Wes Streeting struggled to suppress a surprised laugh when a journalist compared his approach to the NHS to Elon Musk’s new job in the US.

The health secretary announced his NHS reform package today and confirmed hospital managers could be axed if they underperform on the new league table of England’s health institutions.

His announcement comes hours after US president-elect Donald Trump declared tech billionaire Elon Musk (together with Republican Vivek Ramaswamy) would be heading up a new Department of Government Efficiency to cut federal spending.

Musk is known for being particularly brutal with staffing, having cut around 80% of the staff at X (formerly Twitter) when he bought the company.

On Sky News this morning, presenter Wilfred Frost said to Streeting: “It’s so interesting, health secretary, hearing all of those points and that rhetoric from you, because it sounds not dissimilar from the rhetoric we’ve seen in the last couple of weeks from the new head of department inefficiencies in the US, Elon Musk.

“Do you think you and he share similar sentiments towards driving government efficiency?”

Streeting looked perplexed, and then tried to hold in some laughter.

He said: “That was not the comparison I was expecting this morning.”

But the cabinet minister did acknowledge there is a problem with the NHS efficiency and leadership.

“It’s not the frontline staff the public have doubt in,” he said, instead pointing to leadership, management and accountancy in the health service.

But Frost insisted: “In a year’s time though, as both of you have worked hard to try and drive efficiency in big government departments with big budgets, would you welcome a meeting with Elon Musk to compare notes of what works and what doesn’t work?”

“I’ll be very surprised if I see that meeting in my diary,” Streeting replied, before acknowledging that the NHS “is broken but it is not beaten” – and promising Labour can turn it around.