NHS England: Health and Social Care Secretary's statement
Source: gov.uk (2025-03-13)

The Health and Social Care Secretary made a statement to the House of Commons on plans to abolish NHS England.

Since coming into office, this government has made big strides in fixing our broken NHS.

[political content removed] The NHS [has] suffered years of industrial action, costing taxpayers billions and costing patients more than a million cancelled operations and appointments.

We negotiated an end to the resident doctors’ strike within 3 weeks.

We have delivered the 2 million extra appointments we promised in our first year, and we did it 7 months early.

And after years of rising waiting lists [political content removed], we are finally turning the tide, cutting waiting lists for 5 months in a row, cutting waiting lists through the winter pressures, cutting waiting lists by 193,000 so far and counting.

We have agreed the GP contract with GPs for the first time since the pandemic - our first step to bringing back the family doctor - and we have delivered the biggest uplift in hospice funding for a generation.

But there should be no doubt about the scale of the challenge ahead.

We inherited an NHS going through the worst crisis in its history, so there is no time to waste.

We inherited public finances with a £22 billion black hole, so there is no money to waste.

The urgency of the crisis means we have to go further and faster to deliver better value for taxpayers and better services for patients [political content removed].

Lord Darzi’s independent investigation into the National Health Service traced the current crisis back to the 2012 top-down reorganisation of the NHS by the Right Honourable Lord Lansley.

The Darzi investigation said the reorganisation was, and I quote, disastrous, a calamity without international precedent.

It scorched the earth for health reform, the effects of which are still felt to this day.

The Health and Social Care Act established more than 300 new NHS organisations, created a complex and fragmented web of bureaucracy and, to quote the Darzi investigation, imprisoned more than a million NHS staff in a broken system.

Well, today, Madam Deputy Speaker, we are putting the final nail in the coffin of the disastrous top-down reorganisation of the NHS.

There are more than twice as many staff working in NHS England and the Department of Health and Social Care today than there were in 2010, twice as many staff as when the NHS delivered the shortest waiting times and the highest patient satisfaction in history.

Today, the NHS delivers worse care for patients but is more expensive than ever before. The budget for NHS England staff and admin alone has soared to £2 billion. Taxpayers are paying more but getting less.

We have been left with 2 large organisations doing the same roles with an enormous amount of duplication.

It is, especially in times like these, when money is tight, that such bloated and inefficient bureaucracy cannot be justified.

But even if [political content removed] [we had not been left with] a £22 billion black hole in the public finances, the Prime Minister would still be announcing the changes he is today, because every pound that is wasted on inefficient bureaucracy, in good times or bad, is a pound that cannot be spent on treating patients faster.

Nor can it be spent on fixing our crumbling schools, lifting children out of poverty, or putting money back into people’s pockets.

There is always a duty on ministers to get as much value for taxpayers’ money as is possible, and I cannot honestly say that it is achievable with the way that my department and NHS England are set up today.

Nor can I say that the current set up is getting the best out of our NHS.

I am sure members will have heard their local NHS leaders complain about the top-down way in which the NHS is run.

It is something I have heard for years, and now I find myself at the peak of this enormous mountain of accountability.

I do not just recognise the complaint, I agree with it.

Frontline NHS staff are drowning in the micromanagement they are subjected to by the various and vast layers of bureaucracy.

In the Hewitt Review, the former Health Secretary, my Right Honourable Friend Dame Patricia Hewitt, reported that one local service was required to send 250 reports and forms to NHS England and the Department of Health and Social Care in a single month.

That is time and energy that is not being spent delivering care for patients.

The Hewitt Review also concluded that having 2 organisations doing the same jobs has led to, and I quote, tensions, wasted time and needless frictional costs.

Since coming into office, I have sought to correct that by building a one-team approach between my department and NHS England, working towards our shared mission of building an NHS fit for the future.

Today, the Prime Minister is announcing that we are turning one team into one organisation.

I want to acknowledge that there are talented and committed public servants working at every level of the NHS and my department, including at NHS England, who I have had the privilege of working with over the past 8 months.

The reforms we are announcing today are not a reflection on them. They have been set up to fail by a fragmented system that holds them back.

The actions we are taking today will change that.

Work has already begun to strip out the duplication between the 2 organisations and bring many of NHS England’s functions into the department.

NHS England will have a much clearer focus over this transformation period.

It will be in charge of holding local providers to account for the outcomes that really matter, cutting waiting times and managing their finances responsibly.

And it is tasked with realising the untapped potential of our National Health Service as a single-payer public service, getting a better deal for taxpayers through central procurement, being a better customer to medical technology innovators to get the latest cutting-edge tech into the hands of staff and patients much faster, and being a better partner to the life sciences sector to develop the medicines of the future.

Over the next 2 years, NHS England will be brought into the department entirely.

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

That money will flow down to the front line to cut waiting times faster and deliver our Plan for Change, slashing through the layers of red tape and ending the infantilisation of frontline NHS leaders.

We will set local NHS providers free to innovate, develop new productive ways of working and focus on what matters most - delivering better care for patients.

[political content removed]

The Prime Minister has committed to cutting the number of quangos.

Today, we are abolishing the biggest quango in the world.

I am delighted that Sir James Mackey will be leading the transformation team as the Chief Executive of NHS England.

Jim has an outstanding track-record of turning around organisations, balancing the books, driving up productivity and driving down waiting times.

He is putting in place a new transformation team to drive change, and alongside Dr Penny Dash as the incoming chair, I am delighted to have such a capable leadership team of radical reformers to lead NHS England with me through this transformation.

I would also like to take this opportunity to place on record my heartfelt thanks to Amanda Pritchard, who has shown an outstanding commitment to our National Health Service over her decades of service, which I know remains undiminished.

She has also been a rock of enormous support not only in the past 8 months, but also in the past few weeks as we have worked together with Jim preparing for this change.

I would also like to place on record my thanks to her deputy, Julian Kelly, who is one of the most outstanding public servants of his generation, and I would like to thank the rest of the leadership team departing at the end of this month. They deserve our thanks and best wishes for the future.

Madam Deputy Speaker, change is hard. There will always be cautious voices warning you to slow down.

However broken the status quo is, there will be those who resist any change away from it.

But we should be in no doubt. We inherited a National Health Service going through the worst crisis in its history.

Patients awaiting unacceptable lengths of time for an operation, a GP appointment or an ambulance.

This Labour [political content removed] government will never duck the hard yards of reform.

We will take on vested interests and change the status quo so the NHS can once again be there for us when we need it.

The Prime Minister has set an enormously ambitious target for the NHS to cut waiting times for operations from up to 18 months, to a maximum of 18 weeks by the end of this Parliament.

It will require us to go further and faster, but patients in our country deserve nothing less.

The reform the Prime Minister is setting out today will mean fewer checkers and more doers.

It will cut through the complex web of bureaucracy and devolve more resources and responsibility to the frontline to deliver better value for taxpayers’ money and a better service for patients.

And it will set the NHS up to deliver on the 3 big shifts needed to make the service fit for the future - from hospital to community, analogue to digital, and sickness to prevention.

Madam Deputy Speaker, the NHS is broken but it is not beaten. Together, we will turn it around.

And I commend this statement to the House.