Statement in response to abolition of NHS England

By Steve Score

The government has announced the closure of NHS England (NHSE) as well as cuts in the running of other NHS bodies – the Integrated Care Boards (ICBs) and the Trusts. These cuts threaten up to 30,000 jobs. Despite health minister Wes Streeting’s description of this as getting rid of duplication and bureaucracy, we should oppose the job losses.

We are not talking about top executives on inflated salaries here. The ICBs for example say that jobs under threat include the organisation of vaccination programmes, children’s dental health projects and other important tasks. Even when reorganisation is necessary to improve the way things run, workers should be transferred to other useful roles with no attacks on terms and conditions.

Labour has broken its promise not to carry out any major top-down reorganisation in the NHS. Over many years governments of all stripes have pushed through reorganisation that has solved none of the NHS’s problems, while distracting from the real solutions. Here we go again!
Campaigners opposed the 2012 bill that created the NHS England quango along with Clinical Commissioning Groups (CCGs) in local areas and the ramping up of competitive market processes and privatisation which undermined the cooperation and collaboration we need in health care. The shift to Integrated Care Systems in 2022 was supposed to reintroduce greater collaboration and coherence but with Integrated Care Boards being told they are to halve in size, the question must be asked as to whether Starmer’s Labour government has any commitment to integration and more joined up care.

NHSE was meant to manage all of this in England: planning, setting targets, funnelling government money and other functions. It was also an opportunity for governments to try to distance themselves from unpopular decisions. Save Our NHS Leicestershire was established after the successful Save Glenfield Children’s Heart Centre Campaign defeated a proposal to close the only congenital heart centre in the East Midlands. It was NHS England we were fighting. But of course, we knew behind it was the then Tory government pushing for billions in “efficiency savings”.

Labour says it is putting more money into the NHS, and that savings from these measures will go back into ‘front line services’. But it will not compensate for many years of underinvestment, solve its severe staff retention problems or any other of the NHS’s problems. In Leicester, Leicestershire and Rutland, the extra money announced for the NHS in the Budget has been used to cover pay rises and inflation but has not dented the deficit the system cannot avoid.

Labour’s plans for greater private involvement in the NHS will make things worse. NHSE roles that currently are promoting privatisation will be replaced by government roles promoting privatisation. Some functions in NHSE could well be outsourced rather than taken over by the Department of Health and Social Care (DHSC).

Streeting also said that the abolition of NHSE would increase democratic accountability because it would bring direct control back to the government. We welcome moves towards greater democratic accountability and there is good argument for holding ministers directly to account. As Keep Our NHS Public says in its response to the abolition of NHS England, the government’s decision could be seen as taking back the duty to provide a comprehensive service abolished in the disastrous 2012 Act. Real democracy, however, would mean ultimate oversight and control involving elected committees including staff, service users and local communities. You could argue it would also mean nationalising the private health companies and pharmaceutical companies and other associated industries, to utilise their resources for the NHS and include them in a democratically run plan for health.

Instead, the Starmer government’s decision looks more like the centralisation evident in the last Labour government and crude cuts to the state, feeding a common public misperception that the NHS is over-managed.

Perhaps some of those threatened jobs could assist in a more democratic health service. Our campaign supports unions who fight to save jobs, and for them to be useful in a fully funded democratic NHS.

A detailed comment on the closure of NHSE by Keep Our NHS Public can be read here [ https://keepournhspublic.com/nhs-england-abolished/%5D