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Starmer scraps NHS England

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It was widely briefed that the main focus of Sir Keir Starmer’s speech in Yorkshire today was his plan to do away with Whitehall red tape. What was kept under wraps was the Prime Minister’s plans for the NHS – specifically to scrap NHS England. In a bid to tackle bureaucracy in the health service, the PM this morning told reporters that the ‘arms-length NHS’ needed to go – adding that the move will ‘shift money to the front line’ and free the health service to ‘focus on patients’.

The move – which will see NHS England taken back under the control of the Department of Health in a re-politicising of the health service – is another step forward in Labour’s war on NHS management. The government has insisted that the abolition of the ‘world’s largest quango’ will ‘empower’ NHS staff and lead to better prioritisation of patient care. It’s a reversal of the 2012 restructuring of the service which Starmer’s government has slammed as having ‘created burdensome layers of bureaucracy without any clear lines of accountability’. 

Health Secretary Wes Streeting has called for the health service to employ ‘more doers and fewer checkers’, blasting the current set up as ‘setting [NHS staff] up to fail’. This morning’s move comes just weeks after news that NHS England chief Amanda Pritchard would stand down at the end of March. Last week, Professor Stephen Powis, the national medical director for NHS England, announcing he was quitting too. Today’s announcement sheds a little more light on the flux within the institution.

Will taking the system back under the control of the Department of Health lead to noticeable improvements? The NHS has long suffered from bureaucracy problems affecting the way the health service is managed, how funding is directed and the ability of medical professionals to carry out their jobs. With how the NHS has been performing in recent years – wait lists growing and A&E delays piling up – it makes sense for ministers to want to have more oversight of the service. Doctors are on side too – one senior physician said the move was ‘long overdue’. Another medic pointed out that the ramping up of management tiers in the NHS following the 2012 reforms lead to ‘clinicians being pushed out from decision-making’ with hospital managers ‘not understanding that the health service runs differently to most businesses’.

Former health secretary Alan Milburn will lead the restructuring, after he was appointed the lead non-executive director of Streeting’s department in October. The Tony-Blair era health adviser, who himself has links to private healthcare companies, has long been an advocate of the need for ‘big reforms’ in the NHS to make the service ‘fit for the future’. While questions remain over what exact legislation will be required for this shift, the general mood among both medics on the frontline is that something needed to change – and this is a step in the right direction.

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