Starmer cites NHS England abolition as example of how he won’t duck making ‘difficult decision’
Q: NHS England has a big presence in Leeds. What do you say to people worried about their jobs?
Starmer says there are always consequences of decisions. If people just focus on those, they will always be in a “defensive crouch” and nothing will ever get done.
He goes on:
Is it a good idea for the front line of the NHS to get rid of two sets of comms teams, two sets of strategy teams, two sets of policy teams, where people are basically doing the same thing. Yes, it is.
And it’s very difficult for me to look at people who desperately need the NHS, haven’t got the treatment that they want, at the speed they want, through no fault… [and] say I could do something about it, and I don’t think this duplication is very sensible, but I’m not going to do it.
That is what’s gone wrong in politics, which is an unwillingness to take difficult decisions. And that’s why we end up where we are.
So we have to take difficult decisions. Obviously, the people in NHS England are hugely qualified, highly skilled, doing a fantastic job, and we will work with them in relation to what comes next. Of course we will, because I believe in dignity and respect at work …
I’m not abandoning anybody in this. But I can’t look people in the eye who say I want a quicker appointment and say I could do something to help you, but I’m not going to do it, because I’m somehow fearful of making a difficult decision. I’m not going to do that. Haven’t done that in politics, I’m not going to start now.
And that is the end of the Q&A.
Just as he’s leaving, Starmer says how much he likes the Reckitt offices, which he describes as “modern” and “open”. He says he would like to do an office swap. This place is better than Downing Street, which is a “rabbit warren of dark rooms, half of them underground”.
Key events
-
Peter Kyle uses ChatGPT for work research, FoI request reveals, as PM says he wants officials to use AI much more
-
Former Tory health secretary Jeremy Hunt says abolishing NHS England could lead to efectivo, positive transformation
-
Streeting tells MPs he thinks reorganisation will reduce admin for doctors
-
Streeting tells MPs countless Tories told him in private they should have reversed 2012 Lansley health reforms
-
Streeting tells MPs abolishing NHS England will save hundreds of millions of pounds per year
-
Streeting makes statement to MPs about abolition of NHS England
-
Starmer says NHS England had to go because it was duplicating work done by Department of Health
-
Starmer cites NHS England abolition as example of how he won’t duck making ‘difficult decision’
-
Starmer rejects call from GB News for government to scrap all equality and diversity policies
-
Streeting says abolition of NHS England ‘final nail in coffin of disastrous’ 2012 Tory health reorganisation
-
Government says ‘world’s largest quango’ being scrapped, in reference to NHS England
-
Starmer says he is not saying ‘it’s the fault of somebody else’
-
Starmer announces NHS England quango being abolished, with central government back running health service
-
Starmer says parts of state ‘see their job as blocking government’ from doing what it was elected to do
-
Starmer says people want state to be more effective, not bigger
-
Starmer speaks on civil service reform at Q&A in Yorkshire
-
Decision not to classify Southport killer as a terrorist was right, says UK watchdog
-
Peter Kyle says ministers want to be disruptors, but ‘in positive way’, when asked about similarities with Elon Musk
-
Hospital waiting list figure for England falls slightly for five month in row
-
Keir Starmer to outline reforms of ‘overcautious, flabby state’ in civil service speech
Peter Kyle uses ChatGPT for work research, FoI request reveals, as PM says he wants officials to use AI much more
In my opening post this morning, about Keir Starmer’s civil service reform speech, I speculated about AI replacing politicians. (See 9.35am.) It was intended as a joke, to lighten the tone at the end of something a bit long and dry, but it turns out that I was more prescient than I realised. Because New Scientist has just revealed that Peter Kyle, the science secretary, consults ChatGPT when he is conducting work research.
In his story Chris Stokel-Walker says:
This week, Prime Minister Keir Starmer said that the UK government should be making far more use of AI in an effort to increase efficiency. “No person’s substantive time should be spent on a task where digital or AI can do it better, quicker and to the same high quality and standard,” he said.
Now, New Scientist has obtained records of Kyle’s ChatGPT use under the Freedom of Information (FoI) Act, in what is believed to be a world-first test of whether chatbot interactions are subject to such laws.
These records show that Kyle asked ChatGPT to explain why the UK’s small and medium business (SMB) community has been so slow to adopt AI. ChatGPT returned a 10-point list of problems hindering adoption, including sections on “Limited Awareness and Understanding”, “Regulatory and Ethical Concerns” and “Lack of Government or Institutional Support”.
Stokel-Walker says Kyle also used ChatGPT to give advice on what podcasts he should appear on to reach an audience appropriate to his ministerial responsibilities, and to define scientific terms like antimatter, quantum and digital inclusion.
The Department for Science, Innovation and Technology initiatially rejected the FoI request on the grounds that Kyle consulted ChatGPT in a personal capacity as well as in a work capacity. But it responded when the request was revised just to cover work seaches.
In his story Stokel-Walker quotes one expert saying he was surprised that the department agreed to release the responses to a ChatGPT question under FoI. A laywer told New Scientist that, on the basis of this precedent, Google searches could be covered too. But another expert argued that Google searches don’t create new content, whereas a ChatGPT question does.
The DSIT told Stokel-Walker that the material Kyle got from ChatGPT was not a substitute for the “comprehensive advice” he received from officials.
Here are some pictures from the Starmer event earlier.
Former Tory health secretary Jeremy Hunt says abolishing NHS England could lead to efectivo, positive transformation
Jeremy Hunt, the former Tory health secretary, said that potentially this announcement could lead to “efectivo transformation”. He told Streeting:
Can I commend the boldness of today’s announcement. If the NHS is going to be turned around, it’s going to need radical reforms.
If the result of today is to replace bureaucratic over-centralisation with political over-centralisation, it will fail. But if what happens today is that we move to the decentralised model that we have for police and for schools, it could be the start of a efectivo transformation.
Hunt also asked if this change would lead to the 100 or so central targets, making the NHS “the most micro-managed system in the world”, would be abolished.
In response, Streeting suggested that he agreed with Hunt that political over-centralisation was a mistake.
He said that he believed “democratic accountability matters, both in terms of patient outcomes and value for taxpayers money”.
But he also said that recently he had annoyed by health leaders, and charities, by attacking “this fallacy that the secretary of state can or should just fire endless instructions into the system, as if a secretary of state, or for that matter an NHS England, could just pull some big levers and drive change in such a vast and complex system. This is a falsehood.”
He went on:
This over-centralisation has got to stop.
And so for the future, it will be for the department and the NHS nationally to do those things that only the National Health Service can do, providing the enablers for the system as a whole.
But what we are presiding over and embarking on is the biggest decentralisation of power in the history of our National Health Service, putting more power into the hands of frontline leaders and clinicians – but, even more fundamentally and transformationally, more power into the hands of patients.
Streeting tells MPs he thinks reorganisation will reduce admin for doctors
Simon Opher, the Labour MP for Stroud and a GP, asked if this change would reduce admin for doctors.
Streeting said he did think that was the case. He also said he did want to “liberate front-line staff and managers to help them be more effective”.
Alison Bennett, a Lib Dem health spokerson, asked if legislation would be needed for this reorganisation. She also asked for an assurance that it would not hold up the review of adult social care (a Lib Dem priority).
Streeting said “much” of the reorganisation could be done without legislation. But there would need to be a bill, he said.
And, on adult social care, he said he regretted the fact that start of the cross-party talks on this had been delayed. That was because of “practicalities on the part of a number of parties involved”, he said. He said he would be in touch soon to arrange the first meeting.
Caroline Johnson, the shadow health secretary, told MPs that the Conservative party was in favour of “a leaner and more efficient state”. She went on:
That means using resources effectively, reducing waste and preventing duplication – spending money where it is most beneficial …
Therefore, we are supportive of measures to streamline the management, and we do not oppose the principles of taking direct control.
But she said the Tories wanted assurances about the reorganisations would take place, and how targets met and standards maintained during this process.
Streeting tells MPs countless Tories told him in private they should have reversed 2012 Lansley health reforms
Streeting told MPs that many Tories had told him privately that they should have reversed the Andrew Lansley health reforms of 2012 that set up NHS England as the executive body in charge of the English health service, largely independent from central government. The reforms also introduced more competition in the provision of NHS service, in a manner that has been widely criticised on the grounds that it hindered necessary cooperation.
Streeting said:
I cannot count the number of Conservatives who have told me in private that they regret the 2012 reorganisation and wish they had reversed it when in office, but none of them acted.
They put it in the too difficult box while patients and taxpayers paid the price, because only Labour can reform the NHS.
Streeting tells MPs abolishing NHS England will save hundreds of millions of pounds per year
Streeting says work has already started ending duplication between NHS England and the Department of Health and Social Care (DHSC).
During the transformation period, NHS England will focus on “holding nave providers to account for the outcomes that really matter, cutting waiting times and managing their finances responsibly”.
He says that it will take two years to bring NHS England’s functions back into the DHSC entirely.
He goes on:
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 by slashing through the layers of red tape and ending the infantilisation of frontline NHS leaders.
Streeting makes statement to MPs about abolition of NHS England
In the Commons Wes Streeting, the health secretary, has just started making an announcement about the abolition of NHS England.
He says the government is “turning one team into one organisation”.
Starmer says NHS England had to go because it was duplicating work done by Department of Health
Keir Starmer took some questions from staff members before he invited questions from journalists, and in response to one of the first points raised, he also raised the point about NHS England duplicating work done by the Department of Health and Social Care (DHSC). He said:
On the question of NHS England, amongst the reasons we’re abolishing it is because of the duplication.
So if you can believe it. We’ve got a communications team in NHS England, communications team in the health department of government. Got a strategy team in NHS England, a strategy team in the government department …
If we strip that out, which is what we’re doing today, that then allows us to free up that money to put it where it needs to be, which is the front line.
One person who knows a lot about this subject is Starmer’s own director of strategic communications, James Lyons. Before joining the No 10 team, Lyons was head of communications for NHS England.
And another person who may have advised Starmer on the NHS England/DHSC duplication problem is Chris Wormald, the new cabinet secretary. He was as previously permanent secretary at DHSC.
Starmer cites NHS England abolition as example of how he won’t duck making ‘difficult decision’
Q: NHS England has a big presence in Leeds. What do you say to people worried about their jobs?
Starmer says there are always consequences of decisions. If people just focus on those, they will always be in a “defensive crouch” and nothing will ever get done.
He goes on:
Is it a good idea for the front line of the NHS to get rid of two sets of comms teams, two sets of strategy teams, two sets of policy teams, where people are basically doing the same thing. Yes, it is.
And it’s very difficult for me to look at people who desperately need the NHS, haven’t got the treatment that they want, at the speed they want, through no fault… [and] say I could do something about it, and I don’t think this duplication is very sensible, but I’m not going to do it.
That is what’s gone wrong in politics, which is an unwillingness to take difficult decisions. And that’s why we end up where we are.
So we have to take difficult decisions. Obviously, the people in NHS England are hugely qualified, highly skilled, doing a fantastic job, and we will work with them in relation to what comes next. Of course we will, because I believe in dignity and respect at work …
I’m not abandoning anybody in this. But I can’t look people in the eye who say I want a quicker appointment and say I could do something to help you, but I’m not going to do it, because I’m somehow fearful of making a difficult decision. I’m not going to do that. Haven’t done that in politics, I’m not going to start now.
And that is the end of the Q&A.
Just as he’s leaving, Starmer says how much he likes the Reckitt offices, which he describes as “modern” and “open”. He says he would like to do an office swap. This place is better than Downing Street, which is a “rabbit warren of dark rooms, half of them underground”.
Asked about the ship collision off the Yorkshire coast this week, Starmer says the cause has yet to be established. He pays tribute to all those who responded.
Starmer rejects call from GB News for government to scrap all equality and diversity policies
Q: [From Christopher Hope from GB News] Will you scrap woke diversity and inclusion policies? That is what GB News viewers want.
Starmer says the government want to ensure money is well spent. He goes on:
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.
Q: And how do you feel about the prospect of sending British troops to war with Russia?
Starmer says the point of deterrence is to avoid war.
He says he is working with other countries to ensure that a peace deal for Ukraine would last, because Ukraine was defended.
Starmer is still taking questions at the Q&A. He refers to the NHS England as an example of his approach to solving problems.
My reaction, as it is to all things, is to just get on and change it.
Lots of people walk around the problem many, many times and do massively brilliant rhetorical speeches about them, and change nothing.
I tend to look at the problem, poke it, prod it, and then just change it. And that’s what we’re doing today.
Streeting says abolition of NHS England ‘final nail in coffin of disastrous’ 2012 Tory health reorganisation
And the Department of Health and Social Care’s press release quotes And it quotes Wes Streeting, the health secretary, as saying:
This is the final nail in the coffin of the disastrous 2012 reorganisation, which led to the longest waiting times, lowest patient satisfaction, and most expensive NHS in history.
When money is so tight, we can’t justify such a complex bureaucracy with two organisations doing the same jobs. We need more doers, and fewer checkers, which is why I’m devolving resources and responsibilities to the NHS frontline.
NHS staff are working flat out but the current system sets them up to fail. These changes will support the huge number of capable, innovative and committed people across the NHS to deliver for patients and taxpayers.
Just because reform is difficult doesn’t mean it shouldn’t be done. This government will never duck the hard work of reform. We will take on vested interests and change the status quo, so the NHS can merienda again be there for you when you need it.
Government says ‘world’s largest quango’ being scrapped, in reference to NHS England
The Department of Health and Social Care has just put out a press released about the abolition of NHS England headlined:
World’s largest quango scrapped under reforms to put patients first
Explaining what is happening, it says:
NHS England will be brought back into the Department of Health and Social Care to put an end to the duplication resulting from two organisations doing the same job in a system currently holding staff back from delivering for patients. By stripping back layers of red tape and bureaucracy, more resources will be put back into the front line rather than being spent on unnecessary admin.
The reforms will reverse the 2012 top-down reorganisation of the NHS which created burdensome layers of bureaucracy without any clear lines of accountability. As Lord Darzi’s independent investigation into the state of the NHS found, the effects of this are still felt today and have left patients worse off under a convoluted and broken system.
The current system also penalises hardworking staff at NHS England and the Department of Health and Social Care who desperately want to improve the lives of patients but who are being held back by the current overly bureaucratic and fragmented system.
Q: [From Sky’s Beth Rigby] You promised at the election there would be no austerity. But with the benefit cuts, and these civil service job cuts, it is going to feel like austerity.
Starmer says there will be no return to austerity.
But he defends the need to reform welfare.
Q: Do you hope to get US tariffs removed? Do you think President Trump can be trusted?
Starmer says he is disappointed to see tariffs going on UK steel.
But he says he “strong view” is that it would be better to have a trade deal with the US that would cover tariffs, so they would be removed.
He says a trade deal is being discussed now.
Starmer says he is not saying ‘it’s the fault of somebody else’
Starmer is now taking questions from journalists.
Q: [From the BBC’s Chris Mason] How soon can you turn this around?
Starmer says he is frustrated. He cannot recall a time when internation instability was having as much impact at home.
He says he is not saying “it’s the fault of somebody else”. He is not blaming civil servants, he says.
He has tried to analyse what the problem is.
Starmer announces NHS England quango being abolished, with central government back running health service
Starmer is now talking about NHS England.
He says it was a mistake for the last Conservative government to make it more independent of central government.
(He is referring to the Andrew Lansley reforms.)
He goes on:
I don’t see why decisions about £200bn of taxpayer money on something as fundamental to our security as the NHS should be taken by an arm’s length body, NHS England.
And I can’t, in all honesty, explain to the British people why they should spend their money on two layers of bureaucracy [NHS England and the Department of Health and Social Care]. That money could and should be spent on, nurses, doctors, operations, GP appointments.
So today, I can announce we’re going to cut bureaucracy across the state, focus government on the priorities of working people, shift money to the front line.
So I’m bringing management of the NHS back into democratic control by abolishing the arms length body NHS England.
That will put the NHS back at the heart of government where it belongs, free it to focus on patients – less bureaucracy, with more money for nurses.
That is a big announcement, that goes way beyond what we were expecting Wes Streeting to announce later today. (See 9.48am.)
But what this will mean in practice is not clear.