The UK’s healthcare system is about to undergo one of its biggest shake-ups in recent history.
Prime Minister Keir Starmer has announced the complete abolition of NHS England, a move set to impact up to 10,000 jobs.
His decision stems from concerns that the current system is “flabby, unfocused, and over-cautious,” leading to inefficiencies rather than better patient care.
A Radical Move to Streamline the NHS
In a speech addressing public sector performance, Starmer criticized the rapid expansion of the workforce, arguing that increasing numbers haven’t translated into improved services.
His solution? Bring NHS England’s functions back under direct government control, a decision that means the Department of Health will now oversee GP and hospital services.
Health Secretary Wes Streeting had already hinted at significant cuts, labeling NHS England as the “world’s largest quango.”
With a budget exceeding £190 billion and 15,000 employees, the organization will be absorbed into the Department of Health over the next two years, slashing its workforce by around 9,000.
Efficiency Over Job Losses?
Despite concerns about job cuts, Streeting insists that the main goal is efficiency rather than mass layoffs.
He estimates that merging NHS England’s functions with the Department of Health will save “hundreds of millions of pounds.”
However, unions have fiercely opposed the move, calling it unrealistic and an insult to hardworking staff.
The restructuring has already triggered high-profile resignations, with both the NHS England chief executive and national medical director stepping down as the extent of the overhaul became clear.
Political Reactions: A Divisive Decision
The move effectively reverses a major reorganization introduced under the Coalition government.
Some conservatives, including Jeremy Hunt, have welcomed the decision.
However, critics have pointed out that Streeting previously ruled out “top-down reorganization.”
NHS leaders have urged caution, warning that such a drastic change could lead to “disruption” in services.
Their primary concern is ensuring that patient care remains the top priority during the transition.
Cutting Costs and Reducing Red Tape
Starmer argues that NHS England’s abolition will eliminate unnecessary duplication.
He gave an example of how both NHS England and the Department of Health maintain separate communications and strategy teams, performing similar roles.
By consolidating these functions, he claims the government will be able to redirect more funds toward frontline services.
He also emphasized a shift in power toward healthcare workers on the ground rather than layers of bureaucracy.
According to Streeting, “We need more doers, fewer checkers.”
The Role of Technology in Government Reform
Beyond NHS restructuring, Starmer’s administration is also pushing for broader government reforms.
He criticized the civil service for expanding by 130,000 people since the Brexit referendum without delivering proportional improvements in frontline services.
To address this, the government is investing in technology, including artificial intelligence (AI), to streamline operations.
The plan includes recruiting 2,000 tech apprentices to help modernize Whitehall and digitize public services.
Starmer believes that AI can cut administrative costs, speed up processes, and eliminate unnecessary tasks, ultimately saving up to £45 billion.
Merging Regulatory Bodies
The government’s cost-cutting mission isn’t stopping with NHS England.
Another major change is the planned merger of the Payment Systems Regulator with the Financial Conduct Authority.
Ministers believe that reducing the number of independent watchdogs will boost economic growth and remove bureaucratic hurdles for businesses.
However, critics argue that while Starmer is scrapping some regulatory bodies, his government is simultaneously creating new ones, making the overall benefit questionable.
Welfare and Public Service Reforms
In addition to restructuring the NHS and civil service, Starmer has signaled changes to the welfare system.
He insists that while support for those in need will continue, the system must also encourage people to re-enter the workforce.
He expressed concern that one in eight young people remains dependent on benefits instead of pursuing work or training.
According to him, the current system discourages job seekers from taking employment risks because they could end up worse off than before.
The Road Ahead: Austerity or Smart Spending?
Despite concerns about potential budget cuts, Starmer denies that his administration is heading toward another era of austerity.
Instead, he insists that the reforms are about smarter resource allocation rather than spending reductions.
The government’s focus on reshaping public services aligns with a broader strategy to strengthen the economy.
However, unions and opposition figures have warned that major transitions like these often come with growing pains.
Whether this shake-up delivers the promised improvements remains to be seen.