UK Government Thread

managing a top down reform like this without disruption of NHS will be a challenge and take time 

It does seem ludicrous that so kuch work was duplicated by 2 departments, there was never going to be a good time to do this with the nhs in permacrisis 

Posted by: MonkeySpacePilot

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Many of the quangos were just about absolving the government of blame for implementing the policies that government direct them to

This is a bit simplistic and Daily Mail. Quangos are a good way of depoliticising routine "service delivery" and decisions that are too contentious to be partisan.

It's also simply unrealistic to expect a Minister to be accountable for the whole range of things the modern state does. It was okay when 90% of citizen-state interactions were via the Royal Mail, but there are now so many government bodies that it's silly to pretend that a small group of people like the Cabinet can scrutinise all of them.

PARLIAMENT.UK "https://www.parliament.uk/globalassets/documents/commons/lib/research/key_issues/Key-Issues-Quangos.pdf"

Posted by: kelvin

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Spin? What spin?

That others are incapable of reading what he has said in the past especially your simplification to him just talking about NHS England. 

There was also your casual condescending of  "without considering what was really being said." 

So bearing in mind all that has been announced is him consolidating power to himself I think I wont be getting excited yet.

Posted by: kimbers

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managing a top down reform like this without disruption of NHS will be a challenge and take time 

Which is the eternal problem with the NHS. Despite the politicians announcing the problem is its a sacred cow and reforming it cant even be discussed the truth is, apart from the payment model, it has been under continual "reform" with basically every government messing around with it.

The problem is their reforms has often made things worse especially the false free markets (its odd how many believers in free markets dont grasp that creating an artificial market is the furthest thing from a free market possible) and means way too much NHS time is spent reeling from one reform to the next.

Hence they shout loudly that they werent allowed to carry out their reforms to hide the fact they did a shit job.

double post 

I hear Starmer has talked about the Civil Service being "flabby" and I feel personally attacked!

BUT WHY HAVEN'T THEY DONE IT SOONER!! THEY'VE HAD YEARS TO PLAN IT!!

So like what Trump's doing? That's going well isn't it.

A great example of what I've said before - time to take stock, look at the situation with some very smart advisors and civil servants, and then take action. From where I sit, absolutely not in the tent but with occasional chances to look through the flaps, there's a whole lot of this grown up thinking going on away from the front benches and front pages, and a whole lot of small g government in a range of policy areas to come.

But of course it won't be enough for some, who can only see in negative.

Posted by: theotherjonv

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So like what Trump's doing? That's going well isn't it.

Yes it is actually.

You might disagree with the results, as do I, and many of the people who voted for him are going to be rather unpleasantly surprised but it is going great for Trump and those who have managed to endear themselves to him.

The "improvements" are going to be very difficult to undo which is the point. Get the changes in early and they are very difficult to undo. 

If we take Streetings plans thats a year or so wasted messing around with high level management. Now remind me when the social care review is going to finish bearing in mind if you want to "fix" the NHS then you need to start there. 

As a quick edit going back to the NHS. I would suggest you look at the history of the NHS and how even during a World War the Labour party of the time managed to think about what they would do if they got elected.

Posted by: kelvin

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Or... they have been talking about NHS reform for the last four years... I don't know why anyone is surprised that some of that is being announced in the first year of government. The Trump talk is just nonsense.

It turns out that Streeting himself wasn't expecting it and before the general election had absolutely no intention of major reorganization of NHS England:

Before Labour won last summer's election, Mr Streeting said he had "absolutely no intention of wasting time with a big costly reorganisation" of the NHS.

And it wasn't until after Starmer had dropped the bombshell that Streeting claimed that he had changed his mind :

However, hours after Sir Keir Starmer dropped the bombshell that NHS England, the administrative body that runs the national health service, will be abolished to slash red tape, the health secretary said his mind had been changed.

https://news.sky.com/story/wes-streeting-admits-he-did-not-anticipate-scrapping-nhs-england-and-9-000-will-lose-jobs-13327935

Edit : To be clear "dropping bombshells" is not the usual way that health reforms are announced in the UK, so it does have something of the Trump about it.

I reckon that Morgan McSweeney has been keeping a close eye on Trump's modus operandi and learning a few tricks. Can we expect some more "bombshells"..... maybe in education, defence, etc? 

It is certainly making politics more interesting and unpredictable, Trump style.

Posted by: theotherjonv

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flaps

lol

tbf the signs were there for a while, theres been talk of job cuts at NHSE for the past month and the leadership were moved on a few weeks ago. Its only a bombshell if you hadnt been paying attention and pretty desperate to try & link it to Trump!

https://www.theguardian.com/society/2025/feb/25/amanda-pritchard-quits-nhs-england-chief-executive

https://www.theguardian.com/society/2025/mar/06/stephen-powis-step-down-nhs-england-medical-director

https://www.bbc.co.uk/news/articles/cdrxz85886xo

NHSE was an extra layer of bureaucracy that didnt improve outcomes (even ignoring covid) its amazing it lasted as long as it did tbh

the real question is how the new central structure will be run and how the change will be managed and we wont know the answer to that for a while.

To be fair this probably impacts on Streeting's strategy to give his private healthcare backers open access to the NHS, so no wonder he looked a bit wrong-footed. He probably had a late night call from them with some questions to answer.

My wife is fairly senior in the imaging department of the local NHS trust. I asked her if she thought that abolishing NHSE was going to be broadly beneficial or not. She said broadly beneficial, but not evenly. You cannot have two supposedly interdependent organisations of the size of the NHS and NHSE and there not be some beneficial and vital stuff accruing to the NHS from NHSE handling certain things.

But she reckons that if NHSE is cut correctly and the right roles/responsibilities taken in by the core NHS, it will be less wasteful. She cited the current example of a colleague of hers with about 25% her experience. This colleague is on a secondment to NHSE, being paid on the same band as her yet 'doing bugger all'. Mainly because NHSE don't really know what the secondment role ought to include.

The downside to all this is more direct political interference - which we all know can be bad as well as good. I also think it will enable the likes of Streeting to plug his backers in more directly.

NHSE was an extra layer of bureaucracy that didnt improve outcomes (even ignoring covid) its amazing it lasted as long as it did tbh

The only reason it lasted as long as it did was because if the Tory's had abolished it, it would be an admission that their own policy was the monumental **** up that everybody warned them it would be at the time

Can we expect some more "bombshells"..... maybe in education, defence, etc? 

It is certainly making politics more interesting and unpredictable, Trump style.

Exactly what I was saying. I think the penny might have dropped in No. 10 that voters are sick of seeing politicians making excuses for not doing stuff and that they much prefer decisive and authoritative action even if they don't necessarily agree with it. Seems like JFDI might be the new motto in govt, lets hope it's used to tackle some more progressive issues (yeah I know!) like poverty, housing and education.

tbf the signs were there for a while, theres been talk of job cuts at NHSE for the past month and the leadership were moved on a few weeks ago. Its only a bombshell if you hadnt been paying attention

To be fair talk of "job cuts" in NHS England is very different to talk of scrapping it. When organisations talk of job cuts it is generally assumed that it will continue to operate.

Wes Streeting makes it very clear in the Sky News video clip above that he hadn't planned to scrap NHS England. So the announcement was unexpected, that is why it is widely described as a bombshell.

Will the malleable Centrists now get in line and remove the big boy layer of Tory bureaucracy in the form of the OBR? And let the Government take full control of its own finances?

You know if you want some real change ...

Reeves getting in her excuses again for more low growth in Jan. Sigh. We have years of idiocy proving cuts don't lead to growth. All Labour have done so far it cut and cut more. So unless you put the seeds of growth in, celebrating NHS England going is not really the point - besides the Mail and Bruges Group are endorsing this one - that makes me nervous.

There's just going to be lots of nodding about Job duplication now, and efficiency etc.  It's all a bit DOGE lite.

Also GBEnergy - no employees! That's looking like a total and utter failure. But that was pretty much a given.

Slow to act... carefully examining how things are operating (with the access and resources you only get once in government)... then when announcing plans and actions... LOOK, HOW TRUMP LIKE.

On current spending levels... I'm with you on the need to relax the fiscal rules and spend more Rone... but that doesn't require a "jump without looking" abandonment of the OBR or more direct control of the BofE. The government can transparently change budgets and targets, and have them analysed and acted on.

LOOK, HOW TRUMP LIKE.

Oh come on, for at least a decade now big announcements like this and every other major political event (ie the budget) have been pre-announced in the media via tipoffs to certain journalists, press releases or other mechanisms. Then Trump comes along with his off-the-cuff unorthodox 'look at me getting shit done' PR whirlwind and suddenly we're getting surprise announcements about abolishing organisations, cutting thousands of jobs and saving 100s of millions. It's not a coincidence.

Not saying this is a bad thing BTW. It's quite refreshing to see a PM/govt take decisive and radical action on something that clearly isn't working. More of this please!

Other than negatively effecting our economy with his trade policy chaos, and destabilising European defence, both putting further pressure on the UK government and the choices it faces... this has bugger all to do with Trump. Eagerly giving him credit where it isn't due is an odd line to take.

Anyway, it sounds like Laura Kuenssberg was wise to change her MO... that dripping of near daily "tipoffs" her way might be over. We can only hope...

So Labour have selected their candidate for the Runcorn and Helsby by-election and she is an unknown, you have to assume that she is a sacrificial lamb. 

Because this being the first by-election in the current parliament you would expect it to be a shoo-in for former shadow cabinet minister and Morgan McSweeney ally Jonathan Ashworth, who lost his seat at the last general election.

After losing his seat Jonathan Ashworth expressed a strong desire to return to front line politics and Runcorn and Helsby is after all a safe Labour seat with a huge Labour majority.

So why miss this opportunity? You have to assume that Labour are considering the possibility that this by-election might be a catastrophic disaster for them.

I suspect that Labour has been keeping a very close eye on opinion polls which the usual suspects on here dismiss as "pointless".

And the result of this by-election will not be pointless, no matter how large the government's majority. Losing a very safe Labour seat will reinforce the sense of doom within Labour which currently are polling not much more than 25%, and if Reform win it it will massively boost their claim of being an alternative to the three main parties.

I do think there is a reasonable chance that Labour will hold on to the seat though, which would be a massive blow to Nigel Farage, it is just not as certain as it should be.

https://news.sky.com/story/ousted-former-labour-mp-jonathan-ashworth-hints-at-future-return-to-parliament-13188807

Oh come on, for at least a decade now big announcements like this and every other major political event (ie the budget) have been pre-announced in the media via tipoffs to certain journalists, press releases or other mechanisms.

Since always. Even the finer details of speeches yet to be made are released to the media. Dropping political bombshells is not the British way. Or at least it hasn't been.

To be fair talk of "job cuts" in NHS England is very different to talk of scrapping it. When organisations talk of job cuts it is generally assumed that it will continue to operate.

Wes Streeting makes it very clear in the Sky News video clip above that he hadn't planned to scrap NHS England. So the announcement was unexpected, that is why it is widely described as a bombshell.

Actually it was talk of 50% job cuts a few weeks ago, which is exactly the number that was mentioned yesterday

And yes in the link it says that in August Streeting said he wasnt going to scrap NHSE, but from the scale of job cuts and the 'resignations' of the chief exec it was obvious from last month that something big was coming 

That it didnt leak is the amazing thing, I suppose after the last decade plus where every policy decision is leaked weeks in advance it comes as a bombshell that the preferred lobby journos didnt get a heads-up

After losing his seat Jonathan Ashworth expressed a strong desire to return to front line politics and Runcorn and Helsby is after all a safe Labour seat with a huge Labour majority.

So why miss this opportunity?

Clearly you’ve never been to Runcorn Ernesto 😂 

That it didnt leak is the amazing thing, I suppose after the last decade plus where every policy decision is leaked weeks in advance it comes as a bombshell that the preferred lobby journos didnt get a heads-up.

One of Boris Johnson’s former advisors was on Five Live the other week saying how he was watching one of the newspaper news live feeds and it became clear that somebody, presumably a minister, was leaking the content of the cabinet meeting they were all in, in real time

Actually it was talk of 50% job cuts a few weeks ago, which is exactly the number that was mentioned yesterday

Which is completely different to saying that an organisation will be scrapped. With announcements of job cuts it is generally assumed that the organisation will continue to exist.

Clearly you’ve never been to Runcorn Ernesto 😂

It has long been one of my political dreams, that a new fit for purpose parliament building is built, on an industrial estate in Runcorn. I think that is the only chance that a true nationwide regeneration policy is enacted instead of the current "south east first" everywhere else last policy.

And if the politicians moan too much we could build a parliamentary "halls or residence" in Widnes.

Posted by: binners

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After losing his seat Jonathan Ashworth expressed a strong desire to return to front line politics and Runcorn and Helsby is after all a safe Labour seat with a huge Labour majority.

So why miss this opportunity?

Clearly you’ve never been to Runcorn Ernesto 😂 

Never, but I assume you have. So what can the Richard Littlejohn tribute act tell me about this very safe Labour seat?

Are you going explain why despite apparently being the bookies favourite now Reform UK didn't win the seat last July and instead Labour won it with a huge majority?

Anything to do with donkeys?

I’m absolutely with you on that one MSP. That’s genius! A fate worse than death would soon get them to sort things out properly! 

Eagerly giving him credit where it isn't due is an odd line to take.

Eh? Who's giving him credit? I'm just pointing out that Starmer is copying his MO and PR strategy in the hope that it has the same effect here as it does in the US. Whether you agree with Trump or not you can't deny that the way he approaches politics resonates with voters. You might be a fan of carefully planned and considered technocracy and incremental reform, but the vast majority of voters just want to see politicians getting stuff done and making changes to stuff that doesn't work. Starmer finally seems to have understood that and he'll benefit from it.

A colleague's sister works for NHS England and they are shocked at the level of cuts, panic even.  I deal with them through my role on a regular basis, and they are going to be even more 'rubbish' than usual.  

the vast majority of voters just want to see politicians getting stuff done and making changes to stuff that doesn't work. 

Yup, we are hardly experiencing an era of voter satisfaction in the western democracies. Which is why I assume that politicians who support the status quo are no longer trying to pass themselves off as "moderates".

Moderate suggests a lack of urgency to the issues confronting voters. A "careful now" attitude which isn't what voters appear to want.

One of Boris Johnson’s former advisors was on Five Live the other week saying how he was watching one of the newspaper news live feeds and it became clear that somebody, presumably a minister, was leaking the content of the cabinet meeting they were all in, in real time

Well at least we've got the novelty of trying to guess who it is, rather than the Cummings-Kuenssberg axis of evil.

Starmer is like Trump because he announced a technocratic managerial reorganisation of bureaucrats in the health system in one of the four parts of the UK? Come off it - it's hardly "we're gonna deport the Mexicans and Muslims". It seems like even our most Starmerphobic friends are realising the suggestion is a dead donkey - I mean horse - but they're still beating it...

🫏 🐎 🫏 🐎 

‘A Downing Street Source’ 

You mean your mate Dom, Laura? 

Starmer is like Trump because he announced a technocratic managerial reorganisation of bureaucrats in the health system in one of the four parts of the UK? 

Yes that is exactly what has been said. 

Reform UK set to beat Labour in Runcorn and Helsby byelection, poll suggests, with Tories in distant third

https://www.theguardian.com/politics/live/2025/mar/14/rachel-reeves-welfare-disability-cuts-labour-keir-starmer-uk-politics-live-news

Here is an extract from the Ashcroft summary.

Reform are ahead of Labour by 40% to 35% when we weight respondents according to their stated likelihood to turn out and vote at the by-election, with the Conservatives in third place on 10%. This represents a 20% swing from Labour to Reform since the general election.

I'm old enough to remember a few days ago Reform were being written off and disintegrating before the next General Election - because of boneheaded Ruper Lowe's fall-out (he who comes with the baggage of trying to ban Quantitative Easing - despite getting everything possible technically incorrect about the process.)

For sure this will be one by-election to watch.

I hope Labour get a good kicking they deserve.

https://www.theguardian.com/business/2025/mar/14/uk-economy-shrinks-blow-to-rachel-reeves

Reeves blamed global economic uncertainty for the downturn, adding that a plan to increase defence spending would give the economy a lift.

So Reeves believes that public spending lifts an economy? She's been quiet about that!

with the Conservatives in third place on 10%. 

If that turns out to be the case on the day I struggle to see how Kemi Badenoch can remain Tory leader for much longer.

It will be conclusive evidence that the hard-right political niche in UK politics is now occupied by Reform. Either the Tories will have to re-evaluate what they want to offer voters and shift away from the hard-right or maybe throw the towel in and join Reform.

Meanwhile the Left sits on the sidelines saying and doing bugger all. I suspect that the Left won't get its arse into gear until they see Nigel Farage smiling and waving from the steps of Number 10

Edit : I see that the Workers Party are standing a candidate in the by-election. How depressing that the only alternative to right-wing candidates, so far at least, is a candidate from the George Galloway vanity project.

The trouble is with the way politics is currently funded, how can a left wing party even start to gain traction, unless the unions pull funding from labour and move it to a party that actually represents working people.

I suspect that if the rug was pulled on the big money funding political interests then the political landscape would change quite significantly, and frankly in order to prevent the oligarchy takeover of world politics it is an absolutely critical to defend even the  flawed democracy we currently have, but I don't see any government anywhere willing to even voice the concerns never mind take action. Biden spoke about the danger after he had lost, I bet nothing would have been said if he had won, then the money train would have just continued. The greens spoke about it in the recent German election, and the right and centrists attacked them for doing so.

If that turns out to be the case on the day I struggle to see how Kemi Badenoch can remain Tory leader for much longer.

I suppose turnout being low could see them that low, but it would still be bad news for badenoch, a reform win wouldn't change much for labour in the grand scheme but may well help shape their future campaigning.

when is the date i assumed it would be held with the locals in May?

A sweeping reform victory will be worrying for everyone, all eyes on their candidate selection...

The trouble is with the way politics is currently funded, how can a left wing party even start to gain traction, unless the unions pull funding from labour and move it to a party that actually represents working people.

Funding might be an issue but it isn't the issue.  Five left-leaning independents won parliamentary seats at the last general election and the Greens won four seats, none of those seats had big bucks behind them.

Plus unions such as the RMT and the FBU would be willing to use their political funds to back candidates that offered a real alternative.

The problem is multilevel imo, including a lack of talent, extremely low morale following the centrist takeover of the Labour Party and the purges that followed, and an obsession with issues which don't resonate with ordinary working people.

I do think that Nigel Farage being either installed as Prime Minister or as Home Secretary/Foreign Secretary will be a kick up the arse though, hopefully, and a new wide-ranging grassroots movement will emerge post the next general election.

But right now because the current government calls itself "Labour" even though it is adopting policies more in keeping with Reform, such as slashing foreign aid and denying asylum seekers UK citizenship, the Left seem to be resigned to the belief that there is little which can be done.

Posted by: Daz Hall

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the vast majority of voters just want to see politicians getting stuff done and making changes to stuff that doesn't work

2 million more NHS appointments promised in a year delivered in 7 months?

Employees rights bill?

Tough choices and cuts for you lot - Sabrina Carpenter concert tickets for me.

Reeves' timing is ****ing impeccable. She's had her hand in the freebie pot again.

This party are totally shit and will sink themselves into oblivion.

Imagine doing this just in time for your spring statement.

Tough choices and cuts for you lot - Sabrina Carpenter concert tickets for me.

Reeves' timing is ****ing impeccable. She's had her hand in the freebie pot again.

This party are totally shit and will sink themselves into oblivion.

Imagine doing this just in time for your spring statement.

2 million more NHS appointments promised in a year delivered in 7 months?

Well it is  known that the NHS is high up on the voters list of priorities so yes that sort of thing.

Although probably not this sort of thing 

https://www.bbc.co.uk/news/articles/cz9nqppj1llo

Health Minister Karin Smyth said the decision by NHS England, following a lengthy review, was "based on overall affordability" and that "it would not be appropriate to intervene".

hard to know of NHSE are talking BS on that one, without seeing their cost vs survival analysis , its off patent so price is 10x less than it used to be, EU have just changed the law  to make it much easier to approve off patent drugs and Wales & Scotland managed it at presumably the same cost .

The trouble is with the way politics is currently funded, how can a left wing party even start to gain traction, unless the unions pull funding from labour and move it to a party that actually represents working people

You mean like one that’s just put a workers rights bill into law? That kind of thing? 

Posted by: binners

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how can a left wing party even start to gain traction

You mean like one that’s just put a workers rights bill into law? 

Yeah the Labour Party is a proper "left wing party", everyone can see that.

In fact didn't Donald Trump call the current UK government "far-left" recently?

What's Richard Littlejohn's view on the matter?

Posted by: ernielynch

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Health Minister Karin Smyth said the decision by NHS England, following a lengthy review, was "based on overall affordability" and that "it would not be appropriate to intervene

Nhse that, I don't know if you've heard, has a limited life span?

 I don't know if you've heard, has a limited life span?

Is that comment directed at whoever wrote the BBC article yesterday or the Health Minister Karin Smyth ?

Either way what's your point, that abiraterone will be available as soon as NHS England is abolished? If so the Health Minister could have made that point.

2 million more NHS appointments promised in a year delivered in 7 months?

What does 2 million NHS appointments mean exactly?

Nobody serious talks about appointment numbers, e.g1. https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-backlog-data-analysis e.g2. https://commonslibrary.parliament.uk/research-briefings/cbp-7281/

1.3%-ish on top of a number of appointments that had already steadily risen from 146mn NHS appointments in Jan '20 pre-covid (artificial low 118mn during covid) to 157mn in March '24 under the previous government https://fullfact.org/election-2024/labour-2-million-nhs-appointments/

Employees rights bill?

Currently with the House of Lords. It also needs money for changes to statutory sick pay and the new labour market enforcement body, so we'll see how growth and the budget progresses for that