DAUK notes that in his statement, Streeting cited the government’s unpopularity. However, many NHS staff will feel he had become an increasingly unpopular health secretary.

There has been a growing sense that the concerns of frontline NHS workers, and in particularly doctors, were not being listened to or addressed.

DAUK hopes that whoever succeeds him will take a more collaborative approach and will genuinely listen to NHS staff.

Ten Year Health Plan concerns

DAUK has raised concerns about several aspects of the Government’s Ten Year Health Plan, including the increasing role of the private sector in NHS delivery, unresolved issues around pay and working conditions, training.

There are also concerns linked to the Single Patient Record, the involvement of Palantir Technologies in NHS data systems, and the lobbying of Government by corporations and private individuals .

The challenges facing the NHS are significant, and meaningful reform will only succeed through partnership with the workforce delivering care every day.

Meaningful engagement

Dr Matt Kneale, DAUK co-chair, said: “Doctors do not need another period of headline-driven reform, rushed announcements, or policy made without meaningful engagement with the workforce.

“The next health secretary should begin by rebuilding trust, meeting frontline staff, listening without defensiveness and recognising that patient safety and workforce morale are inseparable.

“That means tackling unsafe scope creep, ending the use of ACPs as substitutes for doctors on medical rotas, being honest with patients about who is providing their care, and engaging seriously with the profession to avoid further industrial action.

“It also means addressing doctors’ concerns about the impact of the new draft GMC order, which appears to reverse years of agreed progress on how health regulators should interact with their registrants.”

Stability and leadership

Dr Sarah Jacques, DAUK GP co-lead, said: “During a time when we desperately need stability and leadership, I am concerned about the chaos that we are seeing again.

“However, I am not sad to see the resignation of a health secretary who has shut down the voice of general practice and made conditions for GPs and patients so much worse.

“I look forward to a new health secretary who is prepared to work with GPs and appreciate the genuine worth that we bring to the NHS.”

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

The letter follows Health Secretary’s recent decision to release text messages exchanged with Peter Mandelson.

Signatories to the letter, including DAUK, welcomed that disclosure but argued that the same standard should apply to discussions with donors who may benefit from government health policy.

The letter highlights concerns about the scale and source of donations received by the Health Secretary.

Private health donors

An investigation in April 2025 by the Good Law Project, cited in the letter, reported that Mr Streeting received donations from private health companies or individuals with interests in private healthcare at a rate of £10,000 per month.

The letter says that up to 60% of donations to Mr Streeting since 2015, totalling around £372,000, came from these sources.

The signatories are asking Mr Streeting to release messages relating to health policy, Department of Health and Social Care announcements, and NHS contracts exchanged with five named donors, including executives and investors linked to healthcare recruitment, private providers and US health insurance firms.

Public trust

The letter says the publication of these communications would help to reassure the public that current reforms, including expanding the use of private providers in delivering NHS services, are not influenced by undisclosed ‘quid pro quo’ relationships.

Co-chair Dr Ellen Welch, who has signed the letter on behalf of DAUK, said: “Transparency is fundamental to public trust in our politicians and the motivations for their decisions.

“When senior decision-makers receive funding from individuals and companies that stand to gain from health policy, it is entirely reasonable to ask for openness about those relationships.”

The signatories have also requested a meeting with the Health Secretary to discuss their concerns.

Transparency

Johnbosco Nwogbo, campaign lead at We Own It said: “We can disagree in good faith on the correctness or wrongness of any particular health policy, but voters need to know that private sector parties are not clandestinely influencing what ends up being decided.

“This is an opportunity for Wes Streeting to raise the bar on transparency in public service.”

Read the open letter in full below.

Dear Rt Hon. Wes Streeting MP,

Thank you for publishing your WhatsApp messages with Lord Mandelson in order to be transparent about the nature of your relationship. This step was particularly important because his lobbying firm, Global Counsel, has worked for Palantir and other firms that have a direct interest in government policy, including policy affecting the health service, which he was likely influencing.

We the undersigned are writing to ask you to extend this important step toward transparency to persons who have donated to you and with whom you have discussed health policy, DHSC announcements and NHS contracts.

With 60% of your donations coming either from the private healthcare sector, or from individuals with a financial interest in the private healthcare sector, you can demonstrate that your NHS reforms are driven by principle, rather than unaccountable lobbying.

In April 2025, the Good Law Project revealed that you received donations from private health companies or individuals with interests in private healthcare at a rate of £10,000 per month. Up to 60% of your donations since 2015, totalling £372,000, came from these sources.

We are therefore asking you to release your messages with the following persons:

• Peter Hearn, whose healthcare workers’ recruitment firms MPM Connect and OPD Group have given you a total of £197,900. He has also given you £40,000 in his personal capacity;
• John Armitage, a hedge fund manager with investments of half a billion dollars in United Health, the US’s largest health insurance company, has given you £95,000;
• Sir Trevor Chinn, a senior advisor to a firm holding investments in several private health companies, gave you £18,500;
• Kevin Craig, founder and CEO of PLMR a political consultancy that advises a firm that provides temporary staff to the NHS, has given you £13,000, and
• Red Capital Ltd, controlled by a sitting director of Europa Healthcare Group, Lord Jonathan Mendelsohn, has given you £5,000.

Releasing to the public your messages with these donors (relating to health policy, DHSC announcements and NHS contracts) would help assure the public that your policy of increasing the use of the private sector for the provision of NHS services, is not driven by a quid pro quo relationship.

We would be also grateful for an opportunity to meet with you to discuss this matter further.

We look forward to hearing back from you soon.

Kind regards

Dr Ellen Welch – co-chair, Doctors Association UK

Cat Hobbs – director, We Own It

Linda Burnip – Disabled People Against Cuts

John Puntis – co-chair, Keep Our NHS Public

Mark Ladbrooke – chair, Socialist Health Association

Jan Shortt – general secretary, National Pensioners Convention

Dr Julia Grace Patterson – director, Every Doctor

Diarmaid McDonald – director, Just Treatment

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Belittled workforce

It is difficult to reconcile the public’s expectation of unwavering compassion with the ease with which the same workforce is publicly belittled. As representatives of medical students and soon-to-be doctors, we are deeply concerned by public comments made by figures such as Mr Streeting that risk further erosion of public confidence. While we recognise that recent developments – including UK graduate prioritisation for training posts and progress on pay – suggest that collective action is beginning to have an effect, a pressing question remains: how can the Health Secretary undo what has already been said? For those of us lower down the chain, and the next cohort to inherit this rhetoric, the impact of his words has been hard-hitting. Here are some reflections from members of the DAUK medical student committee.

Joshua Haria:

“Wes Streeting’s comments are damning to the medical profession and certainly do not help the public’s increasingly unfavourable view of doctors. “It is saddening to see that doctors are not as respected as they once were, but obvious to me why so many doctors plan to emigrate. “Even some of my medical student peers have decided they are going to leave the NHS due to the continued poor offers that the government has proposed. “I am worried about joining the NHS workforce but I am hopeful that the situation may get better.”

Safira Taplin:

“As a medical student, comments dismissing the concerns of resident doctors make me anxious to join the workforce. “I worry about joining a system where I will be undervalued and makes me question how sustainable a career in the NHS will be.”

Sami MacRae:

“As a medical student and aspiring future resident doctor, undoubtedly our patients should be the core focus. Yet this does not negate the necessity of the resident doctor workforce needing to be supported, and so requires an improved relationship between politics and healthcare that is not currently present.”

Maya Machesney:

“In my final year of medical school, with friends already working tirelessly as junior doctors, Mr Streeting’s remarks could not be more insulting. “They trivialise genuine concerns and make it harder for the public to see doctors as what they are: professionals trying to keep patients safe in an overstretched system. “Ever resilient, the medical profession and healthcare workers will continue to work, deliver care and advocate for an NHS our patients deserve.”

Alyx Douglas:

“As someone who will soon be joining the resident doctor workforce, it is disheartening to hear tactless remarks aimed at them. “It is equally unfortunate to see such resistance to cooperation or compromise. “Patients benefit from the collaborative efforts of medics and politicians; the current standoff is unproductive and can’t continue.”

DAUK’s members are all volunteers. They campaign and speak in the media about issues facing doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

Attacks on BMA

Dr Hussain said ‘direct and personal attacks’ by the Health Secretary had ‘publicly undermined the BMA’s reputation’. They may ‘constitute a breach’ of the Code of Conduct for MPs, he said. Those attacks include Mr Streeting comparing the BMA to a ‘cartel’ at the NHS Providers conference in November. At the same conference, Mr Streeting said the BMA was ‘no longer a professional voice for doctors’.

Moaning minnies

Dr Hussain’s letter highlighted other instances. They included a recent interview with Sky News, in which Mr Streeting accused the BMA of ‘juvenile delinquency’ and behaving like ‘moaning Minnies’. Dr Hussain said: “As a result of these remarks, the reputation of the BMA, a respected professional body, has been publicly undermined. “The language used was strongly derogatory, dismissive of the organisation’s professional standing, and appears intended to degrade public confidence in the BMA’s role.” DAUK has given its backing to the letter.

Health Secretary

Co-chair Dr Ellen Welch said: “The attacks made by the Health Secretary on a number of occasions aren’t what the public expect from their MPs, and certainly not from a secretary of state. “His comments are unnecessarily unpleasant and hostile. “The BMA is a democratic organisation and its representatives have been voted for by its membership. “Therefore attacks on the BMA, such as accusing it of juvenile delinquency, are attacks on its membership of highly-trained, highly-skilled, and highly-motivated doctors.

Code of Conduct

“We support the calls for the Prime Minister to investigate whether they constitute a breach of the Code of Conduct.” Read the letter in full below. All of our committee members are volunteers. They speak to the media and campaign on the issues facing doctors in their own time. Please support their work by joining DAUK or donating to our GoFundMe. [pdf-embedder url=”https://dauk.org/wp-content/uploads/2025/12/Sir-Keir-Starmer-letter.pdf” title=”Sir Keir Starmer letter”]

The letter to Wes Streeting follows the imposition of a new GP contract variation from 1 October, and warns that the contract is a risk to patient safety.

It has been signed by almost 600 GPs and patients, with more than 150 copies sent to individual constituency MPs.

If general practice fails, the NHS fails

The message in the letter is clear: “If general practice fails, the NHS fails. Don’t let this happen on your watch.”

The new contract requirements demand that GP practices provide online access for patients with no corresponding investment, staffing, or infrastructure support.

Dr Ellen Welch, DAUK co-chair and a GP in Cumbria, said: “Every day, around 1.4 million people get appointments at GP practices compared with 67,000 attending A&E.

“People are getting through, we just don’t have enough capacity to see everyone.

Safe capacity

“Many practices are already operating beyond safe capacity.

“Opening up a new access route has simply created further demand that cannot be absorbed without more GPs and capacity.

“Instead, non-urgent consultations are being cancelled, staff are working late, and patients are waiting even longer.

“Clinicians are already under huge pressure and there’s a danger they will be stretched to breaking point and practices just won’t be able to cope.

“This hasn’t been fully thought through and we urge the Health Secretary to think again.”

DAUK letter

The letter to Mr Streeting calls for:

• A pause in the implementation of online access until full impact assessments and safety reviews are completed
• Proper resourcing for online access routes and service obligations. The GPs required to repair general practice exist – but the funding to employ them does not
• Support for a genuine dialogue with GP leaders, and to actively listen to the concerns that GPs are sharing through them

It concludes with a stark warning: “This contract variation does not modernise general practice, it destabilises it. And once lost, the community-based model of family medicine that defines the NHS will not return.”

The letter is the latest stage in a long-running campaign by DAUK’s GP committee. The campaign which aims to address the disconnect between policymakers and the realities faced by GPs.

Why Can’t I See My GP?

A copy of the book Why Can’t I see My GP?, written by Dr Welch, was sent to Mr Streeting, to every member of the Health Select Committee, and to all MPs who are doctors, following last year’s General Election.

Why Can’t I See My GP? highlights the crisis in general practice and offers some workable solutions.

Dr Steve Taylor, DAUK GP co-lead, said: “GPs have been called laggards and refuseniks for raising concerns about the new contract, our working conditions, and ultimately patient safety and satisfaction.

“We’re anything but laggards and refuseniks, and are providing 20% more appointments than a decade ago with fewer GPs.

Workable solutions

“But hundreds of GPs have signed our letter to say it can’t go on.

“DAUK’s GP committee has decades of experience and has put together workable solutions which we have shared with politicians.

“We’re here and ready to work with Mr Streeting and his team to solve the issues facing general practice.”

Read the letter to Mr Streeting.

DAUK GP committee

The DAUK GP committee is a group of volunteer GPs who advocate for general practitioners by addressing funding, workforce, and patient access and safety issues.

GP committee members provide briefings for politicians and develop policy proposals for improving general practice.

Members regularly raise awareness in the media of the ongoing GP crisis while countering misinformation and incorrect narratives around general practice. Please support their work by joining DAUK or donating to our GoFundMe.

The letter to Wes Streeting, signed by a number of organisations representing NHS doctors including DAUK, calls for urgent reforms to workforce planning.

The letter highlights the findings of a recent British Medical Association (BMA) survey showing more than half of doctors completing foundation training in 2025 will not have secured employment.

Financial catastrophe

This represents not only a personal and financial catastrophe for thousands of newly qualified doctors, but also a major risk to patient care in an overstretched NHS.

“This is not just a statistic,” the letter states. “It represents a looming workforce crisis in the NHS.

“Thousands of newly qualified doctors, trained at great personal cost and national investment, are poised to enter unemployment while the health service struggles under immense clinical demand.”

The letter cites Health Education England (HEE) figures that in 2025 more than 30,000 doctors applied for just 10,000 training positions.

Training posts

The government has pledged an additional 1,000 training posts over three years, but this figure, while welcome, ‘is far from sufficient’, the letter says.

International recruitment is another key issue. The letter criticises the government’s encouragement of international medical graduates (IMGs) to sit the PLAB (Professional and Linguistic Assessments Board) exam without a guarantee of employment or career development.

It argues this risks creating false hope for doctors from abroad while worsening the UK’s own workforce bottleneck.

The letter also raises concerns over the expansion of medical school places without a corresponding increase in postgraduate training opportunities, as well as the growing reliance on physician assistants (PAs) in roles traditionally held by junior doctors.

Physician assistants

“The fast-track integration of PAs into clinical teams, often in roles traditionally filled by early-career doctors, has caused concern among junior doctors, especially given disparities in training, regulation, and accountability,” it warns.

DAUK and the letter’s signatories are calling for a package of urgent reforms, including:

• Substantially expand specialty training numbers to match domestic graduate output and wider NHS needs
• Regulate PLAB intake so international recruitment aligns with the system’s capacity to provide fair and structured career progression
• Clarify and regulate the role of PAs, ensuring their work complements not replaces early-career doctors
• In rural areas where the demand for healthcare is high compared to the number of available providers, it is essential to ensure a fair distribution of resources. Special focus should be given to geographically underprivileged regions, supported by attractive incentives to encourage healthcare professionals to serve there

The letter warns ‘the combination of over-recruitment, inadequate training opportunities, and unclear workforce planning is leading to disillusionment’.

Many young doctors may be forced to leave the profession or emigrate to countries such as Australia, Canada, and the Gulf states, ‘where their skills are valued and career progression is clearer’.

System failure

The letter concludes: “The NHS stands at a critical juncture. Without decisive intervention, we risk losing a generation of doctors – not from lack of talent or commitment, but because the system failed to offer them a viable future.

The letter requests a formal response from the Health Secretary within three months and offers to meet to discuss potential solutions.

Read the letter in full below.

Please support our work by joining DAUK or donating to our GoFundMe.

ARRS restrictions

He said: “As Mr Streeting clearly highlighted, the link between health and social care is important, and removing barriers to innovation is key at national and local levels. “GPs are in a unique position of being at the centre of patient care and links to other services. “As an example we would again ask that restrictions on ARRS (Additional Roles Reimbursement Scheme) be lifted on GPs. “Currently it’s only for GPs up to two years post-qualification. It seems this is an obvious top down issue that needs removing.” Mr Streeting said that one of the things he was most proud of since becoming health secretary was the ‘work with GPs’.

Frontline GPs

He said: “‘It’s not just that we’ve been able to deliver the biggest uplift in funding for years or the satisfaction of seeing a decision I took in my first weeks translate into more than 1,500 GPs employed on the frontline already as a result. “It’s actually the fact that we agreed a contract rather than imposing it, committed to further reform together, and it feels like we’re building a real partnership with the profession.” Dr Taylor has questioned the accuracy of the figure of 1,500 GPs, most recently in DAUK’s response to the spending review, saying thousands of GPs cannot find work.

Collaboration

But he said DAUK’s GP committee was grateful to Mr Streeting for highlighting the significant contribution of GPs in his speech. Dr Taylor said: “Although as he suggested there is a long way to go in terms of recruitment and retention of GPs in the workforce, there is a role for GPs to be involved in the development of the NHS in the next 10 years. “It is vital that collaboration between organisations continues, with those in positions of responsibility listening.” Support our work by becoming a member or donating to our Go Fund Me.

Lack of plan

“Sadly a lack of a plan seems to be the message we are getting. “Even worse, the one that has been implemented so far, in the National Insurance employer contributions, has not been thought through leading to higher costs for social care, charities and GP services. “It is time to take health and social care out of politics altogether. The five-year cycle of government is destroying the services the public needs.” DAUK’s comments follow the announcement of the independent commission, which will be led by the cross-bench peer Louise Casey and split into two phases. The first phase will identify critical issues and recommend medium-term improvements and will report by mid-2026. Phase two will look at how to organise care services and fund them for the future, but it will not report until 2028.

Concerns

Elsewhere, a survey conducted by Ipsos on behalf of the PA news agency found that more than eight in 10 people said they have concerns about the health service overall, with half not confident the Government’s plans for the NHS will lead to improvements in the next five years. The chief concerns were: A&E waiting times (68%); as well as long waits for GP appointments (63%); planned hospital appointments (62%) and ambulances (62%). About half of those with concerns said they are worried about the workload on healthcare staff (52%) and the quality of care being delivered (49%). Some 38% said they have concerns about the NHS’s ability to recruit staff, while a third said they were worried about the wellbeing of existing workers. Dr Ellen Welch, DAUK vice chair, said leaders with a proven background in health care should be appointed to focus on solutions that work for the NHS. Dr Welch said: “We have been calling for some time for a cross-party collaboration on the NHS. “It needs a dedicated group of leaders who can make long and short-term plans for our health service that are not dependent on party politics.

Solutions

“Every time the government changes we have reviews and reforms which feel very much like deckchairs being shuffled on the Titanic. “Appoint people with a proven background in healthcare and NHS leadership who know the pressure points and can adopt solutions for the good of the service, rather than schemes that focus on grabbing votes and headlines.” Please support our work by becoming a member or donating to our Go Fund Me.

GP employment

“And we remain very concerned about the implications of the ongoing employment of GPs through the additional role reimbursement scheme (ARRS). “We need more detail and are concerned this is nothing more than smoke and mirrors.” Dr Steve Taylor, DAUK GP spokesperson: “We cautiously welcome the extra funding, but it fails to address the fact that general practice has had a 20 per cent real terms cut in funding per patient over the past eight years. “GPs are now doing 20 per cent more work than before the pandemic – so we’re doing much more for much less and it needs addressing. “The additional role reimbursement scheme (ARRS) GP recruitment programme is failing to meet the needs of underemployed GPs, particularly those looking for the security of permanent jobs in practices. “Depending on reports, there have been between 60 to 300 GPs employed by the scheme to date at huge expense.

GP funding

“The money would be better spent if it was put into core GP funding.” Dr Alison George, DAUK GP committee member, said: “The concern is that the Department for Health is trying to employ more GPs through ARRS, effectively making them employed by the government on low pay and poor working conditions. “There are around 3,500 full-time equivalent GPs available to work now. Why would the government refuse to fund jobs for them but continue to fund approximately 2,000 physician associates (PAs) in general practice? “Funding GPs, who can give patients holistic care, is the best use of the ARRS funds for PAs and will keep more patients out of hospital. “The money needs to be put back into core budgets and let practices employ the GPs they need.” Dr Ellen Welch, DAUK vice chair and a GP, said: “We have repeatedly called for ARRS funding to be reallocated to restore core GP funding – and do so again.

Darzi review

“Lord Darzi’s review pointed out GPs are the most financially disciplined part of the NHS, and we have the unbelievable situation where thousands of GPs are unemployed or underemployed. “The billions of pounds being spent on inefficient ARRS that fragment care should be reallocated into core general practice. “We need to be able to use our budgets to meet the needs of our patients and communities, and to increase GP numbers for safer ratios of patients to doctors.” Dr Sarah Jacques, DAUK GP committee member, said: “It’s a very uncertain time for practices with many being forced to close or on the brink of closure.

National Insurance contributions

“This money will all be eroded unless the government fully reimburses GPs for the increased National Insurance contributions and we see an uplift in the DDRB (the Review Body on Doctors’ and Dentists’ Remuneration) recommendation for GPs’ rates of pay. “Without those we’re set for another year of defunding.” Support our work by becoming a member or donating to our Go Fund Me. Read more on Mr Streeting’s announcement.

Ms Fernandes says avoidable harm costs the NHS hundreds of millions of pounds each year in insurance, additional treatment, and compensation for patients.

The HSJ last week reported that the ‘costs involved in managing accidents that could be avoided’ neared £3bn per year.

Ms Fernandes said: “Patient safety issues must be at the top of any agenda for the NHS.

“Avoidable harm is costing the NHS hundreds of millions of pounds every year. That is money that’s desperately needed to treat patients, to improve pay and conditions for staff, and to invest in infrastructure.

Patient safety

“Which is one of the reasons DAUK has been warning about the potential for patient harm with the roll-out of physician associates.”

Ms Fernandes comments comes as Health Secretary Wes Streeting today announced the introduction of NHS league tables as part of a package of reforms.

Mr Streeting told the NHS Providers’ annual conference there will be a review of performance, with providers placed into a league table.

Persistently failing managers will be replaced. Turn around teams will be deployed to help providers which are running big deficits or poor services for patients. They will be offered urgent, effective support so they can improve their service.

NHS league tables

Ms Fernandes said: “While holding managers to account is good, I am not in favour of NHS league tables. There is no evidence they actually work.

“Learn Not Blame and a just culture in the NHS do not seem to be at the root of this. And it could demoralise staff.

“Agendas, toxicity, and undervaluing staff with misuse of investigatory and disciplinary and discriminatory practices need to be stamped out.

“We need a just culture to improve morale, productivity, and ultimately patient outcomes.

“At a higher level, decisions taken on GP funding and on physician associates need to be addressed.

“Those who created these scandalous costly unproven schemes also need to be held accountable.”

Read the response to Mr Streeting’s speech from our GP committee.

Read Mr Streeting’s speech in full.