As the Labour party plans yet another costly NHS reorganisation, we should reflect on the former health secretary Andrew Lansley’s disastrous and expensive reforms in 2012 (Keir Starmer scraps NHS England to put health service ‘into democratic control’, 13 March). I worked as an NHS GP and hospital specialist for 25 years. Those of us working in the service could see where many of the major problems lay, but rather than listening to those working at the coalface, David Cameron seemed to be seduced by Lansley’s ideas.
The disastrous effects of the reorganisation were seen most clearly when the Covid pandemic struck, with respect to provision of personal protective equipment and the test-and-trace debacle. Effective public health pathways had been changed and there was no joined-up thinking whatsoever.
Now we have elderly patients fit for discharge lying in hospital beds as plans for social care reform are again kicked down the road. Patients awaiting hospital admission lie in corridors, where care is clearly substandard despite the heroic efforts of doctors and nurses. It is scandalous.
What happens if we have a new administration in four years, another reorganisation? We must stop the NHS becoming a political football and have some cohesive and effective forward planning before it really is too late.
Dr Michael Cohen
Bristol
• The cuts to integrated care boards are yet another example of short-term cost-saving measures that will weaken our economy, public services and workforce (30,000 jobs could go in Labour’s radical overhaul of NHS, 14 March). Good jobs are not just expenses; they are investments in a stable, productive society.
Beyond the numbers, there is a deep human cost. Many of those losing their jobs are the very people who worked tirelessly to keep the NHS from collapsing after years of underfunding. To reward them with redundancy rather than support is an insult. What’s even more troubling is that a Labour government, supposedly the party of workers and vulnerable people, is making these cuts instead of pursuing fairer ways to raise revenue. Rather than increasing taxes on those who can afford it, they are targeting NHS staff while ignoring the system’s deeper issues.
The NHS is inefficient, but not because of its workforce. The real causes are years of deliberate underinvestment and the unchecked power of NHS trusts, which act as bureaucratic fiefdoms obstructing modernisation.
Frontline staff today are less efficient than their predecessors, not due to lack of skill but because they are trapped in an outdated, fragmented system.
If Labour is serious about fixing the NHS, it must invest properly, break down power imbalances, and implement long-term change. Instead, it is choosing the same failed austerity playbook. The UK cannot afford to dismantle its skilled workforce under the guise of fiscal responsibility.
Jeremy Wainman
Pontefract, West Yorkshire
• When I joined the NHS as a manager nearly 35 years ago, my boss explained to me that there was a fundamental rhythm to the reorganisation of the NHS. Incoming governments, he said, centralised things, believing that they could “fix the NHS”, and then, when they discovered that they couldn’t, they decentralised again to avoid the blame. Here we go again…
Nigel Turner
London
• Matthew Weaver (How did Andrew Lansley reorganise health and create NHS England?, 14 March) misses one change that had a big impact on communities: the transfer of the ownership of many health service buildings to a company, NHS Property Services (NHSPS), charged with obtaining national market value from them. In Devon, community hospitals paid for by local donations became the property of NHSPS without anyone being informed, and wards were closed with the intention of selling sites for housebuilding.
In Seaton, more than a third of the hospital – a wing funded entirely by local people – has been empty for nearly eight years, partly because NHSPS won’t vary its rental charges to allow for new uses, despite a huge local outcry and lengthy discussions. Wes Streeting should look into NHSPS, and would be welcome in Devon to see the problems for himself.
Martin Shaw
Seaton, Devon
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