UK PM Starmer announces major healthcare reform as public sector cuts take shape

British Prime Minister Keir Starmer has announced his government is eliminating a key part of the country's healthcare bureaucracy to bring it back under "democratic control".

Overhauling the struggling National Health Service (NHS) is one of the Labour government's top domestic priorities, and on Thursday, the prime minister announced the closure of NHS England, the sub-governmental body that oversees the delivery of health services in the largest of the UK's four nations.

At a press conference, Starmer explained that the decision to scrap the entity was in large part a matter of efficiency — a claim that matches recent reports that his government is increasingly planning to trim the public sector in an effort to turn around the UK's public finances.

"Amongst the reasons we’re abolishing it is because of the duplication. So if you can believe it, we’ve got a communications team in NHS England, communications team in the health department of government, got a strategy team in NHS England, a strategy team in the government department."

"If we strip that out, which is what we’re doing today, that then allows us to free up that money to put it where it needs to be, which is the front line."

Quango chainsawed

National media have reported that some Labour aides have taken to referring to the agenda as "project chainsaw", apparently a reference to the dramatic and legally questionable cuts to the US executive branch currently being overseen by Elon Musk.

The government press release that accompanied the announcement described the body as the "world's largest quango", using the UK coinage for a "quasi-autonomous non-governmental organisation".

Speaking in the House of Commons shortly after Starmer's announcement, Health Secretary Wes Streeting — who has made aggressive moves to use private healthcare capacity to help relieve the overburdened NHS — said it would take around two years to reintegrate NHS England's functions back into the system as a whole.

"These reforms will deliver a much leaner top of the NHS, making significant savings of hundreds of millions of pounds a year," he said. "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."

In 2012, a programme of sweeping and highly controversial reforms to the health system gave NHS England more power to decide how England's roughly £200bn (€238bn) healthcare budget should be spent. But in the ensuing years, with public sector pay largely stagnant, the NHS has seen an explosion in waiting lists alongside a staff retention and recruitment crisis.

While the previous government did increase overall healthcare spending in raw terms, it fell short on its own hospital-building targets, and by the time it lost power at the 2024 general election had failed to turn the tide on waiting times for treatment.

During his statement to parliament on Thursday, Streeting claimed that numerous Conservative MPs had confided in him that the 2012 reorganisation had been a mistake.

Professor Dame Til Wykes, head of the School of Mental Health and Psychological Sciences at King’s College London, said that the reforms announced by Streeting and Starmer missed the point of what has gone wrong with the health service.

“The problems within the NHS are mostly due to lack of funding, not management," she said in a statement on Thursday.

"With the demise of NHS England, the government may regret having the complete responsibility for all issues that arise — there will be no-one to blame except themselves," Wykes explained.

“If scrapping NHS England means more involvement of the private-for-profit sector, then the health services are in for a difficult time. Taking away services from the NHS makes the NHS less efficient and cost more to run.”