Unison attacks ‘shambolic’ announcement of NHS England’s abolition – UK politics live

Unison says handling of NHS England abolition announcement ‘shambolic’

Unison, which describes itself as the largest healthcare union in the UK, has described the announcement about the abolition of NHS England as “shambolic”. Christina McAnea, its general secretary, said:

The health service needs thousands more staff and to be able to hold on to experienced employees. At the moment, it’s struggling to do that. Giving staff a decent pay rise would help no end.

But this announcement will have left NHS England staff reeling. Just days ago they learned their numbers were to be slashed by half, now they discover their employer will cease to exist.

The way the news of the axing has been handled is nothing short of shambolic. It could surely have been managed in a more sympathetic way.

Key events

Nick Davies, programme director at the Institute for Government thinktank, is also sceptical about the need to abolish NHS England. He has posted these on Bluesky.

There’s a decent case for scrapping NHS England but doing so is a major change programme that will take up substantial ministerial and official time. Hard to see how govt can do this while also making good progress on meeting the 18 week target AND the three shifts ahead of the next election.

Less than six months ago, Streeting said top-down reorganisation was the ‘last thing’ he wanted to do. What’s changed since then?

All of the problems cited have been evident for years. Why has it taken 9 months in office for Labour to make such a monumental decision?

Streeting has just told the Commons that while much of this can be done without legislation, a bill is needed. And that the whole process of merging DHSC and NHSE is likely to take 2 years. Even if it’s the right long term decision this will be hugely disruptive in the short term

Leading health thinktanks say, while they can see case for abolishing NHS England, benefits for patients might be modest

Two of the leading health thinktanks in the UK have said that, while they can see the case for abolishing NHS England, the benefits for patients might be modest

In a statement, Sarah Woolnough, chief executive of the King’s Fund, said:

Today’s announcement lands on the same day that NHS stats show people continue to wait days in A&E and many patients remain stuck in hospital beds despite being well enough to leave. The most important question is how will the abolition of NHS England make it easier for people to get a GP appointment, shorten waits for planned care and improve people’s health? That hasn’t yet been set out – ministers will need to explain how the prize will be worth the price.

It is absolutely right that democratically elected politicians must have clear oversight of how the NHS delivers for patients and spends hundreds of billions of taxpayer money. It is also reasonable to want to deliver better value by reducing duplication and waste between two national bodies where they are performing a similar role. It is true that over its just over a decade of existence, NHS England has been asked to take on a lot more additional power, functions and therefore staff, than it was originally designed to do.

Having now made the decision to abolish NHS England, and while we still wait for the publication of the NHS 10 Year Plan, the government must be clear why this significant structural change at this time is necessary, and how it fits into their wider plans. The potential cost 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.

And Thea Stein, chief executive of the Nuffield Trust, said:

Today’s news will be devastating for staff at all levels of NHS England, and we must remain mindful of the human cost of this decision. With the public finances under extraordinary pressure it does, however, make sense to remove the duplication and bureaucracy that exists currently – and patients and the public are probably not going to shed many tears over the shifting of power from an arm’s-length body into central government.

But profound problems facing the NHS remain: how to meet growing patient need in the face of spiralling waiting lists and how to invest in care closer to home with the NHS’s wider finances already underwater and social care reform in the long grass. It is not immediately clear that rearranging the locus of the power at the top will make a huge and immediate difference to these issues, which ultimately will be how patients and the public judge the government.

Here is an explainer by Denis Campbell, the Guardian’s health policy editor, about what the abolition of NHS England means in practice.

Ukraine needs guarantees as Putin’s ambitions ‘are barely disguised’, Starmer says

Keir Starmer has said that he was not entirely surprised by Russia’s apparent rejection of the US-led ceasefire proposal for Ukraine.

In an interview with the News Agents podcast (perhaps he too consulted ChatGPT about the best podcasts to appear on – see 1.08pm), Starmer said:

Well, firstly, keep our focus on a lasting and secure peace in Ukraine, which is what we all want.

It doesn’t entirely surprise me that Russia is taking this stance. They’ve made it pretty clear. They put it in lights a number of times over.

I think progress was made on Tuesday, and I always felt that and hoped that out of Tuesday that would put the ball in the Russian court, if you like, where the pressure would come on Russia. That has now happened.

That is a good thing, because Russia is the aggressor. Russia is the country that where there had been previous deals and agreements, (it) has not honoured those.

We know that Putin has ambitions that are barely disguised.

The News Agents have posted the clip online. The full interview will be available later.

Jakub Krupa has more on what Starmer said on Ukraine in his Europe live blog, which today is largely focused on the Ukraine story.

Unison says handling of NHS England abolition announcement ‘shambolic’

The health service needs thousands more staff and to be able to hold on to experienced employees. At the moment, it’s struggling to do that. Giving staff a decent pay rise would help no end.

But this announcement will have left NHS England staff reeling. Just days ago they learned their numbers were to be slashed by half, now they discover their employer will cease to exist.

The way the news of the axing has been handled is nothing short of shambolic. It could surely have been managed in a more sympathetic way.

No 10 refuses to commit to reduction in overall number of quangos

Downing Street has refused to commit to cutting the overall number of quangos.

At the morning lobby briefing, asked if the government was aiming for a net reduction in the number of quangos, the PM’s spokesperson replied:

The objective here is to deliver better outcomes for the public.

Where the right answer is to remove an organisation in order for the state to be more effective, then that’s what we’ll do.

But where previous governments have sort of said that the outcome here is fewer quangos or fewer civil servants, we are focused on the outcomes on public services, on working people, so we will take the decisions to do that.

Peter Kyle uses ChatGPT for work research, FoI request reveals, as PM says he wants officials to use AI much more

In my opening post this morning, about Keir Starmer’s civil service reform speech, I speculated about AI replacing politicians. (See 9.35am.) It was intended as a joke, to lighten the tone at the end of something a bit long and dry, but it turns out that I was more prescient than I realised. Because New Scientist has just revealed that Peter Kyle, the science secretary, consults ChatGPT when he is conducting work research.

In his story Chris Stokel-Walker says:

This week, Prime Minister Keir Starmer said that the UK government should be making far more use of AI in an effort to increase efficiency. “No person’s substantive time should be spent on a task where digital or AI can do it better, quicker and to the same high quality and standard,” he said.

Now, New Scientist has obtained records of Kyle’s ChatGPT use under the Freedom of Information (FoI) Act, in what is believed to be a world-first test of whether chatbot interactions are subject to such laws.

These records show that Kyle asked ChatGPT to explain why the UK’s small and medium business (SMB) community has been so slow to adopt AI. ChatGPT returned a 10-point list of problems hindering adoption, including sections on “Limited Awareness and Understanding”, “Regulatory and Ethical Concerns” and “Lack of Government or Institutional Support”.

Stokel-Walker says Kyle also used ChatGPT to give advice on what podcasts he should appear on to reach an audience appropriate to his ministerial responsibilities, and to define scientific terms like antimatter, quantum and digital inclusion.

The Department for Science, Innovation and Technology initiatially rejected the FoI request on the grounds that Kyle consulted ChatGPT in a personal capacity as well as in a work capacity. But it responded when the request was revised just to cover work seaches.

In his story Stokel-Walker quotes one expert saying he was surprised that the department agreed to release the responses to a ChatGPT question under FoI. A laywer told New Scientist that, on the basis of this precedent, Google searches could be covered too. But another expert argued that Google searches don’t create new content, whereas a ChatGPT question does.

The DSIT told Stokel-Walker that the material Kyle got from ChatGPT was not a substitute for the “comprehensive advice” he received from officials.

Peter Kyle. Photograph: Wiktor Szymanowicz/REX/Shutterstock

Here are some pictures from the Starmer event earlier.

Keir Starmer speaking at the Reckitt Benckiser Health Care HQ in Hull. Photograph: Oli Scarff/Reuters

Starmer at Reckitt Benckiser Health Care. Photograph: Oli Scarff/Reuters

Former Tory health secretary Jeremy Hunt praises ‘boldness’ of Starmer’s decision to axe NHS England

Jeremy Hunt, the former Tory health secretary, said that potentially this announcement could lead to “real transformation”. He told Streeting:

Can I commend the boldness of today’s announcement. If the NHS is going to be turned around, it’s going to need radical reforms.

If the result of today is to replace bureaucratic over-centralisation with political over-centralisation, it will fail. But if what happens today is that we move to the decentralised model that we have for police and for schools, it could be the start of a real transformation.

Hunt also asked if this change would lead to the 100 or so central targets, making the NHS “the most micro-managed system in the world”, would be abolished.

In response, Streeting suggested that he agreed with Hunt that political over-centralisation was a mistake.

He said that he believed “democratic accountability matters, both in terms of patient outcomes and value for taxpayers money”.

But he also said that recently he had annoyed by health leaders, and charities, by attacking “this fallacy that the secretary of state can or should just fire endless instructions into the system, as if a secretary of state, or for that matter an NHS England, could just pull some big levers and drive change in such a vast and complex system. This is a falsehood.”

He went on:

This over-centralisation has got to stop.

And so for the future, it will be for the department and the NHS nationally to do those things that only the National Health Service can do, providing the enablers for the system as a whole.

But what we are presiding over and embarking on is the biggest decentralisation of power in the history of our National Health Service, putting more power into the hands of frontline leaders and clinicians – but, even more fundamentally and transformationally, more power into the hands of patients.

Streeting tells MPs he thinks reorganisation will reduce admin for doctors

Simon Opher, the Labour MP for Stroud and a GP, asked if this change would reduce admin for doctors.

Streeting said he did think that was the case. He also said he did want to “liberate front-line staff and managers to help them be more effective”.

Wes Streeting in the Commons today Photograph: HoC

Alison Bennett, a Lib Dem health spokerson, asked if legislation would be needed for this reorganisation. She also asked for an assurance that it would not hold up the review of adult social care (a Lib Dem priority).

Streeting said “much” of the reorganisation could be done without legislation. But there would need to be a bill, he said.

And, on adult social care, he said he regretted the fact that start of the cross-party talks on this had been delayed. That was because of “practicalities on the part of a number of parties involved”, he said. He said he would be in touch soon to arrange the first meeting.

Caroline Johnson, the shadow health secretary, told MPs that the Conservative party was in favour of “a leaner and more efficient state”. She went on:

That means using resources effectively, reducing waste and preventing duplication – spending money where it is most beneficial …

Therefore, we are supportive of measures to streamline the management, and we do not oppose the principles of taking direct control.

But she said the Tories wanted assurances about the reorganisations would take place, and how targets met and standards maintained during this process.

Streeting tells MPs countless Tories told him in private they should have reversed 2012 Lansley health reforms

Streeting told MPs that many Tories had told him privately that they should have reversed the Andrew Lansley health reforms of 2012 that set up NHS England as the executive body in charge of the English health service, largely independent from central government. The reforms also introduced more competition in the provision of NHS service, in a manner that has been widely criticised on the grounds that it hindered necessary cooperation.

Streeting said:

I cannot count the number of Conservatives who have told me in private that they regret the 2012 reorganisation and wish they had reversed it when in office, but none of them acted.

They put it in the too difficult box while patients and taxpayers paid the price, because only Labour can reform the NHS.

Streeting tells MPs abolishing NHS England will save hundreds of millions of pounds per year

Streeting says work has already started ending duplication between NHS England and the Department of Health and Social Care (DHSC).

During the transformation period, NHS England will focus on “holding local providers to account for the outcomes that really matter, cutting waiting times and managing their finances responsibly”.

He says that it will take two years to bring NHS England’s functions back into the DHSC entirely.

He goes on:

These reforms will deliver a much leaner top of the NHS making significant savings of hundreds of millions of pounds a year. That money will flow down to the front line to cut waiting times faster and deliver our Plan for Change by slashing through the layers of red tape and ending the infantilisation of frontline NHS leaders.

Unison attacks ‘shambolic’ announcement of NHS England’s abolition – UK politics live | Politics

Unison says handling of NHS England abolition announcement ‘shambolic’

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