Leeds - Photo: KONP

On Thursday, March 13, Reckitt, a private global health giant for over-the-counter pharmaceuticals like Nurofen and Dettol, hosted Prime Minister Keir Starmer at its Science & Innovation Centre in Hull. It was here he chose to make what was a shock announcement on the government's "abolition of NHS England (NHSE)" [1] in remarks that he claimed were "on the fundamental reform of the British state". Some other announcements were also made such as that of the "digital reform of government", which he claimed would save £45 billion a year, while not giving any further detail. However, what became apparent is that he was really there to justify the massive increase in spending on arms and the military at the expense of an overdue and necessary increase of investment in public services, social programmes and welfare. These developments are occurring as part of the government's neo-liberal restructuring of the state to further serve the interests of the monopolies and of militarisation. Health Secretary Wes Streeting later addressed Parliament in an attempt to justify the government's plan to cut 10,000 jobs at NHSE [2], and to deflect the anger and concern that the crisis in the NHS could only intensify under his watch and that of Starmer.

Starmer, in his remarks, firstly focused on trying to justify the massive increase in defence spending. He spoke of global instability and the ongoing Ukraine war, emphasising "the impact it has on the insecurity of working people across the country". He blamed this on Putin's Russia, without mentioning the nefarious role of Britain in NATO in leading up to the war and in waging a proxy war against Russia for three years. Starmer claimed that he wanted a "just peace and lasting peace" but warned that if it continues "that means here, higher prices, higher bills and the cost of living crisis going on for even longer". You can see where this is going.

In this context, Starmer set out his stall on the NHS saying that "given what has happened globally, given the insecurity in our country, now is the time in my belief for greater urgency and to go further and faster on security and renewal". Summoning up the spectre of what he called the "bureaucracy of the state", his logic was to justify making huge cuts, and announcing that the management of the NHS would be brought back into "democratic control" by abolishing NHS England. This he said would bring this "arms length body NHS England" back into "direct control by government" and the Department of Health. He claimed that "we are going to cut bureaucracy across the state, focus money on the priorities of working people and shift money to the front line". Given that the working class and people have for so long been demanding a change in the direction that successive governments have been taking the health service, this does not bode well.

The Prime Minister let the cat out of the bag on what his "front line" was when he said that the priorities he spoke about to cut bureaucracy were also forced by the debt left by the previous government and claiming this would "create security" for the British people. He said: "I believe that the fundamental task of politics right now is to take tough decisions on security. And that's why we raised our defence spending." For "tough decisions", read "decisions that are anti-social, pro-war and opposed by the people". Since Starmer's government took office, it has committed a further £3 billion a year to Ukraine until at least 2030 as well as a further increasing in military spending by £13.7 billion by 2027. This goes alongside the government's continued support for and arming of Israel in its genocide against the Palestinians and the continued NATO interference in West and East Asia, and Africa.

Kent - Photo: KONP

Later on the same day, what Starmer had announced in Hull was conveniently timed to be presented in Parliament and Wes Streeting, Secretary of State for Health, spoke to the House of Commons in making the same announcement. He started by claiming that the government had already been restoring a "wrecked NHS". He said that Lord Darzi's independent report had traced the current crisis back to the 2012 "top down" re-organisation of the NHS by Lord Lansley's Health and Social Care Act. Streeting quoted from Darzi saying that this Act "scorched the earth for health reform for which the effects are still felt to this day". It "imprisoned more than million NHS staff in a broken system" and that "today we are putting the final nail in the coffin of the Conservatives' top down re-organisation". That is, putting the nail in the coffin of top-down reorganisation by top down re-organisation.

There was, however, no hint from Streeting that he appreciated the irony that the government was declaring that it will replace one "top down" re-organisation of the NHS with another "top down" re-organisation. The government has made no attempt to discuss these proposals with health workers and all those fighting to safeguard the future of the NHS. There was no candidness in the fact that the Minister and his advisors at the Department of Health were the ones that were being blocked by NHSE from making the reforms, many of which involve the private sector who Streeting is on record as championing. Nor was there any candidness in having as chief advisor Alan Milburn, the former Secretary of State Health under Blair's government [3]. Milburn had been the champion of privatisation, and had driven through the disastrous Private Finance Initiative (PFI) that substantially reduced hospital beds and forced health authorities into huge debt for hospitals and clinics they could not afford and lined the pockets of finance companies.

Streeting's statement that the solution the government wants is of "one team into one organisation" having been "set up to fail by a fragmented system" and that "today I am abolishing the biggest quango in the world" is a cruel deception on health workers and all those that have been fighting to safeguard the future of the NHS. It is a betrayal of all those that want such a publicly-provided health care system, free to all those regardless of their status as citizens as a just claim of all on the wealth produced by society. This has been represented by health workers and their trade unions, national and local health campaigns and the people themselves. The alternative has been elaborated for a public and human-centred health and care system that the NHS and care sector should be.

Leeds - Photo:KONP

The claim that the government is bringing NHS back into "democratic control" is itself the deception covering over that NHSE is to be brought under the control of the Executive, and all that entails. "Democratic control" will not be achieved by neo-liberal restructuring of the state, and placing the direction of the NHS in the hands of the cartel party system of government in Westminster. This will only be achieved by subjecting the NHS to the solutions of health workers and of the people themselves in a human-centred economy that is pro-social and anti-war. Also, without immediately saving jobs and addressing the lack of necessary investment in the NHS and social care over decades, without stopping and reversing the increasing closures and cuts to acute and community services, without stopping and reversing the increased privatisation of NHS and social care services and its "internal market" and without training enough doctors and nurses to meet the needs of NHS and social care services there can be no permanent solution. Without addressing these vital questions the crisis in the NHS will continue and can only intensify.

None of these aims can be achieved without changing the emphasis and direction of the economy so that it meets the needs of those that live and work in it and stops serving the pro-war, corporate interests.

The fight must continue, people must continue to speak out and discuss and organise to defend their local and national health and care services in the movement to safeguard the future of the NHS. The necessity remains for people's empowerment to lead the change for democratic renewal of our NHS.

Notes
1. Speech PM remarks on the fundamental reform of the British state: 13 March 2025
https://www.gov.uk/government/speeches/pm-remarks-on-the-fundamental-reform-of-the-british-state-13-march-2025
2. Hansard - NHS England Update - Volume 763: debated on Thursday 13 March 2025
https://hansard.parliament.uk/commons/2025-03-13/debates/25838956-1EFB-4AF7-BFB2-67CBCDA59DA9/NHSEnglandUpdate
3. Alan Milburn's Plan: Further Retreat from Society Guaranteeing the Right to Health Care
https://www.rcpbml.org.uk/wdie-02/d02-10.htm
4. Government abolishes NHS England - See Co-Chair of Keep Our NHS Public Tony O'Sullivan interviewed by Novara Media
https://www.youtube.com/watch?v=Yamu_nfA2G4

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