British Labour Prime Minister Keir Starmer on Thursday announced that NHS England would be scrapped to free up more money for frontline services and bring management of the health service “back into democratic control”.
The prime minister said the independent body which runs the NHS would go in a move to slash red tape and dramatically reduce costs by cutting duplication.
The announcement comes as the country’s National Health Service (NHS), which provides free health care to almost the whole population, increasingly comes under fire for long waiting lists and a number of medical scandals.
Labour Prime Minister Keir Starmer made this declaration during a speech in Yorkshire on slashing regulation and slimming the civil service, he said:
“Overstretched, unfocused, trying to do too much, doing it badly,” Starmer said while on a visit to the eastern English city of Hull.
“I can’t in all honesty explain to the British people why they should spend their money on two layers of bureaucracy. That money could and should be spent on nurses, doctors, operations, GP appointments,” he said.
“We’re going to cut bureaucracy across the state, focus government on the priorities of working people (and) shift money to the front line.”
“I’m bringing management of the NHS back into democratic control by abolishing the arms length body – NHS England
“That will put the NHS back at the heart of government where it belongs, freeing it to focus on patients, less bureaucracy, with more money for nurses. An NHS refocused on cutting waiting times at your hospital.”
Under the plans, NHS England, which the government described as the “world’s largest quango”, will be brought back into the Department of Health and Social Care.
Ministers said the plans, which will mean more than 9,000 job losses, would help deliver savings of hundreds of millions of pounds a year, which would be used to cut waiting times.
The move comes just days after a number of senior NHS England executives announced their intention to step down, including bossAmanda Pritchard, chief financial officer Julian Kelly, chief operating officer Emily Lawson and national medical director Sir Stephen Powis.
Sir Keir said the body had created a huge amount of “duplication” – at a time the NHS could least afford it.
He told his audience: “We’re duplicating things that could be done once. If we strip that out, which is what we’re doing today, that then allows us to free up that money, to put it where it needs to be, which is the front line.”
Health secretary Wes Streeting, added: “This is the final nail in the coffin of the disastrous 2012 reorganisation, which led to the longest waiting times, lowest patient satisfaction, and most expensive NHS in history.
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“When money is so tight, we can’t justify such a complex bureaucracy with two organisations doing the same jobs.”
The boss of NHS England Sir James Mackey backed the change although he admitted the announcement was “unsettling” for the organisation’s thousands of staff.
Currently 15,300 people work for NHS England, with another 3,300 at the Department of Health.
The Department of Health said that plans to abolish NHS England and return many of its functions to the department would “begin immediately” and take around two years.
In his speech, the prime minister warned that scrapping the agency was far from the only “tough choice” he would make, adding: “In this era, they will keep on coming”.
But health think tanks warned that another reorganisation of the NHS, by scrapping NHS England, risked diverting and distracting staff from the job of improving the NHS for patients.
Hugh Alderwick, director of policy at the Health Foundation think tank warned: “History tells us that rejigging NHS organisations is hugely distracting and rarely delivers the benefits politicians expect. Scrapping NHS England completely will cause disruption and divert time and energy of senior leaders at a time when attention should be focused on improving care for patients.”
Sarah Woolnough, chief executive of The King’s Fund, said: “The potential costs savings would be minimal in the context of the entire NHS budget, and so (ministers) must ensure that the changes produce the improved effectiveness which is sought by making this change. As with previous NHS restructures, structural change comes with significant opportunity cost, with staff who would otherwise be spending their time trying to improve productivity, ensure safety, and get the best outcomes for patients, now worrying about whether they will have a job.”
Professor Nicola Ranger, general secretary and chief executive of the Royal College of Nursing, warned: “The chaotic reorganisation that created NHS England cost billions and took money and attention away from clinical care. Nobody can afford a repeat now that NHS performance is already at a historic low and money is scarce.”
That view was echoed by Prof Phil Banfield, chair of British Medical Association council, who said: “Doctors’ experiences of reorganisations of the NHS have not been positive. This must not become a distraction from the crucial task that lies ahead”.
Union bosses hit out at the way the PM announced the job losses, with NHS England sources telling The Independent they were given no notice at all and there were audible gasps in the office when the news broke.
UNISON general secretary Christina McAnea said: “This announcement will have left NHS England staff reeling. Just days ago they learned their numbers were to be slashed by half, now they discover their employer will cease to exist. The way the news of the axing has been handled is nothing short of shambolic. It could surely have been managed in a more sympathetic way.”
Despite creating NHS England, the Tories appeared to cautiously welcomed its abolition.
Alex Burghart, the shadow chancellor of the Duchy of Lancaster, said: “We support measures to streamline NHS management and the principle of taking direct control.”
But he added: “Labour ministers now have nowhere to hide or anyone else to blame on NHS performance.”
One former Tory health minister was more enthusiastic. Lord Bethell tweeted: “I wish we’d had the guts to do this.”
Last week Professor Sir Stephen Powis, NHS England medical director, said he would stand down this summer, just a week after the surprise resignation of boss Amanda Pritchard.
