The shadow health secretary, Wes Streeting, has said he will be brutally honest about the challenges in the NHS, and added it “isn’t true” that the NHS is the “envy of the world”. The Labour MP said the NHS was currently struggling enormously due to years of underinvestment and said that was reflected in the deteriorating quality of care. “You won’t hear me pretend that the NHS is great, that somehow the timeliness and quality of NHS care, which is currently appalling, is the envy of the world,” he said in a speech at the parliamentary press gallery. “Because patients know it isn’t true and NHS staff know it isn’t true.” Streeting said he would have “one of the most challenging jobs in government” if Labour win the next election. “The economic backdrop is more challenging and the NHS is facing the biggest challenge in its history.” He said Labour would commit to the biggest expansion of the workforce in NHS history, funded by abolishing non-dom status. He said it was “a serious downpayment on the NHS’ future” but said there was “no sustainable long-term solution to pouring ever more taxpayers’ money into a 20th-century model of care”. Streeting said the answer from the right was that the NHS publicly funded model needed to change. “It’s a miserablist position, we think things should get better, not worse, over time, and it’s misguided. It is not the funding model that is broken, it is the model of care.” He added: “We have a healthcare service that does late diagnosis, being more urgent and more expensive treatment. It should be the other way round.” Streeting said the “interests of patients must always come ahead of the interests of providers. I have no truck with producer interests, no matter how much the BMA complains about my outrageous suggestion that patients should not have to wait on the phone at 8am to book appointments. I am the shop steward for patients.” Streeting also spoke about Labour’s chances at the next election, saying the party was confident but did not believe the extent of the current poll leads. Labour cannot rely on the Tories being “crap” to win the next general election, Streeting said, adding that Keir Starmer had constantly warned against being “complacent or cocky”. He said the latest cabinet reshuffle had shown that PM Rishi Sunak was “too weak to reverse” the economic crisis and the turmoil in the Conservative party, pointing to the controversial reappointment of Suella Braverman, which he called a “grubby deal” to win the leadership. “You don’t have to scratch too far beneath the surface to find the ill discipline in the Conservative parliamentary party and he has shown that his instinct is to appease those factions, not to confront and defeat them,” Streeting said. “In the Labour party, the cranks have been kicked out or left. In the Conservative party, the cranks are sat around the cabinet table,” he said. But he said that Labour had to win “on our own terms” and present a positive vision. “We can’t rely on the Conservatives being crap, however reliable that proposition has turned out to be,” he said. “None of us in the shadow cabinet believe the polls that show there will be a few dozen Conservative seats. Eventually the polls will settle. “If I had a pound for every time I’ve heard Keir say that in recent weeks I’d be joining Rishi Sunak on the Sunday Times rich list. “The next election is there for us to win … but because Labour has changed. We have a serious leader, with a serious team and a serious plan for Britain.”