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Keir Starmer pledges to tackle 'overcautious' and 'flabby' state NHS England to be brought under government control
(about 1 hour later)
Sir Keir Starmer has pledged to tackle the "overcautious" and "flabby" state to make it more efficient. NHS England will be abolished and brought under "democratic control" in an attempt to cut bureaucracy and duplication, Sir Keir Starmer has announced.
Writing in the Daily Telegraph ahead of a speech later, the prime minister insisted he was not interested in ideological arguments about whether the state should be bigger or smaller, adding: "I simply want it to work." The prime minister said the move would free up money for front-line services.
The government has not put a figure on what size it wants the Civil Service to be but on Sunday Cabinet Office minister Pat McFadden said it "would and can" be smaller. The government said it expected around 50% of jobs at NHS England, which currently employs 15,300 staff, to be cut.
Unions have warned the government will struggle to compete for skilled specialists without offering higher pay. In a speech in Hull, Sir Keir said for too long politicians had "chosen to hide behind vast arrays of quangos" - organisations funded by taxpayers but not directly controlled by the government.
"In such uncertain times, people want a state that will take care of the big questions, not a bigger state that asks more from them," the prime minister wrote. The government said work would begin immediately to return many of NHS England's current functions to the Department of Health and Social Care, with the aim of completing the process in two years.
"The Civil Service has grown by 130,000 since the [Brexit] referendum, and yet frontline services have not improved. It's overstretched, unfocussed and unable to deliver the security people need today." The bold move gives the government more control and accountability over one of their key pledges - to cut NHS waiting times.
The current headcount of the Civil Service is more than 500,000. NHS England - which the government dubbed "the world's largest quango" - oversees the health service, working with government to agree funding and priorities, as well as monitoring the performance of local NHS services.
It was given autonomy by the then-Conservative Health Secretary Andrew Lansley in 2013, with the aim of freeing the organisation from interference by politicians.
Announcing the decision, Sir Keir said: "I can't in all honesty explain to the British people why they should spend their money on two layers of bureaucracy.
"That money could and should be spent on nurses, doctors, operations, GP appointments."
Sir James Mackey, who will be taking over as transition chief executive of NHS England, said while the news would be "unsettling" for staff it would help "deliver the biggest bang for our buck for patients".
NHS England's chief executive Amanda Pritchard and medical director Sir Stephen Powis have both announced they are stepping down in recent weeks.
The Conservatives said they supported "measures to streamline NHS management and the principle of taking direct control".
Shadow chancellor of the Duchy of Lancaster Alex Burghart said: "Labour ministers now have nowhere to hide or anyone else to blame on NHS performance."
However, Sharon Graham, head of the Unite union, said: "Taking an axe to these jobs is an ill-thought-out strategy that could end up meaning frontline healthcare staff struggle to do their jobs effectively if they aren't paid on time, don't have basic medical supplies or are forced to do additional administrative work rather than treat patients."
The announcement came as part of a wider speech on reforming the state, which Sir Keir described as "overstretched" and "unfocused".
"Over a number of years politicians have chosen to hide behind vast arrays of quangos, arm's length bodies, regulators, reviews," the prime minister said.
"A sort of cottage industry of checkers and blockers using taxpayer money to stop the government delivering on taxpayer priorities."
The number of quangos has fallen by more than half since 2010 but there are still more than 300 across the UK.
They include regulators, cultural institutions and advisory bodies, ranging from large organisations like NHS England, to smaller ones like the Gambling Commission and the British Film Institute.
The new Labour government has set up more than 20 new quangos since winning power.
These include Great British Energy, which will invest in renewable energy to help meet the government's clean power goals, and Skills England, which aims to support people to find jobs.
The government has also suggested it wants to cut the size of the Civil Service, which has a headcount of more than 500,000.
Civil servants are politically impartial officials employed by the government, covering areas including policy development and services like benefits and prisons.Civil servants are politically impartial officials employed by the government, covering areas including policy development and services like benefits and prisons.
In his speech later, Sir Keir will link the need to reshape government to global instability which has pushed up bills at home, saying the state needs to be operating at "maximum strength". Writing in the Daily Telegraph ahead of his speech, the prime minister insisted he was not interested in ideological arguments about whether the state should be bigger or smaller, adding: "I simply want it to work."
He will promise to cut the costs of regulation for businesses by 25% to boost economic growth. In his speech, Sir Keir linked the need to reshape government to global instability which has pushed up bills at home, saying the state needs to be operating at "maximum strength".
He promised to cut the costs of regulation for businesses by 25% to boost economic growth.
His plan also includes greater use of artificial intelligence, underpinned by the mantra that civil servants should not be spending time on tasks where digital or AI can do it better and quicker.His plan also includes greater use of artificial intelligence, underpinned by the mantra that civil servants should not be spending time on tasks where digital or AI can do it better and quicker.
The government gave the example of an AI helper for call centre workers, in partnership with Citizens' Advice, which it said could halve the amount of time it takes call handlers to respond to complex questions. Earlier this year, Sir Keir faced a backlash saying "too many people in Whitehall are comfortable in the tepid bath of managed decline".
New AI and tech teams will be sent into public sector departments to improve efficiency, with one in 10 civil servants working in tech or digital roles within the next five years. In his speech he was keen to stress his criticism of the state was not aimed at individuals.
Meanwhile, the PM will take aim at the "cottage industry of checkers and blockers slowing down delivery". "This is not about questioning the dedication or the effort of civil servants," he said. "It's about the system that we've got in place."
Writing in the Telegraph, he said there had been "a tendency to avoid difficult questions by sweeping them under a carpet of regulation" to "outsource and delay decision-making and avoid accountability". Mike Clancy, general secretary of the Prospect trade union, which represents civil servants, said he agreed reform was needed.
"For any challenge faced, for too long the answer has been more arm's-length bodies, quangos and regulators which end up blocking the government as we're trying to build," he added. "An essential part of this reform needs to be ensuring that the pay framework enables the civil service to recruit and retain 'the brightest and the best' in areas like science and digital, and it is good to see that the government accepts this problem," he said.
Earlier this week, the government said it would abolish the Payment Systems Regulator, which looks after Faster Payments and Mastercard, because it had increased costs for small businesses. "But the government must recognise that there is a fine line between cutting back bureaucracy and undermining the essential functions of the state.
But the new Labour government has also set up more than 20 new arm's-length bodies since winning power. "Civil servants in agencies such as HSE [Health and Safety Executive] and the Environment Agency are at the frontline of delivering on the government's missions - writing them off as 'blockers' is a profound mistake."
These include Great British Energy, which will invest in renewable energy to help meet the government's clean power goals, and Skills England, which aims to support people to find jobs.
Mike Clancy, general secretary of the Prospect trade union, which represents civil servants, said they were not "hostile to reforms" but more pay flexibility was needed to recruit and retain specialists in areas like science and data.
"Government should also be doing more to utilise the talented specialists it already has at its disposal, many of whom are working in regulators and other agencies that have been starved of funding in recent years," he added.
He warned against the "incendiary rhetoric and tactics we are seeing in the United States", where Elon Musk has pledged to take a "chainsaw" to the federal government and drastically cut the workforce.
On Wednesday a Labour spokesperson rejected characterisations of the governments plans as "taking a chainsaw to the system".
"It is not about slashing the state, it is about reshaping the state so it works for working people," they said.
Earlier this year, Sir Keir was criticised for saying "too many people in Whitehall are comfortable in the tepid bath of managed decline".
However, in his Telegraph article the PM was keen to stress his criticism of the state was not aimed at individuals.
"The problem isn't our fantastic civil servants – it's the system they're stuck in," he wrote.
The Conservatives accused Sir Keir of having "no plan to reform the Civil Service or cut public spending", criticising tax increases for businesses.
The Liberal Democrats said the PM was "tinkering around the edges while our economy continues to stutter".
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