NHS Staff Redundancies to Continue After Treasury Deal

The government announced earlier this year that 18,000 administrative and management jobs would go to NHS England, the organization that runs the NHS, and be transferred to the Department of Health and Social Care, while cuts would be made to local health boards. NHS bosses and health ministers had been in discussions with the Treasury about how the one-off £1bn bill would be paid as the health service wanted extra money. The Treasury has blocked this but a compromise has been reached allowing the NHS to overspend this year.

A Pragmatic Step

As job cuts result in savings in the coming years, the NHS is expected to recoup the costs later. Overall, there is no extra money going into the NHS beyond what was agreed at this year’s spending review – an extra £29 billion a year above inflation until 2028-29. The Health Secretary said that patients and NHS staff had told him that the health service had “too many layers of management, too many layers of bureaucracy”. People want the front line to be a priority and that is exactly what is being done.

Redundancies and Savings

The government says the reforms will raise £1 billion a year by the end of the term to improve services for patients. Every billion pounds saved in bureaucratic costs is enough to fund an additional 116,000 hip and knee operations. NHS England is expected to be folded back into the Department of Health within two years, while cuts to the Integrated Care Boards (ICBs), which plan health services for individual regions, will see their staff numbers reduced by 50%.

Concerns Over Redundancies

The CEO of NHS Providers said: “This is a pragmatic step which means planned redundancies can now go ahead.” However, the Royal College of Nursing warned the redundancies could backfire. Frontline services require more investment, but doing so while laying off thousands of professionals is a false economy. Skilled nurses working across NHS England and ICBs not only lead key public health programs and oversee care programs for vulnerable people – they link the NHS and social care services together.

Why is NHS England Being Abolished?

NHS England – the body that runs the NHS in England – was created as part of reforms introduced in 2012. The idea was to free the health service from political interference – by having ministers instead set the broader strategy but refrain from day-to-day interference. But the health secretary recently said NHS England had become a "bureaucratic monster" that was stifling innovation. Some organizations were reportedly completing 250 forms a month at one point just to satisfy both NHS England and the Department of Health.

Control and Management

Ministers have argued that it is only right that a democratically elected government is responsible for the day-to-day management of the health service. However, given that opposition has criticized the manipulation of the NHS structures, initiating its own restructuring carries significant risk. Those working in the health service are already talking about the disruption and distractions these changes are causing – and given that NHS England oversees the day-to-day running of the health service, organizes some specialist services and plays a role in training and digital innovation, it’s not hard to see why there are some serious concerns about the reforms.