Law Student Analysis of Key News Stories: Labour says goodbye to NHS England

The Labour government announced National Health Service (NHS) England will be abolished to cut ‘bureaucracy’ and reform how the National Health Service is run. The Department of Health and Social Care will take on NHS England’s functions. These impacts only affect England. It is important to note that the changes will not affect access to the NHS. The NHS will remain free to use and will continue to cover all its existing services for its patients. This article will explore how the change affects the legal and policy aspects in the public sector.

Background and the role of NHS England

NHS England was established in 2013 following the Health and Social Care Act 2012. NHS England is a non-departmental public body. NHS England is the administrative body which is made up of managers and officials who manage the health service up and down the country.

Its key responsibilities included:

• The government provides money to NHS England and tells it what its priorities are for the health service. For example, it might be cutting waiting times or improving cancer survival rates.
• NHS England’s key role is deciding how much funding local integrated care boards (ICBs) and NHS trusts are given each year to provide the range of clinical services in their areas, such as GP care.
• Overseeing that performance targets are met, such as ensuring that key waiting time targets, such as the maximum four-hour wait for emergency care or the 18-week maximum wait for hospital treatment, are met.
• NHS England is also responsible for other functions like overseeing training and data collection, as well as managing GP services.
• NHS England’s role is to channel/guide the money into different parts of the health service and ensure the resources bring about the change the government wants to see.

Why now?

Labour argues this reform will cut down bureaucracy, make the NHS more responsive to local needs, and save £500 million per year – funds that can be reinvested into frontline services like hospitals and ambulances

Wes Streeting (Secretary of State for Health and Social Care) stated to the House of Commons that the frontline NHS staff are “drowning in the micromanagement they are subject to by the centre.” He cited the Hewitt review, which reported that one local service was required to send 250 reports and forms to NHSE and DHSC in a single month – “that is time not spent delivering care for patients.”

What will replace it/what is changing?

9,000 administrative roles will be cut at NHS England and the Department of Health and Social Care as part of the changes.

Rationale behind the reform:

Moving decision making down to a local level and nearer to patients will make health leaders more attuned to the needs of patients in the area where they are making calls. They will also know what the locals need and their weaknesses in their structure.

With £500 million in expected annual savings, the government can potentially redirect more funding into frontline services such as nurses, ambulances, and hospital infrastructure.

By eliminating a centralised layer of administration, local health leaders will gain greater autonomy, making services more accountable and tailored to patient needs.

Legal and Policy Impacts:

This development highlights the tensions between centralisation vs localisation in public service delivery:

Positives:

• Projected savings of £500 million per year to frontline NHS care – but this may be offset by transition costs, redundancy packages, and loss of institutional knowledge.
• Digitisation and reduction in physical paperwork may have environmental benefits.
• More local accountability and quicker responses to local health issues – meaning fewer waiting times and quicker diagnosis of patients.

Challenges:

• Potential for legal disputes over employment rights and redundancies. Legal risks include employment law disputes, judicial review of decisions made under new governance, and concerns over transparency in how powers are delegated to local boards.
• NHS productivity may suffer short-term disruption during structural changes and redundancy payouts.
• The loss of jobs may increase regional unemployment in administrative sectors.
• Risk of reduced accountability and blurred responsibility between DHSC and local systems.

Conclusion

While cost savings and decentralisation are promising, the legal and operational risks of a major overhaul cannot be overlooked.

For public sector legal professionals, the coming years will be pivotal in shaping the frameworks of accountability, transparency, and justice in the healthcare sector.

Article written by Amanpreet Singh, Birmingham City University LLB graduate and current LLM student at the University of Birmingham.