Keir Starmer is abolishing NHS England to bring management of the health service “back into democratic control”. His health secretary said it would ensure the NHS delivers better care and better value for money – but it will mean thousands of people lose their jobs.
false,Thursday 13 March 2025 13:38, UK
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The prime minister’s announcement that he is abolishing NHS England may at first glance seem like a shock, but actually the signs have been coming for weeks.
At the end of February, Amanda Pritchard announced that she was standing down as the head of NHS England.
She said in a statement at the time that that was the “right time” to leave ahead of the launch of the government’s 10 Year Health Plan.
‘A change in focus’
Just over a week later, the medical director of NHS England, Professor Sir Stephen Powis, announced his departure from his role.
Our health producer Mark Thompson said at the time that those two resignations “signal not only a change in leadership but also a change in focus and strategy at the top of the health service”.
And then on Monday, three more NHS England executives announced that they will be standing down “in the coming weeks”.
‘Radically reduced’ – that’s one way of putting it…
Buried in that latest press release was this crucial line: “As part of the need to make best possible use of taxpayers’ money to support frontline services, the size of NHS England will be radically reduced and could see the size of the centre decrease by around half.”
We know now that NHS England is not just being radically reduced, it is being scrapped entirely, and staffing to oversee the health service from within “the heart of government” will be dramatically reduced.
The shutdown of NHS England will take around two years to complete, Downing Street has said.
Number 10 insisted the move, announced unexpectedly by the prime minister this morning, is a “necessary measure” to deliver on Labour’s promise to reduce NHS waiting lists.
The prime minister’s spokesman could not put a number on job losses as a result of the shutdown, but the health secretary has said he hopes to cut the numbers (around 15,300 in NHS England, and 3,300 in the government’s health department) by 50%.
The spokesman added that artificial intelligence and digitalisations will free up around £45bn to be spent elsewhere in the NHS.
Downing Street would not confirm when the decision to abolish the administrative body was made.
It also insisted Starmer is not attempting to criticise civil servants with his additional plans to reform public services.
Our political editor Beth Rigby says it is clear Sir Keir Starmer “really does believe in” reform, as he confirmed he will abolish NHS England.
But, she says, at the heart of his announcement is a concern about austerity.
Reacting to Starmer’s speech in Hull, Beth says: “He said there was too much duplication between this arms-length body and the department of health, and he said he was abolishing it.
“Just to put that into context, there are about 13,000 jobs in that organisation.
“This was a PM that came to prove that he really is set on trying to reform the state and speed up planning and try to reduce regulation.”
Watch Starmer announce abolition of NHS England:
Beth says you can see Starmer “really does believe in this”.
“When I talked to his team about it, they say that he’s genuinely appalled every time someone tells him there’s a review or consultation, something can’t go ahead.”
But, she adds, at the heart of this is a question about austerity.
“When he talks about reform, what many people see is that this actually a byword for cuts, for cuts to state jobs, but also cuts to budgets,” she says.
“And we are going to see that coming in the next coming weeks around the welfare bill.”
Beth reiterates that austerity is a hot topic.
“It is really concerning a number of his own MPs,” she says.
Jeremy Hunt is the longest serving health secretary ever – he was in the role from 2012 to 2018.
He commends the “boldness” of scrapping NHS England, saying “radical reforms” are needed to turn the health service around.
He hopes it will see the NHS move to a “decentralised model” like for police and schools.
He asks Wes Streeting if he will scrap the “central targets that make the NHS the most micromanaged system in the world”, that “makes it impossible for managers to deliver real change on the ground”.
If that is the case, Hunt asks if there remains a role for a reformed Care Quality Commission (CQC) “to call out poor care whenever it finds it”.
‘Better outcomes and better value’
The health secretary thanks Hunt for his “thoughtful question”.
He believes his job is “to be the champion for patients, and the champion for taxpayers, and to make sure the system as a whole delivers better outcomes for patients and better value for taxpayers”.
Streeting hits out at the “fallacy” that the health secretary “can or should just fire endless instructions into the system”, as if that just drives change “in such a vast and complex system”.
The overall programme of reform, he insists, is “the biggest decentralisation of power” in NHS history.
More political control will mean the system “will fail”, he adds.
Alison Bennett, the Liberal Democrat spokesperson, has welcomed steps to reform the NHS confirmed by the government today.
Bennett asks Health Secretary Wes Streeting whether new legislation will be needed to scrap NHS England considering this “merger” will take two years to complete.
She adds that any attempt to fix the NHS will “ultimately fail if we don’t address the crisis in social care”.
The MP tells Streeting to show the “same urgency in reforming social care as being shown to the NHS”.
Responding, Streeting says “much of the change can be delivered without the need for primary legislation”.
Streeting adds that Bennett is “right” to talk about the issue of social care, and mentions measures announced by the chancellor last year.
He points to the biggest expansion of carer’s allowance since the 1970s, and the £86m uplift in the disabled facilities grant.
Shadow health minister Dr Caroline Johnson is responding to the health secretary’s statement on behalf of the Conservative Party.
She says they are “supporting of measures to streamline the management” of NHS England, backing moves towards a “leaner, more efficient state”.
But she asks whether ministers have learned from Labour’s record of running the health service in Wales, which has the “highest waiting lists and longest waiting times”.
She also wants to know:
She also questions how clinical prioritisation will work with the health secretary taking more direct control, and how this tallies with the government’s promise to devolve more power.
Half of NHS England and DHSC jobs to be slashed
In response, Health Secretary Wes Streeting says they will be “working immediately to start bringing teams together”, and wants the “integration of NHS England into the department to be complete within two years”.
He says there are 15,300 staff in NHS England and 3,300 with the Department for Health and Social care, and wants to slash those totals by 50% to “deliver hundreds of millions of pounds worth of savings”.
On productivity, Streeting says he is “demanding stronger clinical leadership to drive those improvements”.
He says the deal to increase pay for resident (formerly junior) doctors “does include reforms that will improve productivity”, and points to NHS waiting lists having fallen for five months in a row as evidence.
And on the shadow minister’s Wales attack line, Streeting says: “The lesson is that when you have a Conservative government in Westminster – in England, Wales, Scotland, and Northern Ireland, the NHS suffers.”
Wes Streeting is now giving a statement in the Commons following Sir Keir Starmer’s announcement NHS England is to be abolished.
The health secretary starts by listing ways he says the Labour government is “turning the tide” on the NHS, including cutting waiting lists, agreeing a new contract with GPs and uplifting hospice funding.
“But there can be no doubt about the scale of the challenge ahead”, he says, saying there is “no money to waste” because of the inheritance Labour received from the Tories.
He cites Lord Dazi’s report into the health service which blamed the 2012 reorganisation of the NHS on many of its problems, including creating a “fragmented web of bureaucracy”.
“Today we are putting a final nail in the coffin of the Conservatives’ disastrous top-down organisation,” he says.
‘Worse care – but more expensive’
He adds there are more than twice as many people working in NHS England AND the Department of Health and Social Care (DHSC) today than 2010, adding that’s “twice as many staff as when the NHS delivered the shortest waiting times and highest satisfaction in history”.
“It delivers worse care for patients but is more expensive than ever before”, he says.
There are now two large organisations doing the same roles, he says, saying “bloated and inefficient bureaucracy can’t be justified”.
However, he says even if the Tories hadn’t left a £22bn black hole in the economy, the decision to scrap NHS England would still have been made.
There’s always a duty on ministers to get value for taxpayers and that is “not achievable” with the way NHS England and DHSC is currently set up.
He stressed the reforms are not a reflection on people working for NHS England.
After Sir Keir Starmer made the bombshell announcement that his government is scrapping NHS England, the health secretary is giving a statement to the House of Commons explaining the decision.
NHS England is the body which leads the National Health Service in England. It is responsible for delivering high-quality care, supporting staff, and ensuring value for money.
Watch Wes Streeting live in the stream above, at the link below, and follow updates here in the Politics Hub.
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