Prime Minister Keir Starmer today announced the abolition of NHS England as part of a wider government effort to “cut bureaucracy” and deliver a more agile state. Under the plans announced by Starmer, NHS England will be abolished, with many of the body’s functions brought back under the “democratic control” of the Department for Health and Social Care and central government. The aim is to complete this process within the next two years.
Speaking at a press conference in Hull, the Prime Minister took aim at what he described as the “cottage industry of checkers and blockers slowing down delivery for working people.” The prime culprit in this is the network of quangos (quasi-autonomous non-governmental organisations), which Starmer said had too often been used as a shield by politicians as an excuse for inaction on the big challenges of the day.
Today’s announcement comes as part of a wider effort by government to create what it sees as a more streamlined and agile state. Though Starmer is unlikely to appear on stage with a chainsaw in the style of Argentinian President Javier Milei, the restructuring of NHS England – described by Starmer and Health Secretary Wes Streeting as the world’s largest quango – represents the most significant step on the journey to deliver on its NHS reform mission.
Starmer again reiterated the government’s intention to harness new technologies such as AI to drive this public sector reform, claiming that more than £45 billion could be saved through greater digital adoption in the civil service.
Nevertheless, the government must tread some fine lines in ensuring that these political arguments resonate with their various constituents, both within the Labour Party, civil service, and the wider public.
Given Labour’s historic role in creating the NHS, any talk of sweeping reform will likely be met with resistance in some parts of the party. Yet equally, these links between Labour and the health service mean that they perhaps have more cover to take on the more ambitious reforms in a way that the Conservatives could not. As Starmer has proven during his time as leader, he is never more at ease than when taking on his own party, so as long as the value of these changes can be understood and demonstrated to voters – mainly in the form of a more effective health service which delivers results – that will be all that matters.
Yet despite this, there remains somewhat of a contradiction at the heart of Labour’s deregulation agenda. On the one hand, it passes the most sweeping set of worker rights (or regulatory burdens, depending on your view) in a generation in the Employment Rights Bill, while on the other, it champions the potential for efficiency savings through reducing the number of roles in the public sector. Equally, it aims to create a more agile state by abolishing quangos such as NHS England and the Payments Systems Regulator, while at the same creating an additional 27 in its first year in power, with a new football regulator to come.
Ultimately, this government knows that delivery matters above all else. If these restructurings do deliver the results that the government wants and help to deliver on the five overarching missions, that will be the ultimate vindication of this approach.