The Prime Minister said the move would ‘put an end to the duplication resulting from two organisations doing the same job, in a system currently holding staff back from delivering for patients’. ‘Stripping back layers of red tape and bureaucracy’ would, he said, ‘mean more resources being put back into the frontline, rather than being spent on unnecessary admin’.
In a Department of Health and Social Care press statement elaborating on the rationale, the Health Secretary, Wes Streeting, said: “NHS staff are working flat out, but the current system sets them up to fail. These changes will support the huge number of capable, innovative, and committed people across the NHS to deliver for patients and taxpayers. We need more doers and fewer checkers, which is why I’m devolving resources and responsibilities to the NHS frontline”
Wes Streeting described the decision to abolish NHSE – ‘the world’s largest quango’, and bring back under Department of Health & Social Care its key functions, as ‘the final nail in the coffin of the disastrous 2012 reorganisation, which led to the longest waiting times, lowest patient satisfaction, and most expensive NHS in history’. He said: “When money is so tight, we cannot justify such a complex bureaucracy, with two organisations doing the same jobs.” He added that ‘the current system’ – with duplication of some work by the DHSC and NHSE, penalised hard-working staff at both organisations, ‘who desperately want to improve the lives of patients, but who are being held back by the current overly bureaucratic and fragmented system’.
Sir James Mackey, who will take over as ‘Transition CEO’ of NHS England from the organisation’s current Chief Executive, Amada Pritchard, on 1 April, added: “We know that while unsettling for our staff, today’s announcement will bring welcome clarity as we focus on tackling the significant challenges ahead, and delivering on the government’s priorities for patients. From managing the COVID pandemic – including overseeing the biggest and most successful vaccine campaign which got the country back on its feet, to introducing the latest, most innovative, new treatments for patients, NHS England has played a vital role in improving the nation’s health. I have always been exceptionally proud to work for the NHS – and our staff in NHS England have much to be proud of.
“But,” he continued, “we now need to bring NHS England and DHSC together so we can deliver the biggest bang for our buck for patients, as we look to implement the three big shifts – analogue to digital, sickness to prevention, and hospital to community, and build an NHS fit for the future.”
The Department of Health & Social Care said work would ‘begin immediately’ to return many of NHS England’s current functions to it, with a longer-term programme delivering the changes to bring NHS England back into the Department, ‘while maintaining a laser-like focus on the government’s priorities to cut waiting times and responsibly manage finances.’ The work would also, the statement said, ‘realise the untapped potential of the NHS as a single payer system, using its centralised model to procure cutting-edge technology more rapidly, get a better deal for taxpayers on procurement, and work more closely with the life sciences sector to develop the treatments of the future’.
Too much centralisation and over-supervision had, the DHSC added, ‘led to a tangled bureaucracy’, which focused on ‘compliance and box-ticking, rather than patient care, value for money, and innovation’.
The DHSC says NHS England’s new leadership team, Sir Jim Mackey, and new Chair, Dr Penny Dash, will ‘lead this transformation, while re-asserting financial discipline and continuing to deliver on the government’s priority of cutting waiting times through the Plan for Change’.
Dr Dash is currently Chair of the NHS North West London Integrated Care Board, and is leading a major review into the regulation of health and social care quality in England. The Department of Health and Social Care says her interim report, published last year, ‘shone a light on the scale of the failure at the Care Quality Commission, and sparked the appointment of new leadership to turn around the health and care regulator’. A former NHS doctor, senior partner at McKinsey and Company working on healthcare globally, and DHSC head of Strategy, she has ‘a wealth of experience’ in the public, private, and government sectors.