The BMA and the RCN have greeted news of the axing of NHS England (NHSE) with caution, after Prime Minister Keir Starmer made the surprise announcement yesterday. Sir Keir said scrapping the body and bringing its executive functions back into the Department of Health and Social Care, would bring ‘put the NHS back at the heart of government where it belongs – freeing it to focus on patients, less bureaucracy, with more money for nurses’.
But while acknowledging that ‘ It has been increasingly clear that NHSE no longer has a grip on the health service, its staffing or the future of the NHS’, Prof Phil Banfield, chair of BMA council warned that: ‘This is a high stakes move from the Government. Without NHSE acting as a buffer between himself and delivery of healthcare to patients, the buck will now well and truly stop with the Health Secretary.
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‘Doctors' experiences of reorganisations of the NHS have not been positive,’ he added. This must not become a distraction from the crucial task that lies ahead: dealing with a historic workforce crisis, bringing down waiting lists and restoring the family doctor.’
Condemning the ‘chaotic reorganisation that created NHS England cost billions and took money and attention away from clinical care’, Professor Nicola Ranger, RCN General Secretary and Chief Executive saw an opportunity for nurses to wield more influence the new NHS. ‘As the largest workforce in the NHS, delivering the vast majority of care, it is vital our expertise is heard at the top table of government. The chief nurse must have a place alongside the other new medical directors within the department.’
But the major health think tanks all questioned whether another NHS reorganisation would produce enough gains to justify the disruption. While conceding it was correct for ministers to end ‘duplication and waste between two national bodies’ and be able to monitor ‘how the NHS delivers for patients and spends hundreds of billions of taxpayer money’, Sarah Woolnough, Chief Executive of The King’s Fund, said: ‘The Government must be clear why this significant structural change at this time is necessary, and how its fits into their wider plans.
‘The potential costs savings would be minimal in the context of the entire NHS budget, and so they must ensure that the changes produce the improved effectiveness which is sought by making this change.’
Established as part of the controversial 2012 Health and Social Care Act, NHS England now controls about 90% of government health spending. Its closure will lead to an estimated 10,000 job losses.