From crisis to cure: Wes Streeting has cash and a bold vision for the NHS – but can he deliver?

The health secretary's plans for prevention, digital reform and community care may well turn decades of rhetoric into reality

- Andrew Rawnsley

Wes Streeting has been sounding even chirpier than usual since the spending review. Speaking the day after to a conference of health professionals, he told them that an extra £29bn for the NHS was “a hell of a lot of money”. Indeed it is.

The health secretary is not just the standout winner of the financial arm wrestling with the Treasury - he came out many, many miles ahead of envious cabinet colleagues. The jump in the cash allocated to his department means that health accounts for £9 out of every £10 of the real additional funding for day-to-day spending. The NHS is on track to consume 40% of all state spending by the end of this decade. That is another advance along a trajectory to a point where we will have a health service with a government attached. And yet barely had the largesse been announced than significant figures in the NHS were complaining that it wouldn't be enough to give the British people the health service they thought they deserved.

Having bagged what was a generous settlement in the fiscal climate, the health secretary must now match it with the "revolutionary" modernising programme he has promised or he will be sloshing more water into a leaky bucket. Without reform, a creaking service will be unable to cope with the rising demands of an ageing society, and the government will cop the blame for its failings.