NHS England will be abolished to “cut bureaucracy” and bring management of the health service “back into democratic control”, British Prime Minister Keir Starmer has said, the sudden and very significant announcement being likely to affect around 15 000 staff.
It is being merged with the Department of Health and Social Care (DHSC), which is run by Wes Streeting, the Health Secretary.
The Guardian reports that Starmer announced the shock move last Thursday in his speech on reforming the state.
The NHS as a whole employs about 1.5 people, mainly through 220 health trusts, and is one of the world’s biggest organisations.
Starmer said the decision was a cost-saving and bureaucracy-slashing exercise that would put ministers back in charge and benefit patients.
“I don’t see why decisions about £200bn of taxpayer money on something as fundamental to our security as the NHS should be taken by an arm’s length body, NHS England,” he added.
“And I can’t, in all honesty, explain to the British people why they should spend their money on two layers of bureaucracy (NHS England and the Department of Health and Social Care). That money could and should be spent on nurses, doctors, operations, GP appointments.”
‘Two layers of bureaucracy’
In October 2011, the NHS Commissioning Board was created, its key role being to commission clinical commissioning groups – local NHS bodies, which replaced primary care trusts – to provide the range of clinical services needed in their areas, like GP care.
Its name changed to NHS England in spring 2013. Since then, it and the DHSC have contained many teams of officials who each do roughly or exactly the same thing. For example, each has a dedicated team covering different areas of care such as GP services, mental health and urgent and emergency care (A&E and ambulance services).
Starmer cited these examples of duplication: “Is it a good idea … to get rid of two sets of communications teams, two sets of strategy teams, two sets of policy teams, where people are basically doing the same thing? Yes, it is.”
NHS England directs, manages and oversees the whole of the health service in England, including its 1.5m staff and its budget, which from next month is due to be close to £200bn. It is responsible for ensuring that key waiting times, such as the supposed maximum four-hour wait for A&E care and 18-week wait for hospital treatment, are delivered.
Regarding its 13 000 staff, some will be made redundant, while the others will start working for the DHSC. Both organisations have large offices in London. Both also have offices in other parts of the country, including Leeds, where NHS England is headquartered.
Amanda Pritchard, NHS England’s outgoing chief executive, told staff in an email on Monday that as a direct result of the DHSC’s decision to change its relationship with the NHS, the size of “the centre” – the NHS England/DHSC axis in London – “could … decrease by around half”.
People working for the 42 NHS integrated care boards – regional bodies that oversee NHS trusts in their area – were told that half of them would be losing their jobs.
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