Trade Union rep in NHS England
The top boss of NHS England says he is embarrassed by the mess that surrounds him. In a meeting with trade unions on 4 November, Sir Jim Mackey, NHS England Chief Exec, admitted that the lack of progress towards integrating NHS England with the Department of Health and Social Care (DHSC) was embarrassing.
To deal with the redundancies that come with their vision for the reorganisation of the NHS, special dispensation has been granted by the Treasury to pay the bill. It is likely to be in the region of £1 billion. It’s also important to note that this is not new money – it is merely a permission to overspend on existing NHS budgets! Senior leaders are unable to explain the benefits of spending this money on contract terminations.
Keir Starmer and Wes Streeting’s plans cover both NHS England and Integrated Care Boards, which are both to be downsized by 50%. They announced a colossal programme of change without providing any way of paying for it!
The Socialist covered the announcement that NHS England was to be abolished in March, with functions being merged into the Department of Health (see ‘Streeting abolishes NHS England: no job cuts!’). It has been over eight months since this announcement, and yet senior leaders still cannot outline the structure of the new organisation, nor can they demonstrate how spending hundreds of millions on a restructure would deliver any benefits to the system!
The government said this would reduce duplication across the system, and yet, after eight months, the only tangible outputs are the creation of duplicated executive ‘leadership’ posts! These posts attract six-figure salaries of up to £210,000.
As our previous article explained, the Socialist Party (along with much of the trade union movement) opposed the creation of NHS England in 2012. In part, this is because the creation of NHS England meant significant decisions were moved away from elected office, and into the hands of unaccountable executives. But that it is Starmer’s pro-big business Labour making these changes means they won’t be in the interests of NHS workers, civil servants or patients. The restructure will lead to attacks on jobs – which will need a joint trade union fight to prevent compulsory redundancies.
To try and downsize on the cheap, NHS England attempted to launch a ‘Mutually Agreed Resignation Scheme’. This would see workers leave on a form of bogus redundancy, with much worse terms and a fraction of their contractual entitlement. Trade unions successfully pushed backed on this, forcing NHS England into a U-turn. A complicating factor is that voluntary redundancy for NHS England staff is an appealing prospect for many – with over 3,000 expressions of interest before the scheme has even been launched. In part, this is due to the constant restructures at NHS England and previous bodies such as Health Education England and NHS Digital. Staff at these workplaces have been dealing with constant change for six years now.
Both Streeting and Starmer have used this abolition for political posturing; to appear tough on ‘back office’ workers and quangos. This Labour government has already created 20 new quangos since 2024; and this botched attempt at restructure is leading to more and more senior managers being announced with no increase in operational staff!
Streeting has also said that this move would lead to more democratic accountability. Real democracy would mean control and management by elected committees of workers at every level in the NHS, alongside NHS users. It would also mean bringing all associated health industries, such as pharmaceuticals, IT and private health providers under public control – and including them in a democratically run plan for health to ensure that frontline services and associated functions are all adequately funded. For an immediate cash injection for public services, a tax on the super-rich would go a good way to funding it.
Socialist Party members in the NHS trade unions continue to argue for such policies – alongside the immediate aims of blocking compulsory redundancies, arguing for worker involvement in organisational designs, and protecting the key functions delivered by NHS England.
