The Prime Minister of the United Kingdom, Keir Starmer, has unveiled plans for a sweeping overhaul of the healthcare system, including the dissolution of a major bureaucratic body. According to Starmer, this move aims to return control of the system to democratic institutions.
One of the Labour government’s top domestic priorities is the transformation of the struggling National Health Service (NHS). On Thursday, Starmer announced the dismantling of NHS England, a semi-autonomous agency responsible for overseeing healthcare delivery in England, the largest of the four UK nations.
During a press conference, the Prime Minister explained that the main driver behind this decision was the need to boost efficiency — an assertion in line with recent reports suggesting the government is considering significant cuts to the public sector to restore the country’s finances.
“One of the reasons we’re abolishing it is due to duplication. Believe it or not, NHS England has its own communications team, and so does the Department of Health; both also have their own strategy teams,” Starmer emphasized. “By removing this duplication — which we are doing today — we can redirect the funds to where they are most needed: the frontline.”
Chainsaw Project
According to British media reports, some Labour aides have nicknamed the reform effort the “chainsaw project” — a reference to the aggressive and legally controversial cuts seen in U.S. government agencies under Elon Musk’s influence.
In the government’s press release accompanying the announcement, NHS England was described as “the world’s largest quango,” using the British term for a quasi-autonomous non-governmental organization.
Shortly after Starmer’s statement, Health Secretary Wes Streeting — a strong advocate for utilizing private healthcare to ease the burden on the NHS — addressed Parliament. He stated that it would take about two years to fully reintegrate NHS England’s functions into the main NHS structure.
“These reforms will create a much leaner NHS leadership, delivering savings worth hundreds of millions of pounds annually,” Streeting said. “These funds will be channeled to the frontline, helping to reduce waiting times and accelerate the delivery of our Transformation Plan. We aim to cut through bureaucratic layers and empower frontline NHS leaders.”
It is worth recalling that in 2012, a sweeping and highly controversial health reform granted NHS England significant decision-making power over the allocation of approximately £200 billion (€238 billion) in healthcare funding for England. However, in the years that followed, stagnant public sector wages, growing waiting lists, and staffing crises plagued the NHS.
Although the previous government increased overall healthcare spending, it failed to meet its own hospital construction targets and was unable to reverse the worsening treatment wait times by the time of its defeat in the 2024 general election.
Speaking in the House of Commons, Streeting noted that many Conservative MPs now acknowledge the 2012 reorganization as a mistake.
Professor Til Wykes, head of the School of Mental Health and Psychological Sciences at King’s College London, expressed concern that the reforms announced by Starmer and Streeting do not address the underlying causes of the NHS’s struggles.
“The main problems in the NHS stem from underfunding, not poor management,” Wykes said. “By abolishing NHS England, the government risks assuming full responsibility for any emerging issues, with no external body left to blame. If these reforms result in greater involvement of the private sector, healthcare services could face difficult times. Diverting services from the NHS will only make it less efficient and more expensive.”