The outgoing chair of NHS England has issued a stark warning to ministers about their decision to abolish the quango. Richard Meddings, who took up his role in March 2022 and is due to step down at the end of the month, said: “There will no longer be a separate vehicle that can be pointed [at] to say that’s what got it wrong.”
The Government announced last week that NHS England would be merged into the Department of Health and Social Care. Up to 10,000 jobs are thought to be at risk as Health Secretary Wes Streeting takes tighter control of the health service’s management. The decision is not expected to have an immediate impact on patient care, but will change how the vast organisation is run.
Speaking to BBC Radio 4’s The World This Weekend, Mr Meddings became the first senior NHS England official to be interviewed since last week’s major announcement.
He acknowledged that ministers wanted to have more control of the system, but suggested micromanagement had already been happening.
He said: “At times, some weeks, almost 20 new instructions, commissions coming from government and ministers into the system.”
The NHS was described by the Government this week as the world’s largest quango — an arm’s length body to which the Government devolves some power and provides funding.
Defending quangos, Mr Meddings added: “I’ve worked with six secretaries of state and complete changes of ministers.
“So there is an argument for a construct that would separate the delivery vehicle from government.” He added that many of the factors driving in health in England are outside of the NHS’s control.
“The NHS deals with whoever or whatever comes through the gates in whatever condition,” Mr Meddings said. “And many of the conditions of poor health are driven by factors outside the NHS.”
Sir Keir Starmer has argued that abolishing NHS England will reduce duplication in management, cut red tape to speed up improvements and free up cash for frontline services.
He said on Thursday: “If you can believe it, we’ve got a communications team in NHS England, we’ve got a communications team in the health department of government; we’ve got a strategy team in NHS England, a strategy team in the government department. We are duplicating things that could be done once.”
The decision has been broadly welcomed including by opposition MPs, however some health leaders have reminded ministers of the stark consequences for thousands of staff.
Thea Stein, head of the Nuffield Trust think tank, said the announcement will be “devastating for staff at all levels of NHS England”.
She added that it “makes sense to remove the duplication and bureaucracy that exists currently” but warned: “We must remain mindful of the human cost of this decision.”