MPs have raised concerns that the government\u2019s major structural reforms to the healthcare system are \u201creplicating poor practices\u201d seen on the HS2 and New Hospital programmes, and will lead to wasted effort.<\/p>\n
In a new report published today, the Public Accounts Committee said the major changes, namely the absorption of NHS England into the Department of Health and Social Care and Integrated Care Boards being ordered to cut costs by 50%, are being made without ensuring there is funding in place to pay for the changes.<\/p>\n
It said the government has\u00a0also failed to conduct impact assessments or take other steps to safeguard value for money. And it said much greater emphasis should be placed on producing an impact study to accompany these large changes.<\/p>\n
The report warns these changes, \u201cespecially the planned cuts to local health boards, could have a significant negative impact on patients and on the workforce through the level of uncertainty they create\u201d.<\/p>\n
The MPs noted that previous reports PAC has published have highlighted the risks to value for money raised by sudden policy changes that are not supported by sufficient funding and planning.<\/p>\n
In 2023, PAC reported that the decisions made by DHSC in planning the New Hospitals Programme could not be justified as no supporting documentation existed.\u00a0<\/p>\n
And in a September 2025 report on governance and decision-making on major projects, it found that announcing projects or programmes too early, or where the design of the proposed changes are immature, presents serious threats to governance.<\/p>\n
The report seeks confirmation from\u00a0DHSC\u00a0that it will not announce unfunded commitments, and asks the department to set out the likely costs of planned redundancies and the absorption of NHS England.\u00a0<\/p>\n
Clive Betts MP, deputy chair of the Public Accounts Committee, said: \u201cAlarmingly, in the government\u2019s approach to the absorption of NHSE and 50% cuts to local health boards, we are now seeing chilling echoes of past failures on HS2 and the New Hospital Programme.<\/p>\n
“Our committee has long established that large, unfunded commitments, without plans for delivery, while good at generating headlines, can only end one way. We hope the government can provide reassurance as part of this inquiry that it can come forward with the underpinning detail that can marry its ambitions to reality.\u201d<\/p>\n
Speaking at the NHS Providers annual conference last week, the health secretary, Wes Streeting, announced he was giving ICBs\u00a0the go ahead and the funding for voluntary redundancy programmes that\u00a0will see overall headcount drop by 50%<\/p>\n
He also said DHSC is on track to absorb NHS England within two years and confirmed the two bodies’ combined headcount\u00a0will be halved.<\/p>\n
Dr Hugh Alderwick, director of research and policy at the Health Foundation said the committee “is right to question the government’s approach to major policy change in the NHS”.<\/p>\n
“The government has embarked on yet another round of top-down restructuring of the health service, at a time when the NHS is under massive pressure and political ambitions for improvement are sky-high. This is risky, at best, given experience from a long line of previous reorganisations suggests they cause widespread disruption, take years to deliver, and rarely deliver the benefits policymakers expect. The big worry is that NHS leaders are distracted from the task of improving services.<\/p>\n
“Rather than reforms to the structure of the health service, like merging or scrapping organisations, greater attention is needed on what happens within it, including by developing the skills and capabilities for the NHS to identify, implement, evaluate and spread improvements to care in different contexts. Cuts to local NHS bodies risk making this harder.”<\/p>\n
\u2018Serious risk\u2019 of missing health mission milestone<\/p>\n
The report also warns that NHS England has missed several post-Covid recovery targets by a significant margin and that DHSC is at “serious risk” of failing to meet its key pledge to fix the NHS.\u00a0<\/p>\n
The MPs found that:<\/p>\n
\n\tNearly 192,000 patients were waiting over a year for care by July 2025 \u2013 a wait time that should been eliminated by March
\n\tFor diagnostic tests, 22% of patients were on a waiting list for more than six weeks – against a target of 5% by March 2025, and an operational standard of 1%
\n\tPlans to reduce follow-up outpatient appointments by 25% (compared to 2019-20) by March 2023 saw NHSE achieve only 0.1% fewer appointments between June 2022 and July 2023
\n\t
<\/p>\n
Only 59% of patients were treated within the statutory standard of 18 weeks, against a target of 92%<\/p>\n
\n\t
<\/p>\n
The report says these failures were \u201cdriven in part by NHSE\u2019s and the government\u2019s flawed approach to improving its own services\u201d. It said \u00a33.24bn in spending \u2013 most of which paid for new surgical hubs and diagnostic centres \u2013 was approved by government \u201cwithout sufficient focus on what exactly its funding would deliver and without any focus on outcomes for patients\u201d.<\/p>\n
The MPs said freeing up more outpatient appointments could have made the most difference as the vast majority (80%) of elective care pathways end through such an\u00a0appointment, but NHSE \u201chad no credible plan to achieve this, failing to secure meaningful engagement from clinicians to do so\u201d.<\/p>\n
The report warns that\u00a0DHSC will need “get a grip” on the recovery programmes when it takes them over from NHSE or\u00a0there is a “serious risk” of failing on its pledge to treat\u00a092% of patients within the statutory standard of 18 weeks by 2029,\u00a0 the key milestone the government has set in this parliament for\u00a0its health mission: build an NHS fit for the future.\u00a0<\/p>\n
A DHSC spokesperson said: \u201cThis government inherited a broken NHS, with waiting lists soaring and elective services in dire need of modernisation. This report focuses on the previous government, and we have taken immediate and robust action to tackle waiting lists and modernise elective care.<\/p>\n
\u201cFor the first time in 15 years, waiting lists are falling. Through record investment and modernisation, we\u2019ve cut backlogs by more than 230,000 and smashed our target for additional appointments, delivering more than five\u00a0million extra.<\/p>\n
\u201cHealth service productivity is up 2.7% on last year \u2013 and just last week, we pressed ahead with halving the headcount of NHSE and DHSC, saving billions to reinvest into the frontline and patient care.<\/p>\n
\u201cWe\u2019re delivering the change the NHS is crying out for \u2013 while slashing wasteful spending to ensure maximum value for taxpayers.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"MPs have raised concerns that the government\u2019s major structural reforms to the healthcare system are \u201creplicating poor practices\u201d…\n","protected":false},"author":2,"featured_media":276402,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[43],"tags":[102,2960,56,54,55],"class_list":{"0":"post-276401","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-uk","11":"tag-united-kingdom","12":"tag-unitedkingdom"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/276401","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/comments?post=276401"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/posts\/276401\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media\/276402"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/media?parent=276401"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/categories?post=276401"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/uk\/wp-json\/wp\/v2\/tags?post=276401"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}