The Prime Minister, Sir Keir Starmer, has announced that NHS England will be abolished in a move to cut bureaucracy. Management of the health service will be brought “back into democratic control.”
The government has described NHS England as possessing “burdensome layers of bureaucracy without any clear lines of accountability.” Speaking in Hull, the Prime Minister noted that the NHS us “overstretched” and “unfocused.”
Established in 2013 by former Conservative health secretary Andrew Lansley, NHS England was intended to offer the NHS greater independence and autonomy from government interference. Founded as a quango (funded by taxpayers,but not controlled directly by central government) NHS England serves a wide range of statutory functions, boasting various responsibilities and regulatory powers, such as agreeing funding and priorities for the NHS alongside the government, and overseeing the delivery of safe and effective NHS services.
NHS England employs around 15,300 people at present, while the Department for Health and Social care has approximately 3,300 members of staff on its books. Health Secretary Wes Streeting has said that the government wants to slash those numbers by 50% to “deliver hundreds of millions of pounds worth of savings.”
BDA response
The British Dental Association has said the plans to reallocate resource from the abolition of NHS England should contribute towards a fair funding settlement for NHS dentistry.
Last month the BDA gave written evidence to the Public Accounts Committee indicating a decade of austerity funding means thousands of NHS dentists are now delivering some NHS treatment at a loss. The Treasury’s unwillingness to help NHS dentistry stand on its own two feet is accelerating the exodus to the private sector. A simple new NHS patient exam loses a typical practice £7.69; a denture – £42.60.
The professional body has lambasted recent Government plans to raise NHS charges, which in the past merely acted as a cover for cuts, within a static budget that’s barely changed in a generation. Labour has pledged reform of the failed contract in NHS dentistry. The BDA says a fair funding settlement has to underpin meaningful negotiations.
In managing this overhaul, the BDA stresses that ministers must ensure that there is sufficient capacity within the Department of Health to cover reform of the dental contract, and maintain the existing Dental Public Health workforce, who are vital to delivering the Government’s agenda on improving oral health and reducing inequalities.
Shiv Pabary, Chair of the British Dental Association’s General Dental Practice Committee, said: “The PM says he’s going to ‘shift money to the frontline,’ but will a broken NHS dental service see a penny of this? Choices made at the Treasury have left millions unable to access care, while practices lose money doing NHS work. We cannot build a service fit for the future without sustainable funding.”
Medical Defence Union statement
Also responding to the Prime Minister’s announcement, Thomas Reynolds, director of policy and communications at the Medical Defence Union (MDU), said: “Today’s announcement by the Prime Minister that NHS England is to be abolished has the potential to be a landmark moment in the NHS’s story. However, the NHS is not about structures and agencies, it’s about people. Healthcare professionals and patients. Regardless of where control of the NHS sits in England – with central government or another body – the same challenges remain.
“From ensuring the workforce is properly supported, to having regulatory frameworks which enable healthcare professionals to get on with the job of caring for patients, to tackling unsustainable costs facing the NHS such as those associated with clinical negligence: all require urgent attention. They cannot be sidelined in this latest health service structure. That is why the MDU will continue to champion and highlight these issues.”
Wesleyan and Practice Plan comment
Iain Stevenson, Head of Dental at Wesleyan Financial Services, has also issued a response: “After more than a decade of work on dental contract reform under NHS England, the announcement of plans to abolish the body will understandably cause concern among dentists. With no clear indication of who will take responsibility for ongoing reform efforts while the government moves to ‘scrap’ NHS England, dentists across the country will be seeking assurances that this work will not be derailed or abandoned.
“NHS dentistry is already battling major headwinds, with few effective solutions found so far. It is now crucial for the government to set out its next steps to ensure progress continues — addressing workforce shortages, expanding NHS dental services, and improving access to care for patients across the country.”
“Few would disagree that the NHS as a whole needs a significant shake-up, and time will tell whether the disruption caused by this radical move is a price worth paying,” added Nigel Jones, Strategy Director at Practice Plan. “However, the price is likely to be ‘time’ that NHS Dentistry simply doesn’t have, given the current workforce issues, a flawed contract, stretched ICBs and burnout that are all breaking the professions back today.”
Comment from Dr Nigel Carter, Chief Executive of the Oral Health Foundation
“The Prime Minister’s decision to abolish NHS England marks a seismic shift in healthcare governance. While we support efforts to cut bureaucracy and direct resources to frontline care, there is an urgent need for clarity on what this means for NHS dentistry.
“For too long, NHS dentistry has been in crisis. Millions struggle to access care, worsening oral health inequalities and piling pressure on GPs and A&E. This restructure must not push dentistry even further to the margins. The abolition of Public Health England saw dental public health teams fragmented and diminished. Now, with NHS England gone, the risk is even greater – there is no strong, coordinated leadership to prioritise prevention and protect the nation’s oral health. If NHS dentistry continues its terminal decline, investment in dental public health becomes more critical than ever.
“The government’s pledges – extra urgent dental appointments and supervised toothbrushing – are welcome but do not address the root problem. Without a long-term, sustainable plan for NHS dentistry, these are just sticking plasters on a system in freefall.”
