British Prime Minister Keir Starmer aims to “reduce bureaucracy” and restore democratic control, asserting that this will improve resources for frontline services and reduce waiting lists before the next election. Health Secretary Wes Streeting plans to reduce the size of NHS England by 50%, with its chief executive set to leave soon.
Streeting stated that the government is dismantling the largest global quango by transferring NHS England under the Department of Health and Social Care, a merger expected to take about two years. Streeting opposed extensive NHS reorganisation before elections despite recognising inefficiencies arising from overlapping responsibilities between the DHSC and NHS England.
Frustration grew in Whitehall about the inefficient structure, with sources indicating that a direct abolition was sought to save time and resources. However, unions warned that cost-cutting measures might harm employee morale. Starmer denied any return to austerity, asserting that current public service issues originated a decade ago and promising that their plans wouldn’t follow that path.
Political reactions
While the Conservatives did not oppose this move, the Liberal Democrats emphasised the need to address social care issues in conjunction with NHS reform. Some former DHSC officials remain sceptical about the anticipated efficiencies, arguing that the government already had the authority to manage NHS England.
Hugh Alderwick of the Health Foundation cautioned that reorganisations often detract from core priorities, potentially leading to operational disruptions that compromise patient care. The interim chief executive of NHS England, James Mackey, acknowledged the unsettling nature of the changes but emphasised that they could clarify the department’s goals and enhance patient care by focusing on digital transformation and the community.