Manchester nurses during the 2023 pay fight. Photo Workers.
In March the government began a shake-up of the NHS, abolishing NHS England (NHSE). Although that was welcomed, medical professionals and trade unions warned against repeating mistakes of the past.
The role of NHS England was inextricably tied up with the disastrous and chaotic 2012 Lansley reforms which sought to entrench an “internal market”. But health secretary Wes Streeting, speaking to parliament, focused on cutting costs – halving funding for integrated care boards (one of the ways the NHS tried to mitigate the impact of the 2012 reforms).
As yet there is no sign of developing a new model of a fully integrated, planned model that the NHS needs. NHSE was the custodian of the ten-year plan for the NHS. That had limitations, but was at least a start. And the fate of workforce planning is so far unknown.
Trade unions and professional bodies were critical of the 2012 reforms. They now fear a repeat of past mistakes. The Royal College of Emergency Medicine and others are concerned that the latest restructuring will detract from patient care.
The way that the announcement was made, with policy changing daily, and the lack of regard for those displaced, also causes concern.
Streeting asked eminent surgeon Ara Darzi to review the performance of the health system. He reported that the NHS was in trouble and set out what needs to be done.
He pointed to the “costly and distracting process of almost constant reorganisation”. Starmer and Streeting seemed to have missed that point, and have ignored Darzi’s view that some of the recent changes like integrated care boards “had the makings of a sensible management structure”.
• A longer version of this article is on the web at www.cpbml.org.uk