Unions are unhappy about potential job losses while others are worried it could lead to further privatisation of the health service
Following Keir Starmer’s announcement yesterday that Labour will abolish NHS England, unions and health experts have raised concerns about the potential consequences.
While think tanks such as King’s Fund have pointed out there is “duplication and waste” as NHS England (NHSE) and the Department for Health and Social Care have a similar role, there is fear that removing it could lead to more political interference in the health service.
Some argue the move could have merit if it improves efficiency, but for it to succeed, it must result in tangible outcomes, particularly in reducing long waiting times for GP appointments and in A&E. The Prime Minister claims that the savings from scrapping NHSE will be reinvested into frontline services, but organisations are questioning how Labour will ensure this.
While Starmer emphasised that he is aiming to make the state “more agile” and less “flabby”, unions have criticised how the decision has been communicated as thousands face losing their jobs.
“Nothing short of shambolic”
UNISON general secretary Christina McAnea said that Starmer’s announcement will have left NHS England staff “reeling”.
She said: “just days ago they learned their numbers were to be slashed by half, now they discover their employer will cease to exist”.
McAnea added that “The way the news of the axing has been handled is nothing short of shambolic”, and said she felt it could have been managed in “a more sympathetic way”.
“Thousands of expert staff will be left wondering what their future holds. Wherever possible, their valuable skills must be redeployed and used to the benefit of the reformed NHS and patients.”
Unite general secretary Sharon Graham said she was “deeply concerned” about Labour cutting NHSE staff without consultation with the unions.
She said that the NHS is “one of the largest organisations in the world and is hugely complex”, noting that as well as technical and clinical experts, it requires administrative staff for payroll, procurement, human resources and other back office roles to make it work effectively.
Graham added that “Taking an axe to these jobs is an ill-thought-out strategy” and if frontline healthcare staff “aren’t paid on time, don’t have basic medical supplies or are forced to do additional administrative work rather than treat patients”, it could mean they can’t do their jobs effectively.
“Ministers will need to explain how the prize will be worth the price”
Sarah Woolnough, Chief Executive of The King’s Fund, a health policy think tank, 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.”
Woolnough noted that the potential cost savings of scrapping NHS England “would be minimal” in context of the overall NHS budget, which will be £192bn in 2025/26. She also said that the government must be clear on why the restructuring needs to be done now.
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.”
Concerns about ministers taking on more control of the NHS
Dr Julia Patterson, chief executive of campaign group, Every Doctor, said the news that NHS England will be abolished has come “as a shock to many”.
She added: “It’s currently unclear whether this move will reduce bureaucracy, or whether NHS England will be removed, only to be replaced with a new layer of bureaucracy created by Starmer and Streeting.
“We are also concerned about ministers taking on more control of the NHS. The NHS needs long-term, sustainable plans to rebuild the service, not plans driven by a political agenda to win votes at the next election for whichever minister is calling the shots.”
“How can the answer be more cuts, delivered chaotically?”
Director of We Own It, Cat Hobbs, said that Lord Darzi’s independent review of the NHS noted that “austerity is responsible for the dire state of the NHS”, adding that staff are suffering and patients are dying due to government cuts over the past 14 years.
Hobbs questioned the cuts, stating: “How can the answer be more cuts, delivered chaotically? Where is the evidence base for this decision, where is the plan to shift money and jobs to the frontline?”
She said: “If you talk to NHS staff, they are actually desperate for more managers to free up their time to do the caring.”
She argued that if the decision is about improving patient care, Wes Streeting must demonstrate it by significantly increasing the number of GPs, hospital staff, community nurses, and frontline managers to support them in their roles.
She added: “If this decision is about democracy, Wes Streeting must prove it by listening to the 87% of the country who want to stop NHS privatisation. End the waste of outsourcing contracts, PFI deals and private consultants.
“The last thing patients need is massive cuts to an already stressed NHS and a power grab that doesn’t end wasteful privatisation.”
Olivia Barber is a reporter at Left Foot Forward
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