NHS England to be abolished to ‘cut bureaucracy’ and save millions – Starmer

NHS England, which has been called the “world’s largest quango” by the Government, is to be abolished, the Prime Minister has said.

Sir Keir Starmer said decisions about billions of pounds of taxpayer money should not be taken by an “arm’s-length” body, as he promised sweeping reforms to deliver better care for patients.

The move is expected to save at least £500m a year and could see half the workforce of NHS England and the Department of Health and Social Care axed.

“Overstretched, unfocused, trying to do too much, doing it badly,” the Prime Minister said.

Sir Keir promised the move would free up money for doctors, nurses and frontline services, and cut red tape to help speed up improvements in the health service, amid frustrations about the pace of change.

NHS England is a public body delivering services with taxpayers’ money, which was set up to support and oversee NHS trusts and wider organisations to deliver healthcare.

It has worked with the Government to set priorities and agree funding for the NHS.

The latest news comes after the announcement of the departure of senior leaders at NHS England in recent weeks, including NHS chief executive Amanda Pritchard, chief financial officer Julian Kelly, chief operating officer Dame Emily Lawson, chief delivery officer Steve Russell and national medical director Professor Sir Stephen Powis.

He told MPs: “Today we’re abolishing the biggest quango in the world.”

On staff reduction, he added: “The size of NHS England, there are 15,300 staff; in the Department of Health and Social Care 3,300; and across both we’re looking to reduce the overall headcount by 50%.

“That will deliver hundreds of millions of pounds worth of savings, and the exact figures will be determined by the precise configuration of staff.”

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.

Speaking during a visit to Hull, 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.

“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.

“So I’m bringing management of the NHS back into democratic control by abolishing the arm’s-length body NHS England.”

Answering a question from a cancer patient on how the decision would improve NHS services, Sir Keir said: “Amongst the reasons we are abolishing it is because of the duplication.

“So, if you can believe it, we’ve got a communications team in NHS England, we’ve got a communications team in the health department of government, we’ve got a strategy team in NHS England, a strategy team in the government department. We are duplicating things that could be done once.

“If we strip that out, which is what we are doing today, that then allows us to free up that money to put it where it needs to be, which is the frontline.”

The Government said work would begin “immediately” to return many of NHS England’s functions to the Department of Health and Social Care, “to put an end to the duplication resulting from two organisations doing the same job”.

Mr Streeting said in a statement: “When money is so tight, we can’t justify such a complex bureaucracy with two organisations doing the same jobs.

“We need more doers and fewer checkers, which is why I’m devolving resources and responsibilities to the NHS frontline.

“NHS staff are working flat out but the current system sets them up to fail.

“These changes will support the huge number of capable, innovative and committed people across the NHS to deliver for patients and taxpayers.”

He told MPs the “curve of cost and demand” in the NHS needs to be stopped, adding: “The NHS’ long-term workforce plan, for example, has one in nine people working for the NHS, and on current trajectories in 50 years’ time, 100% of the public would be working for the NHS. That is clearly not a sustainable position.

“And I tell people now who resist this reform out of love for the NHS, do not kill it with kindness.

“We have got to bend the curve of cost and demand to make sure that our health service is sustainable for the long term.”

It added: “We recognise this is very difficult news. Understandably this is going to be unsettling.”

A letter to staff from Mr Streeting also said: “I know that this will be unsettling and you will all have views about the process. This is a change process and change is unsettling.”

Hugh Alderwick, director of policy at The Health Foundation, said there was some logic in bringing the workings of NHS England and the Government more closely together.

He added: “But 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 most important question is how will the abolition of NHS England make it easier for people to get a GP appointment, shorten waits for planned care and improve people’s health.

“That hasn’t yet been set out, ministers will need to explain how the prize will be worth the price.”

On Tonight With Andrew Marr on LBC radio, Mr Streeting was asked whether doctors and nurses could lose their jobs as a result of the struggle with NHS finances.

Mr Streeting said “we should not be losing frontline staff and services because we have got, I think, a bloated bureaucracy and layers and layers of bureaucracy”.

Pressed on frontline doctor and nurses, he said: “I can’t say there’ll be no changes to services but, for example, we’ve put now almost 1,000 more GPs on to the front line since we came in.”

He said losing medics “should be the last resort for frontline leaders”, adding that prioritising the front line “does mean more doctors, it means more nurses and it means better care and services available to people at the right time in the right place..

He added: “But the reason why I was being careful about my words is because inevitably there’ll be some service changes where a doctor or nurse might be employed in one place and that may change, but they should find jobs elsewhere.”

Conservative Party leader Kemi Badenoch has said she has “no qualms” with the Prime Minister’s decision to abolish NHS England.

“I think every government that is elected should do whatever it thinks it needs to do to deliver services for the public.

“So if that’s what they think is needed, then I have no qualms with that.

“I don’t think everything needs to go to a quango,” she said.