NHS England will be scrapped under major reforms aimed at cutting waste and bureaucracy, Sir Keir Starmer announced yesterday.
Almost 10,000 office jobs face the axe as the Government looks to save hundreds of millions of pounds a year in admin costs.
The Government said the ‘world’s largest quango’ duplicates work that is already done by officials at the Department of Health and Social Care.
Half the 18,600 staff employed by the two organisations will be lost, with the funds redirected to doctors, nurses and frontline services.
This will help to cut waiting lists and improve care, Sir Keir added.
Ministers are understood to be adamant that the reorganisation will change the NHS, and allow the service to get back to the basics of focusing on patient care.
They believe that while some equality schemes in the health service are important, there are far too many that are well meaning but misguided.
As well as saving hundreds of millions of pounds, ministers believe the move will allow the NHS to make greater use of the private sector and make it more democratically accountable.
NHS England will be scrapped under major reforms aimed at cutting waste and bureaucracy, Sir Keir Starmer announced yesterday.
Almost 10,000 office jobs face the axe as the Government looks to save hundreds of millions of pounds a year in admin costs
The Government said the ‘world’s largest quango’ duplicates work that is already done by officials at the Department of Health and Social Care
But experts warned the biggest restructure of the health service in a decade is likely to be a big distraction for managers and cause disruption to patients.
NHS England is responsible for the overall management of the health service, allocating £192billion to local health bodies and giving them direction.
However, the PM said decisions about billions of pounds of taxpayer money should not be taken by an ‘arms-length’ body.
Bringing remaining NHSE staff into the DHSC will put management of the health service ‘back into democratic control’ and ‘back at the heart of government’, he added.
Work will begin immediately to execute the takeover, with the process expected to take two years to complete.
Speaking on a visit to consumer goods company Reckitt, which owns brands including Dettol and Durex, Sir Keir said: ‘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.
‘So today, I can announce we’re going to cut bureaucracy… focus Government on the priorities of working people, shift money to the front line.
Half the 18,600 staff employed by the two organisations will be lost, with the funds redirected to doctors, nurses and frontline services
This will help to cut waiting lists and improve care, Prime Minister Sir Keir Starmer added
‘So I’m bringing management of the NHS back into democratic control by abolishing the arms-length body, NHS England.
‘Sir Keir added that the Government wants to push power to frontline workers ‘and away from the bureaucracy which often holds them up’.
The decision follows the resignation of several high profile NHS England board members in recent weeks, including chief executive Amanda Pritchard and chief financial officer Julian Kelly.
The changes will reverse the 2012 shake-up of the NHS under the Conservative-Liberal Democrat coalition, which the Government says created ‘burdensome’ layers of bureaucracy without any clear lines of accountability.
Wes Streeting told the Commons he was ‘abolishing the biggest quango in the world’, with staff cuts delivering ‘hundreds of millions of pounds worth of savings’, although the exact figure will be determined by the ‘precise configuration of staff’.
The health secretary described the move as the ‘final nail in the coffin of the disastrous 2012 reorganisation’, which he said led to the ‘longest waiting times, lowest patient satisfaction, and most expensive NHS in history’.
Mr Streeting added: ‘There are more than twice as many staff working in NHS England and the Department of Health and Social Care today than there were in 2010 – twice as many staff as when the NHS delivered the shortest waiting times and the highest patient satisfaction in history.
‘Today, the NHS delivers worse care for patients, but is more expensive than ever before.
‘The budget for NHS England staff and admin alone has soared to £2billion. Taxpayers are paying more but getting less.
‘We have been left with two large organisations doing the same roles with an enormous amount of duplication.
‘It is especially in times like these, when money is tight, that such bloated and inefficient bureaucracy cannot be justified.
‘We have got to bend the curve of cost and demand to make sure that our health service is sustainable for the long term.’
Conservative shadow health minister Dr Caroline Johnson told the Commons: ‘The public understandably want to see the focus on patient care and not on backroom managers, therefore we are supportive of measures to streamline the management and we do not oppose the principles of taking direct control.’
The government said Sir Jim Mackey, interim chief executive of NHS England, and Dr Penny Dash, its new chair, will oversee the transition.
Sir Jim said: ‘We now need to bring NHS England and DHSC together so we can deliver the biggest bang for our buck for patients.’
Detailing the need for change, DHSC said: ‘Too much centralisation and over-supervision has led to a tangled bureaucracy, which focuses on compliance and box-ticking, rather than patient care, value for money, and innovation.
‘By stripping back layers of red tape and bureaucracy, more resources will be put back into the front line rather than being spent on unnecessary admin.’
The NHS Confederation and NHS Providers, which represent health organisations, said: ‘This is the end of an era for the NHS and marks the biggest reshaping of its national architecture in a decade.
‘History tells us this will cause disruption while the transition is taking place.’
Sir Keir used his speech, in Hull, to outline his desire to slash red tape, saying he wanted to take on a ‘watchdog state completely out of whack with the priorities of the British people’.
The PM said global instability made it important to reform public services.And in a blast at the British state, he said it was ‘weaker than it’s ever been’ – despite the number of civil servants having grown by 130,000 since the Brexit referendum.
Despite criticising the Blob last year, Sir Keir instead commended the civil service for having ‘some of the best talent in the country’ – but said their energy had been misdirected into ‘blocking’.
The PM said: ‘I believe that working people want an active government. They don’t want a weak state, they want it to secure our future, if you like, to take on the big decisions so they can get on with their lives.
‘So, we don’t want a bigger state, a more intrusive state, an over-expanding state, a state that demands more and more of people as it itself fails to deliver on core purposes. So, we’ve got to change things now.’
How unions and health leaders feel about Keir Starmer’s plan to scrap NHS England:
Unions and health leaders were quick to criticise the government’s plan to scrap NHS England, warning that patient care is likely to suffer.
The service remains under extreme pressure and is failing to hit targets for routine, emergency and cancer care, newly published figures revealed yesterday.
Some 6.25 million patients were estimated to be waiting for treatments at the end of January, up slightly from 6.24 million at the end of December, the new figures show.
And only 73.4 per cent of patients urgently referred for suspected cancer were diagnosed or had cancer ruled out within 28 days in January, down from 78.1 per cent a month earlier.
Meanwhile, ambulances are failing to meet response time targets and an average of 13,740 hospital beds per day were filled last week with patients who were fit to be discharged but were unable to leave.
Unions and health leaders were quick to criticise the government’s plan to scrap NHS England, warning that patient care is likely to suffer
This is up from 13,430 the previous week.
Dave Penman, general secretary of the civil servants union the FDA, dismissed the suggestion that the reforms would deal mostly with duplication as ‘for the birds’.
He said: ‘If they’re going to cut staffing in half, the idea that that’s you’re going to get away with that because there are two comms teams is just for the birds.
‘If you’re going to do away with [NHS England], you’re going to have a lot of time taken up by reorganising the deck chairs, even if that’s into a central department.’
Unions hit out at the proposed job cuts, with Christina McAnea, general secretary of public services union Unison, saying the prime minister’s announcement will have left staff at NHS England ‘reeling’.
She added: ‘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.’
The NHS Confederation and NHS Providers, which represent health organisations, said: ‘This is the end of an era for the NHS and marks the biggest reshaping of its national architecture in a decade.
‘History tells us this will cause disruption while the transition is taking place.’
The service remains under extreme pressure and is failing to hit targets for routine, emergency and cancer care, newly published figures revealed yesterday
Rachel Power, chief executive of the Patients Association, said: ‘The Government must ensure this transition delivers tangible improvements and doesn’t divert attention from urgent priorities like reducing waiting times and improving access to primary care.
‘Patients are less concerned with organisational charts than with whether they can get the right treatment, at the right time, delivered by well-supported healthcare professionals.’
Sarah Woolnough, chief executive of The King’s Fund, a health think tank, said the potential cost savings from axing NHS England are ‘minimal’ and the Government must ensure it delivers a net benefit.
She added: ‘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.’
And Hugh Alderwick, director of policy at the Health Foundation, a think tank, said: ‘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.
‘It will also eat up the time of ministers, with new legislation likely needed.’
