, complete with clear timelines, milestones, and accountability measures, as part of its planning guidance. “Failure to prioritise this framework will let down those who experience unwanted sexual attention and behaviour when they are at their most vulnerable.

This is a time for the NHS to get its house in order and to demonstrate to staff and the public that there really is zero tolerance for sexual misconduct.” Mr Streeting’s mandate comes after chancellor Rachel Reeves announced a £26bn injection over two years into the health service in her first budget. On Wednesday, MPs expressed “frustration” over “lengthy and diffuse answers” given by senior health leaders as they were challenged over NHS performance in a Health and Social Care Committee hearing .

NHS England chief executive Amanda Pritchard was questioned after a separate Public Accounts Committee report concluded that NHS and Department of Health officials were complacent and “out of ideas” on transforming the health service for patients. Ms Pritchard said there were “factual inaccuracies” in the PAC report, adding: “I would like to say NHS England is absolutely not complacent about productivity, and it is completely wrong to suggest otherwise.” She also insisted women’s health was a priority, as she was quizzed about medical misogyny in the NHS.

“Can I first say I agree with you on misogyny – I think we’re really clear that there is a big cultural challenge within the NHS, and the work of the committee has been really helpful in shining a light on that,” she said..