Wes Streeting Faces Potential Pay Dispute Over NHS England Reforms
Wes Streeting, the Health Secretary, may be on the brink of a new pay dispute following a call from the leader of the largest health union. Christina McAnea, the general secretary of Unison, urged that the funds saved from the proposed abolition of NHS England should be redirected towards enhancing pay for clinical staff. This restructuring is poised to eliminate approximately 10,000 jobs within the arms-length body as it is reintegrated into the Department of Health and Social Care, with additional Whitehall roles also at risk.
Sir Keir Starmer, leader of the Labour Party, has expressed a desire to eradicate what he perceives as “two layers of bureaucracy” that hinder progress, aiming to achieve savings of around £500 million through this merger. In announcing this decision, Starmer criticized NHS England for becoming “overstretched, unfocused, and attempting too much while performing poorly.”
McAnea contended that the insufficient staffing levels are primarily responsible for the lengthy waiting lists, asserting that a pay increase could significantly aid in staff retention. Current statistics reveal over 106,000 vacancies within the English health service, a decline from nearly 132,000 two years prior. Although the waiting list for routine treatments has seen a reduction over the past five months, there remains a staggering backlog of 7.43 million treatments affecting 6.25 million individuals.
McAnea emphasized the impact of the decision to abolish NHS England, stating that it would likely leave staff “reeling,” especially considering they had just learned that the workforce at the quango would be halved.
“Delays and extended waits for operations and appointments have rendered millions unable to work, adversely affecting economic growth,” she noted. “An increased focus and greater investment in the entire NHS team—beyond just nurses and doctors—are essential for revitalizing a struggling NHS. To put it plainly, the health service requires thousands more personnel and must retain experienced employees. Presently, it is facing challenges in doing so, and providing staff with a reasonable pay increase would be immensely beneficial.”
Last year, approximately 1.5 million NHS staff in England received a 5.5% pay rise, while the government has indicated that increases will be capped at 2.8% for the fiscal year 2025/26. In July, junior doctors’ representatives agreed to a 22.3% pay increase over two years. However, the British Medical Association (BMA) has made it clear that their focus remains on achieving “pay restoration” for both junior doctors—now referred to as resident doctors—and consultants, arguing that inflation has led to a real-term pay decrease, alongside negotiating a new contract for General Practitioners (GPs). The BMA has not dismissed the possibility of further strikes this year regarding these issues.
McAnea criticized the manner in which the announcement of NHS England’s abolition was handled, calling it “shambolic.” She stated, “It could have been managed with greater sensitivity. Thousands of skilled professionals are left uncertain about their futures. Wherever possible, their expertise must be redeployed for the benefit of the restructured NHS and its patients. Ministers must reassure NHS employees that there is a solid plan in place to rejuvenate the beleaguered NHS and effectively serve the public.”
Concerns Raised Over Impact on Patient Care Amid Reforms
By Alannah Francis
Frontline NHS staff, including doctors, have voiced their concerns regarding the implications of the reforms introduced by Wes Streeting, particularly regarding potential effects on patient care. They are also urging the government to ensure that any savings resulting from these reforms are reinvested into frontline services for the benefit of patients. With plans to cut around 9,500 jobs—approximately half of NHS England’s workforce—questions are being raised about how these changes could impact patient care.
Several Royal Colleges have issued responses to the government’s plans, while others await further information on how these changes will affect their operations and the patients they serve. Dr. Katharine Halliday, President of the Royal College of Radiologists, remarked, “While we understand the rationale behind re-integrating NHS management into the Department of Health and Social Care, especially if it leads to increased funding for frontline care, such a significant reorganization will inevitably affect the vital work carried out by NHS England at a time when progress is urgently needed.”
The campaign group EveryDoctor emphasized the necessity for the government to clearly articulate its vision for the NHS, especially regarding how the cessation of NHS England will benefit the service. “Patients and staff are understandably concerned about the current state of the NHS and deserve clear leadership along with a robust plan to rebuild the service,” they stated.
While some medical professionals have welcomed the changes, they stressed that clinical leadership will be crucial. Dr. Claire Shannon, President of the Royal College of Anaesthetists, described the reforms as a significant opportunity to enhance patient care. She stated, “These changes represent a pivotal shift in the operational management of the NHS in England. Although we await additional details, effective clinical leadership will be essential. We look forward to collaborating with the government to improve patient care and support healthcare professionals, including those in anaesthetic training.”
It is anticipated that the funds saved will be allocated to frontline providers, granting them discretion over their expenditure. The government emphasized that it will not micromanage frontline NHS managers, as ensuring quality patient care while managing finances responsibly remains paramount. However, the £500 million savings are merely a fraction of NHS England’s overall budget, which stands at £180 billion, prompting skepticism among health policy experts about the tangible benefits of abolishing NHS England for either staff compensation or patient care.
Furthermore, a substantial sum will be required for redundancy payments for the estimated 10,000 affected individuals. Helga Pile, UNISON’s head of health, stated, “Regardless of the fate of NHS England, the health service is grappling with immediate challenges that require urgent attention. The staffing crisis is already severe, and it will only worsen without a timely, decent pay rise for staff. The NHS must retain its talented and experienced workforce while actively seeking to recruit more personnel. A reasonable wage increase is fundamental to achieving this and turning around the fortunes of the NHS.”
In his address to the Commons, Health Secretary Wes Streeting asserted, “These reforms will result in a significantly leaner top tier of the NHS, generating substantial annual savings. This funding will be redirected to frontline services, enabling quicker reductions in waiting times and facilitating our Plan for Change, which aims to streamline processes and empower frontline NHS leaders. We will enable local NHS providers to innovate and develop new, productive methods of operation, prioritizing what matters most—enhancing patient care.”
