...in a reform of the health service that they say will cut bureaucracy and save money that will be better spent in delivering front-line services to the frail and infirm. Sir Keir Starmer said “I don’t see why decisions about £200 billion of taxpayer money on something as fundamental to our security as the NHS should be taken by an arm’s length body, NHS England. And 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 I’m bringing management of the NHS back into democratic control by abolishing NHS England. That will put the NHS back at the heart of government where it belongs, free it to focus on patients — less bureaucracy with more money for nurses”. Whether that actually happens when the NHS returns directly to the “democratic control” of the Department of Health and Social Care is, of course, a matter of opinion.
Hugh Alderwick, the Director of Policy at the Health Foundation, said “Abolishing NHS England is a watershed moment in how the English NHS is governed and managed – and ends a 12-year experiment with trying to manage the NHS more independently from ministers.
“There is some logic in bringing the workings of NHS England and the government more closely together – for example, to help provide clarity to the health service on priorities for improvement. And – in reality – it is impossible to take politics out of the NHS.
“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”.
The unions were equally unimpressed. PCS general secretary Fran Heathcote said “technology has a part to play in improving public services and enhancing our members’ job satisfaction, but we are also clear that it cannot be used as a blunt instrument to cut jobs. Better public services and better front-line delivery will require human beings making empathetic decisions, not automatons incapable of understanding people’s needs”.
Only time will tell whether this will end the shameful sight of patients left for days in hospital corridors due to the shortage of beds or better pay for nurses and the other medical staff that keep the NHS going. What is certain is that around 9,000 jobs will be axed at NHS England and the Department of Health and Social Care as part of the changes – and that is largely what lies behind the Prime Minister’s decision.
