Keir Starmer to abolish NHS England and bring health service back under 'democratic control' - live updates

Summary

NHS England will be abolished to "cut bureaucracy" and bring management of the health service "back into democratic control", Keir Starmer announces
Speaking in Hull, the prime minister says the state is "overstretched" and "unfocused"
The move partially reverses a Conservative-led reorganisation of the health service in 2012, which created NHS England to handle its day-to-day running
But the government says NHS England has "burdensome layers of bureaucracy without any clear lines of accountability"
It's hardly surprising ministers want more direct control of the NHS, given its importance to voters, our political correspondent Henry Zeffman writes
Have you got questions? Send them to us via WhatsApp on +447756 165803

Live Reporting

Edited by Jenna Moon and Malu Cursino

What's a 'quango' - and how many are there?published at 14:30 Greenwich Mean Time
Image source, PA Media
The prime minister has vowed to cut the costs of regulation, taking aim at a "cottage industry of checkers and blockers slowing down delivery for working people".
His key announcement was the abolition of the "world's largest quango", NHS England, which works with the Department of Health to oversee the delivery of health services. Its functions will be absorbed back into government within two years.
Quangostands for Quasi-Autonomous Non-Governmental Organisation. These are arm's-length bodies such as regulators and advisory groups, which are funded by taxpayers but not directly controlled from Whitehall.
They range from huge organisations like NHS England to smaller ones like the British Film Institute.
Their numbers have fallen by more than half since 2010 - David Cameron's coalition government abolished nearly 300 - but there are still more than 300 across the UK.
The Labour government has set up more than 20 since winning power last July. These include Great British Energy, which will invest in renewable energy to help meet clean power goals, and Skills England, which supports people in finding jobs.
But precise numbers - and costs - are hard to pin down, since some new quangos are, in effect, rebrands of previous ones.
The total budget for quangos in 2022/23 - when the latest figures were published - was £353bn.
Will this mean an increase in funding to the NHS and better access to medicines?published at 14:18 Greenwich Mean Time
Nick Triggle
Health correspondent
National Institute for Health and Care Excellence guidelines recommend what treatments can be afforded and what treatments are cost effective for the NHS to deliver.
If there's a new drug produced by the pharmaceutical industry, they will decide if the NHS can afford it and whether it is better than other drugs that are used. Once they make a recommendation, frontline health services are meant to then make that drug and treatment available to the NHS.
The announcement today though isn't about funding. We will get an announcement about funding - that's likely to be in early summer perhaps June. The NHS budget decided for the financial year that's starting next month in April.
The NHS is getting an uplift of about 3-4%. Come June, we'll be told what the spending is to be for three years beyond that.
Today's announcement is about the management structure of the NHS.
We'll continue answering your questionspublished at 14:11 Greenwich Mean Time
We've been hearing from our health correspondent Nick Triggle and political correspondent Helen Catt.
The live stream has wrapped up - but we're still taking a look at how the decision to scrap NHS England could impact you.
Stay with us as we address your questions throughout the day.
Will local authorities have control over decision-making and budgets?published at 14:08 Greenwich Mean Time
Nick Triggle
Health correspondent
Frazer asked does this announcement mean more decisions will be made by local health authorities? I think they will. We've been talking about merging one national organisation into another.
I think what we will see is some of the responsibilities NHS England holds devolved down to regional bodies.
Jeremy Hunt, the former health secretary, has talked about how he felt NHS England was stifling innovation.
I think one of the arguments being made is that this will devolve some of that decision making down to a local level and nearer to patients - local health boards will be more responsive to the needs of patients.
They will know what local populations need and where the weaknesses are, and that in theory should improve services for patients in different parts of the country.
Tory MP questions how changes will improve life for patientspublished at 14:04 Greenwich Mean Time
Image source, PA Media
Let's break away from answering your questions for a moment to bring you some reaction to Keir Starmer's announcement.
Conservative MP Alex Burghart says that structural reform of the NHS's management can be a "great thing", but "could be a total disaster if handled the wrong way".
Wes Streeting told the House of Commons earlier on that the government estimated "hundreds of millions" of pounds could be saved in the overhaul.
But, Burghart suggested that there is "no detail" behind the prime minister's plans.
"The prime minister hasn't set out how this is going to make life better for patients across the country, he hasn't set out how much money he's going to save by doing it," Burghart tells reporters.
What is bureaucracy?published at 13:58 Greenwich Mean Time
Helen Catt
Political correspondent
In the context that the government has been talking about it, bureaucracy is what you might also think of as "red tape".
It's based on the idea that something is particularly complicated, or requires excessive amounts of administration, paperwork, regulations or layers of management.
It's a term used to talk about stuff that people would think of as getting in the way through admin.
Why do we call it NHS England - isn't the NHS for the whole UK?published at 13:56 Greenwich Mean Time
Nick Triggle
Health correspondent
Will the NHS now be called NHS UK? asks Peter, who lives in Wales.
Health is a devolved matter.
When we talk about the Department of Health and Social Care - where Health Secretary Wes Streeting holds office - that's for NHS England.
While the UK government decides on the spending, the nations - England, Scotland, Wales, Northern Ireland - remain themselves responsible for how that money is spent in their respective regions.
Today's announcement is for the NHS just in England.
Did this decision come out of the blue?published at 13:46 Greenwich Mean Time
Nick Triggle
Health correspondent
Naomi contacted us to ask has this come out of the blue?
Within the NHS and Westminster, the writing has been on the wall for NHS England for some months.
Even in the latter years of the Tory government, health ministers expressed frustration that they weren't in charge of the day-to-day running of the health service.
NHS England was set up as part of the Andrew Lansley reforms in 2012. As the years have passed, there has been a frustration in government.
When Labour came in, it was clear Wes Streeting wanted more control of the NHS - he saw a lot of duplication and bureaucracy roles that existed in the Department of Health and NHS England.
In recent weeks we've seen NHS England's chief executive Amanda Pritchard saying she was stepping down at the end of the March - and a number of her senior leadership team have followed suit.
So bit by bit we did start to see there was going to be a significant change. This, however, is as big a change as you could possibly get at the heart of the NHS management structure.
What does NHS England do?published at 13:42 Greenwich Mean Time
The first question we're getting from you is on NHS England - asking what the body does and who works there.
NHS England leads the NHS in England.
It takes the money provided by the government and funnels it into the different parts of the health service.
It has therefore been NHS England's job to translate minister's priorities into the services people get on the frontline.
The body is also responsible for things like overseeing training and collecting data, as well as managing GP services.
About 18,000 people work for NHS England and the Department of Health, but we expect this workforce to get cut by 50% after today's announcement.
Experts answer your questions - watch live nowpublished at 13:30 Greenwich Mean Time
We're answering your questions on Prime Minister Keir Starmer's announcement, with health correspondent Nick Triggle and political correspondent Helen Catt.
Follow along by pressing the watch live button at the top of the page.
- This is part of our Your Voice Your BBC News project, which you can find out more about here
Can AI do jobs better than civil servants?published at 13:24 Greenwich Mean Time
By Marc Cieslak, AI correspondent
Ahead of his speech this morning, Starmer said in a Daily Telegraph article that “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.”
Big question marks still hang over the risk presented by a wide variety of AI technologies, while many can speed up certain tasks, note taking and transcribing interviews or meetings for instance, they still require human oversight to ensure accuracy.
With many jobs - especially when it comes to running the country - the devil is often in the detail and the jury is most certainly still out when it comes to the risks posed by relying on or leaning heavily into AI.
The PM talks about AI in very broad strokes and there’s very little detail about how it will specifically be used.
Have questions? Get in touchpublished at 13:05 Greenwich Mean Time
As we've been hearing, the government has announced NHS England will be scrapped – but what does this mean for patients and the wider NHS?
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What Wes Streeting has told the House of Commonspublished at 13:05 Greenwich Mean Time
Image source, Getty Images
Health Secretary Wes Streeting continues to answer questions from MPs in the House of Commons after this morning’s announcement that NHS England is set to be scrapped.
Streeting is touting the benefits of this decision, saying it will lead to “hundreds of millions” in savings and adding that each pound not “wasted” on bureaucracy can be spent on patient care.
Shadow Health Secretary Caroline Johnson, though, asked whether Labour is up to the task given its “failure” to successfully run the NHS in Wales.
And, Lib Dem MP Alison Bennett emphasised the need to reform social care too, as well as questioning whether legislation would be needed to deliver the plans for change - Streeting suggested it wouldn’t.
We’ll continue to bring you analysis of what the decision means for the NHS here, so stick with us.
This government has been critiqued on creation of new quangospublished at 12:52 Greenwich Mean Time
Helen Catt
Political correspondent
The prime minister says he wants to get rid of over regulation and quangos.
He was scathing about what he calls Westminster’s knee-jerk reaction of farming things out to reviews.
Of course one of the criticisms of his government so far has been the number of reviews and quangos it has created - around 20 quangos so far, including Great British Energy.
As a reminder, when we say quangos we are referring to Quasi-Autonomous Non-Governmental Organisations.
These are funded by taxpayers but not directly controlled by central government, and include regulators, cultural institutions and advisory bodies.
Why does NHS England's abolition only affect England?published at 12:40 Greenwich Mean Time
NHS England leads the NHS in England - which means the PM's announcement only affects this area.
After devolution, Scotland, Wales and Northern Ireland became responsible for a number of policy areas, one of which was health.
The UK has had devolved governments since the late 1990s, which work alongside the Westminster Parliament.
Former health secretary Hunt commends plan's 'boldness'published at 12:33 Greenwich Mean Time
Former Tory chancellor and health secretary Jeremy Hunt now commends the "boldness" of the plan announced today.
He warns that if this only serves to replace bureaucratic over-centralisation with political over-centralisation "it will fail".
He asks Streeting about getting rid of central targets, and also whether he agrees the care regulator, the Care Quality Commission (CQC), retains a "vital" role to call out poor care.
The health secretary responds that "democratic accountability matters".
He underlines that over-centralisation "has got to stop", calling this the "biggest decentralisation of power" in the history of the NHS.
Streeting asked if new legislation is needed for NHS England changepublished at 12:29 Greenwich Mean Time
Back in the Commons, Liberal Democrats MP Alison Bennett asks Streeting if new legislation is needed to scrap NHS England and if so, when it will be brought forward.
Bennett also emphasises the need to reform social care as part of attempts to fix the NHS and asks where the urgency for this is.
Streeting says much of the change needed to deliver plans can be done without the need for primary legislation - but some new legislation will be needed down the line to enact the government's plan.
"We will work immediately to move forward," he says.
On social care, Streeting says the urgency was found with the immediate steps the chancellor took to stabilise the finances of the Department of Health and Social Care, by releasing funding.
Incoming NHS England chair will work to bring it in line with DHSCpublished at 12:19 Greenwich Mean Time
Let's briefly dip away from the House of Commons to bring you remarks from the incoming NHS England chair, Dr Penny Dash.
As a reminder, NHS England is separate to the NHS itself - it's a public body with statutory functions enabling it to oversee the health service.
Last month, Amanda Pritchard announced she would be stepping down as the head of NHS England after taking up the role in 2021. She called it a "hugely difficult decision".
Image source, Getty Images
Image caption,
Amanda Pritchard quit as head of NHS England last month
Today, incoming chair Dr Dash says she is "committed" to working with colleagues across NHS England to ensure the body begins 2025/26 "in the strongest possible position to support the wider NHS".
She adds that she will help lead the work "to bring together NHSE and DHSC (the Department of Health and Social Care) to reduce duplication and streamline functions."
Job cuts will save millions of pounds, Streeting sayspublished at 12:13 Greenwich Mean Time
Shadow Health Minister Caroline Johnson is now asking questions in the Commons.
She asks how many people will be moved into different roles and lose jobs, and what lessons Labour has learned from its "failure" running the NHS in Wales.
Streeting, back on his feet, says there are currently 15,300 staff at NHS England, and 3,300 in the Department of Health and Social Care.
Across both, Streeting says his teams are looking to reduce the overall headcount "by 50%". He adds this will mean "hundreds of millions of pounds worth of savings".
Streeting: We are abolishing biggest quango in worldpublished at 12:07 Greenwich Mean Time
"Today we're abolishing the biggest quango in the world," Streeting tells the House of Commons.
He adds that he is "delighted" with the "capable" leadership team he will be working with to lead NHS England through the transformation.
"Change is hard," he adds, but says the Labour government will "never duck the hard yards of reform".
He says there have been a "number" of Conservatives who have told him in private they regret the "2012 reorganisation". "None of them acted," he said.
Reforms in 2012 saw the creation of NHS England to run the health service as well as the scrapping of primary care trusts in favour of GP-led clinical commissioning groups to organise local services.