They're making it up as they go along
Keir Starmer and Wes Streeting seem to be making up their NHS policy as they go along
Labour had 14 long years in opposition to come up with a coherent plan for the NHS, yet within their first year in power they appear to be chaotically making it up as they go along.
Yesterday’s announcement that they’re going to completely scrap NHS England came as a massive surprise, not just to the thousands of workers who are to have their jobs scrapped or dramatically changed at short notice, but also to anyone still labouring under the illusion that Starmer’s Labour have a clear plan for Britain’s terribly degraded health service.
Less than six months ago Wes Streeting said that a massive top-down reorganisation of the NHS was "the last thing" he wanted to do. Now he’s boasting about his sudden and massive top-down reorganisation as if it makes total sense.
Abolition of NHS England wasn’t mentioned in Labour’s 2024 general election manifesto, nor in the plans they announced for NHS England in May 2023.
In January 2025 Wes Streeting explicitly stated that he had no plans to merge NHS England and the Department of Health.
Also in January 2025 Streeting lauded NHS England’s plans to cut waiting times; increase local decision making; and reduce NHS reliance upon expensive agency staff.
Just last week Streeting was talking about a "radical restructuring" of NHS England, which was to cut around half of NHS England jobs.
Now, suddenly, the plan is to completely abolish it.
It’s not just the bizarre timeline of: no plans, no plans, no plans, NHS England is doing a great job, restructure it and downsize the workforce, abolish it!
It’s also the damaging way announcement has been made. Tony Blair’s former Cabinet Secretary Gus O’Donnell was extremely critical of the rhetoric coming from Starmer’s inner circle, especially the briefing that they were going to take a "chainsaw" to the civil service, which is a clear nod to Argentina’s insanely right-wing President Javier Milei and his ideological vandalism of the Argentine state.
O’Donnell also objected to Starmer’s accusation that civil servants are happy in the "tepid bath of managed decline" and asked whether workers would really be inspired to deliver their best if the Prime Minister accuses them of liking managed decline and his minions threaten to take a chainsaw to them.
Abolishing NHS England is going to take a lot of time, effort, restructuring, and legislation, and it’s more than apparent that this hasn’t been carefully thought through.
It’s impossible to convince anyone sensible that you’ve got a coherent and carefully considered plan when you’ve gone from no plans to abolish it last month, to briefing that you’re going to cut the workforce in half last week, to announcing you’re abolishing the whole thing just days later.
It’s particularly obscene to see Labour imitating the extreme-right antics of a lunatic like Milei, who has already delivered record-breaking poverty rates in his first year in power.
And it’s also extremely rich of Starmer to blame civil servants for Britain’s "managed decline" when he’s brazenly intent on continuing the Tory agenda of more austerity cuts; more privatisation profiteering; more vandalism of the social safety net; more infrastructure under-investment; and continued inaction against wealth and property hoarders.
The sudden decision to scrap NHS England reeks of desperation. These are people who wanted power for power’s sake, taking action for action’s sake.
They haven’t conducted any kind of cost-benefit analysis; done impact assessments; or drawn up a coherent strategy for what comes next, because they’ve simply made the decision on a whim, hoping to win plaudits from the kind of people who like what Elon Musk and Javier Milei have been up to in the US and Argentina.
Whatever your views on the management structure of NHS England, the only thing that’s clear about Starmer and Streeting’s sudden announcement that they’re completely abolishing it, is that it’s a slapdash plan that hasn’t really been thought through.
As chaotic and ill-planned as it seems, I think Starmer and Streeting do have a very well-thought out plan:
April 2025 "we need user fees to cut abuse of the health service";
May 2025 "we need to increase user fees and cut unnecessary use of the health service";
Pick a month 2026 "we are introducing an insurance purchase plan for all UK citizens";
Pick a month 2027 "we are selling our hospitals and infrastructure to the private sector who can provide more efficient service through our insurance plan";
Pick a month 2028 (pre-election); "we are selling our insurance plan to the private sector.
Nobody wants a privatised NHS but this is obviously their intention the contracts are probably already being written and as we can see with Kim Leadbeaters assisted dying bill the safeguards and checks and balances will not safeguard the public. In fact I would not be surprised to see the NHS privatisation and assisted dying bill rolled into one contract.
If you can't afford the treatment there will always be an alternative.....