Sir Keir Starmer’s decision to take an Elon Musk-sized chainsaw to NHS England – described today by the Government as “the world’s biggest quango” – might be one of the bravest decisions he takes as Prime Minister.
Essentially, he is doing the necessary surgery to the nation’s health service which successive Conservative administrations did not have the courage to do.
I was regularly told by senior Tories about their frustration that health policy was controlled by NHS England – yet they regularly took the beatings for NHS failings which they often lacked the power to correct.
Yet none of them felt able to unwind the reforms introduced by Andrew Lansley, a former Tory health secretary, and bring the bloated health budget back under the direct control of ministers.
Starmer announced plans to reform the civil service and abolish NHS EnglandPOOLHere in Hull, where the Prime Minister made the announcement at the manufuring home of Dettol, Gaviscon and Nurofen, I was struck by Starmer’s reasoning. He told us that he wanted to put the NHS back “as part of the Government, where it belongs”.
It was unjustifiable he said that the Government had two policy teams – for NHS England and the Department of Health – as well as two communications teams – for the NHS and DH; a waste of money when patients needed treating.
He is right of course. I have said for many years that only a Labour government will have the political space to overhaul the NHS. Starmer has taken on that challenge.
This is not without risk of course. Once the changes are enacted, all health problems will be at the door directly of Wes Streeting, the Health secretary because he cannot blame NHS England any more.
And – as one former Health official told me today – Starmer and Streeting might find that they do not have as many levers as they think they do when it comes to fixing the nation’s health.
NHS waiting lists have continued to spiral since the pandemic BMA And he may well face a battle with public sector unions – some of which are huge donors to Labour – over the scale of these reforms.
Starmer admitted in questions from journalists that it will be worrying time for the thousands of staff employed at NHS England in Leeds. But as the PM said, he has to put the interests of patients first.
More generally Starmer’s speech at Reckitt’s research and development operation was about slashing the flabby size of the state and getting better value for taxpayers. “Every pound must deliver for working people,” he said.
But when I asked him directly if that meant he would instruct the civil service to ban “woke” diversity, inclusion and equity policies and spend the savings on taxpayers, the PM pulled back.”
Every pound has to be spent rightly. Every pound we have at our disposal as a government is not our money, it’s taxpayer money. It’s your money,” he told me. “And we must keep that in mind with every decision that we make.”
But he added: “We’re not slashing our commitment to equality and important issues like that. Nobody would expect that. But we are making sure we’re stripping away what is unnecessary.”
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Keir Starmer announcing the abolition of NHS England today
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Well, GB News viewers might agree to differ with the PM on that one. But the direction of travel to cut wasteful spending and put the interests first of taxpayers will be a fillip to the party which has been trailing Reform UK in the polls.
It comes ahead of a week when Labour is expected to announce a £6billion cut to a welfare and benefits budget, some of which “can’t be defended on economic or moral terms”.
That will come after he slashed aid spending by billions of pounds to spend the money on the Armed Forces. Slowly but surely Starmer is making political choices which are moving Labour into the centre ground, squeezing out the Tories and others.
It is a reminder too for Reform UK that while its five MPs elected last July bicker and fall out, Sir Keir Starmer is stealing their clothes and looking to construct a support base to deliver a second term Labour government.