Right time to scrap NHS England

Independent

19-03-2025

Outgoing NHS boss Amanda Pritchard has said that the 'time is right' to abolish NHS England.
With the Government due to announce its 10 Year Health Plan later this year, Ms Pritchard said that it was 'right' that the 'centre' should work more closely together.
The Government said that scrapping the 'world's largest quango' would reduce duplication at the top of the health service.
Thousands of jobs across NHS England and the Department of Health and Social Care are on the line as a result of the decision.
In her final public appearance as NHS England chief executive, Ms Pritchard urged health leaders to inform staff about their futures as 'quickly as possible'.
Ms Pritchard told delegates at an event at the King's Fund in London: 'There's no doubt that last week in particular was a very difficult one for lots of colleagues.
She said that 'given the challenging financial context', it is 'right' that the service does 'everything it can' to make the most of taxpayers' money.
'But none of that is to ignore the fact that many people are now worried about their own personal futures, their own livelihoods, and many others will be worried about the future of the work they are doing.
'And on NHS England specifically, I've said before that I support the need for the Department, NHSE and other bits of the centre, to work better together.
'Reducing duplication, getting stuff done more effectively and giving local teams the space and support that they need to deliver for patients, these are the right things to do.
'But I also acknowledge that it is Government's decision and, in this case, Parliament, to make decisions about how public services are structured.
'What is crucial is that whatever comes next is done fairly, and done right, and that colleagues are given certainty on their futures as quickly as possible.'
Ms Pritchard added: 'I do think it is the right thing for the centre, so NHS England, the Department of Health and others, to work more closely together.
'And I think the time is right to take the next steps to sort of radically reshape and reform how the centre works.
'I think that is right, because we need to be really able now to turn our attention to what it's going to take to deliver the 10 Year Plan, and then one team working on that.
'I think it's also really important that we do challenge ourselves on making sure we're making absolute best use of taxpayers' money, and therefore, where there is duplication, where there is friction in the way that we work, it is right to tackle that.
'It is ultimately the Government's decision about what the exact structures are that they want, and I would support 100% it is their right to do that, but radical reform definitely required.'
She went on: 'The thing I would say, though, is it's really important to remember that there are real people who are working unbelievably hard every day to do the things that we ask them to do – whether that's in the Department of Health, whether that's in NHS England, whether that's in other parts of the health system.
'So the way this is done, doing it quickly, doing it fairly, and making sure it's done with really clear communication and support, is hugely important.'
Health Secretary Wes Streeting told the Commons on Thursday he wanted the merging of NHS England with the Department of Health to be completed within two years.
He told MPs: 'Today we're abolishing the biggest quango in the world.'
On staff reduction, he added: 'The size of NHS England, there are 15,300 staff; in the Department of Health and Social Care 3,300; and across both we're looking to reduce the overall headcount by 50%.'
Ms Pritchard will become leader of Guy's and St Thomas' hospitals later this year.
She joked that she would take speaking roles for 'weddings, birthdays, bar mitzvahs, until I start my next job'.
She added: 'I'll be selling CDs afterwards in the car park, of my greatest hits, which I have entitled Never Mind The Bureaucrats'.'
Reflecting on her role, she highlighted some of the 'peculiarities' which come with the position, 'like being asked to attend a late-night karaoke party in the office of one of the secretaries of state – who I shall not name – to mark the publication of a new plan'.
She added: 'If ever there was an incentive to slow-roll policy development, it's the prospect of being asked to belt out power ballads on the top floor of Victoria Street every time you launch a new initiative.'