NHS England to go is Keir being unreasonable?

[43percentburnt]

I don’t work for the NHS but have friends who do (and are increasingly looking at leaving - in some cases to move abroad).

https://www.bbc.co.uk/news/live/cx29lrl826rt

Is the removal of NHS England a good thing? Or is this a Labour gimmick?

To include an Aibu for Keir -

Yes Keir - you are being unreasonable

Or

Good job Keir, please get rid of NHS England - you are NOT being unreasonable

Oh I don't mean Tracey from HR gets handed a stethoscope and becomes a doctor. But when I worked through one of these (large private company) staff were encouraged to apply to internal positions elsewhere. In some cases that meant retraining which isn't necessarily a bad thing. But if you work in a job that requires knowledge of employment law, or procurement or statistical analysis those are all transferable a lot of the time. There are good ways of handling this sort of thing and bad ways basically.

After working within executive offices within NHS trusts for many years - I think its a fabulous thing.

I am sure there are many who work for NHSE that do their job with integrity, but the 'consultants' that are sent into many trusts at £600+ per day (at the costs of the Trust by the way, so its usually the hospital having to find this money out of their already too tight budget) to do very little except go through data and spreadsheets already created within the trust - to tell them information they already know.

Huge, huge, huge waste of many for many trusts already struggling.

The most ironic thing is that the main NHS England functions were originally transferred out of DH when it was created.

Then ministers kept wanting to recruit more people into DHSC. It is that which has caused the duplication. But much easier to blame the Quango staff.

DHSC under Streeting has continued to grow while NHSE has had a recruitment freeze - indeed they're still recruiting.

Agree. When large organisations are failing often the solution is seen to be adding. Often it's stripping back to basics and simplifying.

Agree with the principle, wait to see the detail. I'd also like to see GPs being employed directly in the NHS, but don't see that happening.

This is literally what NHS management does. 'NHS experience' always, always trumps skilled management competence from outside, which is why nothing ever changes.

People elected Starmer thinking there was going to be a Labour government, but they are out Torying the Tories.

Slash the foreign aid budget.
Reform the civil service
Spend more on defence.
Dont raise taxes
Hit people on benefits and force them into work.
Cosy up to Trump.

Now attack the NHS.

People often describe the Labour right as "Tory Lite" but it looks more like Tory Heavy to me.

Yes. So they need to reduce the duplication, not just absorb them into other things.

Surely all these cover SHOULD already be going on in existing gvt departments?

It’s not attacking the NHS.

I’m ex-NHS management (not in England). Was recruited for my external experience. Did 4 years then moved on.

I do wonder if the people working there will just be swallowed up into gov positions and this is a gimmick as he has set up 27 quangos since election!

From long experience of working alongside the public sector I'd be amazed if it didn't happen

Never trust a politician in pursuit of a good headline, and certainly never trust the sector to have the slightest concept of saving taxpayerss' money ... as with the quangos they're all-too-convenient roosts for the otherwise unemployable to whom government owes favours

Who was it that said the most scary phrase in the world is "I'm from the government and I'm here to help" ?

That's are no training posts for our newly qualified doctors so we don't need more med school
Places we need to stop recruiting to training posts from abroad and use our own unemployed graduates

Well they are also cutting the CCGs (now called ICBs) in half, following 30% cuts last year.

NHS England and the ICBs deliver between them:

1. A load of central NHS IT services e.g. what national record systems there are (usually called the spine)
2. Almost all education for the NHS via a body previously called health education England
3. Determining how much and of what services need delivering in what places - which someone does have to do or how do you make sure the right services are in the right places for people to actually access them
4. Specialised services - e.g. proton beam therapy - so for things where each local hospital can't have one, how do you make sure that the population has appropriate access etc. Same for tertiary (super specialist) hospitals.
5. Continuing healthcare provision - health care services for people who need long term healthcare but don't need hospital care.

And there are plenty more on top of that.

You can't get rid of these functions.

"This move is projected to cut approximately half of NHS England's 15,000 jobs, potentially saving hundreds of millions annually."

yet more people will be on universal credit instead

Like Rachel Reeves, I'm no economist, but I don't even think she could have done much worse than the BofE has over the last few years.

Ronald Reagan. But he also thought trickle down economics was a great idea and is largely the reason the US went down the path it did on debt/spending. So ironically the republicans that love to quote that line are also deeply against the direction he set America on (debt, transitioning to a service economy) in many regards.

Technically, an NHS paramedic is "from the government" but I wasn't terrified to see them when I almost cut my hand of. Although they didn't say "I'm from the government" because that would be a really weird thing to say.

medic family here - there is famous story of a cardothoracic surgeon who was hauled before management to explain why half his acute aortic aneurysm patients were in the hospital for less than 12 hours and the other half were in for weeks. Why could he not have them all for only 12 hours. After a pause he explained that the 12 hour 50% were the ones that died... (fyi AAAs have an approx 50% death rate before getting to hospital, and 50% after).

Managers who do not know what they are managing are purely target hunters and will not implement changes that are coherent and of long term benefit.

Lol!!! 5 fold!!!

Attacking the NHS FFS!! billions more for patient care, cutting out unnecessary management...

What everyone has been calling for...

Starmer could invent a cure for Cancer and Tory supporters would complain.... must be something in the genes?

If only more trusts did this

We've huge labour shortages, skilled people will always be employable.

Or are you saying that tax payers money should be used to create 1000s of well paid but pointless jobs.....

Billions of pounds spent on pen pushers. Good call to abolish this.

yes because thats the way its headed, the amout of companies outsourcing, then Ai taking roles, more population growing , then global businesses

in the end it all comes to a point that you will only need a few major companies doing x,y,z and the rest are not necessary

plus businesses are always looking to cut costs when ever so then whats , the answer make more jobs for the purpose of jobs or you cut all but essentials similar to when covid was and then what do you do with all the people ?

I don’t know whether this is a good idea or not, but @Novotelchok describes the functions of NHSE very well. I’m a long time out of the NHS now, but the average person has absolutely no idea of the scale of the effort that is required behind the scenes to make sure that frontline services are delivered, or the almost unimaginable amounts of money that flow through the system to make this happen. Free at the point of use does not mean free.

We all want services that are…

Localised but not a postcode lottery

Overseen but not by people in ivory towers

Accountable but without too much paperwork

Joined up, but without too many people communicating by email or having meetings with each other

Developmental but without compromising service delivery today

Value for money, but without spending to much, or skimping on things

To have just the right amount of capacity for every clinical need, in the right place, at the right time

To deal kindly and professionally with many people who don’t care for themselves for whatever reason

To help people live longer, healthier lives, but also to deal cheerfully with the consequences of that which results in the need for more, and more complex health services over time

To manage people’s performance, but never to dismiss anyone for underperformance, because it’s the NHS FGS! We should sympathise with our staff and find a space for them all somewhere, god forbid a Board should stand by its decision to dismiss someone who was useless or toxic… it’s a myth that the NHS can’t dismiss for underperformance, and it’s often Board members, not HR teams that don’t have the stomach for it

That lots of decision-making should be clinically informed; however we don’t want to take clinicians from the frontline

All of the above is the art and science of management in the NHS, and someone has to do it, wherever they are employed.