The jobs of health service staff put at risk following the abolition of NHS England is due to the “failure of the system they work in”, the Health Secretary has said.
Wes Streeting told MPs he did not “take these decisions lightly”, but said patients and frontline staff will welcome the move to “free up hundreds of millions of pounds”.
He also said reports suggesting the cuts could cost up to £1 billion is not an “unreasonable ballpark figure”.
Prime Minister Sir Keir Starmer announced NHS England, an arm’s-length body, would be axed last month and reintegrated into the Department of Health and Social Care (DHSC) over the coming two years.
Appearing before the Health and Social Care Committee on Tuesday to discuss the work of NHS England, Mr Streeting told MPs: “We want to reduce the size of the centre by 50% – I’m not kind of so dogmatic that if we ended up just below 50%, or just above 50%, that I would be feeling like we failed one way or another.”
It is estimated the move will result in more than 9,000 job losses.
When asked about reports the packages offered to staff may end up costing the department up to £1 billion, Mr Streeting said: “I didn’t think that was an unreasonable ballpark figure.”
However, he stressed precise numbers will not be known until DHSC “have confirmed what the ultimate size and shape of the organisation will be”.
When quizzed on where the money is coming from, NHS England chief executive Sir Jim Mackey told MPs he has “started the discussion with Treasury about how redundancy costs are managed”.
Asked when all parts of the NHS are going to get the details they need to make the right decisions on redundancies, Mr Streeting said integrated care boards (ICBs) will be sending their plans to Sir Jim.
Mr Streeting said: “I just want to say up front, I am mindful that with the scale of the change that we are doing and the level of headcount reduction, there are lots of people whose jobs are at risk.
“We don’t take these decisions lightly and I don’t for a moment suggest that because there is waste, inefficiency and duplication, or that there are too many layers of bureaucracy, that this is somehow a kind of failure on the part of people who are turning up for work every day, working extremely hard as dedicated public servants.
“This isn’t their failure, but it is a failure of the system they work in.
“I wouldn’t pretend for a moment that people whose jobs are affected are happy about this change. They will be experiencing the same sorts of fears and anxiety of anyone whose jobs are risk. And I don’t take that lightly.”
Asked if more arm’s-length bodies are likely to be axed, Mr Streeting replied: “We’re committed to reducing them overall as a Government and I’m certainly committed to reducing the number of arm’s-length bodies attached to my department during my tenure the Secretary of State.”
He also suggested there are too many “checkers” in the NHS and that the health service could “do with some more doers”.
When asked what he hopes to achieve from reforms, Mr Streeting told MPs: “First and foremost, we want to make sure that the NHS is well-led, and in terms of the various layers of bureaucracy that exist in the NHS we’re reducing waste, inefficiency and duplication.
“Where we currently have effectively two head offices for the NHS, we will have one, where we have duplication of functions across the Department of Health and Social Care and NHS England, we will eliminate that duplication, and that also applies down at ICB levels.
“We’ve got too many checkers in the system, we could do with some more doers. We will free up hundreds of millions of pounds in the process that can be redeployed to frontline services.
“I think that is welcomed by patients. I think it’s welcomed by lots of frontline staff who agree with that diagnosis of too many layers.”
When asked about private finance initiatives (PFIs), Mr Streeting said: “Not only is there a historic under-capitalisation of the NHS, there are also ongoing emerging capital pressures.
“I don’t see how, even with the biggest capital allocation that the NHS has had since Labour was last in government, which the Chancellor has given their budget, I don’t see how you deal with that challenge without some private investment.”
He added that he treads “extremely cautiously in this area” as he is aware PFIs brought in under the last Labour government “came at a significant cost and many trusts are still paying those costs”.
“I do want to reassure people that, as we do, we are mindful not just of the things the last Labour government did, also the things we got wrong.”
Meanwhile, Mr Streeting was quizzed over cuts to health and disability benefits.
He told MPs: “Just because someone is suffering from mental ill health, it doesn’t mean that they should be written off, and it doesn’t mean that they we should make an assumption that they are unable to work, or that as employers we shouldn’t try and show a degree of flexibility, and that with the right support people couldn’t be supported to stay in work or to find work.
“There are lots of people who would say … if you can get someone back to work, that is also good for their mental health, because it gets them out of the house, socialising with colleagues, feeling like you’re sort of getting back on your feet.
“It’s really important that the welfare system isn’t just a safety net that people can fall onto when they hit hard times, but it’s a springboard that helps them back into work.”
