Wes Streeting has ordered a restructuring of the NHS' “high stakes” that will scrap 10,000 jobs in an attempt to free cash for frontline care.
Experts warned that the move to abolish NHS England and fold it into the Ministry of Health could divert the minister from the urgent work to finish treatment, but trade unions have expressed concern about the “shambolic” announcement of reducing work for civil servants.
However, the health secretary said the move to abolish the “world's largest Quango” would save the minister hundreds of millions of pounds that could be spent on doctors, nurses and improve frontline care while also providing medical services.
“Now please kindly kill it to those who resist this reform from their love for the NHS,” Streeting says.
The decision to scrap NHS England, announced on Thursday, is a dramatic reversal of the unpopular NHS changes brought by the conservative Lib Dem Coalition government over a decade ago.
Former Health Minister James Bethel said he hoped conservatives would “have the courage to do this,” but former health secretary Jeremy Hunt praised the proposal for “boldness.”
Announcing the plan, Kiel Starmer said the move would “reduce the bureaucracy” and “return the management of health services to democratic control,” but Street said it was. “The final nail in the co-death reorganization of 2012. This led to the longest waiting times in history, patient satisfaction and the most expensive NHS.”
Whitehall sources said Streeting had decided that NHS England should be scrapped earlier this year.
The aim is for the pastor to regain responsibility, but it can put an end to microcontrolled arm length authorities by central authorities and make their own decisions to hospitals and local health authorities on how to improve.
Personally, Streeting was deeply frustrated that the NHS was unable to improve waiting times, improve hospitals, and stop overexpenditure. It also made major strategic changes to how it operates, including increasing community-based care to reduce A&E demand, despite significant increases in budgets and employees in recent years.
“By reducing the layer of red tape and ending infantilization of frontline NHS leaders, by freeing innovating local NHS providers, developing new ways of working, focusing on what's most importantly, providing better care for patients,” he told the House.
People close to the street said they retain views that other recent health secretaries also share. NHS England has many different teams specializing in a variety of care fields, but said it lacks an overall strategy to rescue the NHS from “Perma-crisis.”
Streeting was seen as an organization that “is in charge of everything but seems unable to achieve what is most important to politicians,” said one insider.
The reform took two years, saving up to £500 million, half the size of the merged Ministry of Health and NHS England, collectively employing 19,000 people.
However, while there was warning that the reforms attempted could risk linking health services in an expensive and time-consuming bureaucracy, Unison, a leading union with health staff, said the announcement was “unsetting the staff at NHS England.”
“Just a few days ago they learned that their numbers would be cut by half. Now they discovered that employers would stop being present,” said Christina McCaneer, General Secretary at Unison. “The way the news on the axis was handled is nothing but shambolic. It could have certainly been managed in a more sympathetic way. Thousands of expert staff will wonder what their future holds.”
The BMA, a trade union for doctors, said “it is a high movement of interest from the government. It is now very halted with the Health Secretary without the NHSE acting as a buffer between itself and the delivery of medical care to patients.”
Professor Phil Banfield, chairman of the BMA Council, said: “The doctors' experience in reorganizing the NHS has not been positive. This is not distracting from the important tasks ahead: dealing with the historic workforce crisis, reducing waiting lists and restoring family doctors.”
Three health think tanks, King's Fund, Health Foundation, and Nuffield Trust also had reservations on the bandwidth that the changes caused.
Nuffield Trust CEO Thea Stein said that while removing the duplicates makes sense, “the deep problems facing the NHS remain: how to deal with increasing patient needs in the face of a spiral waiting list and invest in close-to-home care with the wider finances of the NHS and social care reforms in the already long grass.”
“It is not immediately clear that reorganizing the trajectory of upper powers will make a big difference to these issues. This will ultimately be a decision between patients and public government,” she said.
However, sources say Amanda Pritchard's successor, Sir Jim McKee, CEO of the “in transition” NHS England, is expected to be far more demanding that the service visibly and quickly improve performance.
At Commons, Streeting praised Mackie for “an outstanding track record of turning NHS organizations around, balancing books, increasing productivity and pushing down waiting times.”
In the Commons, the Health Secretary described Professor Ala Dalzi's verdict in a review of the NHS last fall as “a catastrophic… international untold disaster” as part of a massive reorganization under the Tory/lib de coalition.
-
Join Wes Streeting and chat with Pippa Crerar to discuss England's health and social care system and how to turn around labor plans from 7pm to 8.15pm (GMT) on Tuesday, March 25th, 2025. Book your tickets here or at GuardianLive.com
