Labour considers tightening Whitehall control of NHS

A Labour government would seek to tighten Whitehall control over the NHS in a push to boost productivity and meet ambitious targets to cut waiting times for treatment within its first term of office.

Two people familiar with discussions inside the opposition party said shadow cabinet member Wes Streeting could look to align the Department of Health and Social Care and NHS England more closely if, as expected, he became health secretary after the election.

One option being discussed by Labour figures is to bring the senior leadership of NHS England (NHSE), the body that runs the health service in England, into central government through shared executive meetings. 

“Wes is understood to be frustrated by the lack of accountability in NHS England,” one health official said. “It’s a logical move to make as having operational independence for the NHS works on paper but not in reality.” 

The person added: “It is being seriously considered and much depends on their early exchanges with NHSE.”

Party insiders denied there was any plan to officially merge NHSE with the health department, a move that would reverse the operational independence granted to the service under controversial reforms introduced in 2012 by Andrew Lansley, then Conservative health secretary.

Another person briefed on discussions said that while relationships worked well between some key players at the top of both organisations, responsibilities lower down were not always so clearly delineated.

The possibility of a shake-up comes amid speculation that Labour will also seek to replace Richard Meddings as chair of NHS England. The former banker was appointed to the role two years ago by the then health secretary Sajid Javid.

Alan Milburn, health secretary under prime minister Tony Blair between 1999 and 2003, and former Labour home secretary Jacqui Smith were among the frontrunners if a decision was taken to replace Meddings, one health official said.

With the NHS facing budget pressures and named as a top priority by voters, Labour is likely to be wary of any suggestion it is planning the kind of wholesale change that Lansley ushered in, which consumed large amounts of management time and was widely viewed as disastrous.

The health service is seeking to strengthen disease prevention and early diagnosis while clearing waiting lists for routine care, which stood at 7.57mn at the end of April. Streeting has repeatedly said extra investment would be conditional on reform. 

A Labour spokesperson said the party was looking to foster “closer alignment and shared meetings” between NHSE and the health department if it were to form the next government.

“There has been a really bad relationship between the two bodies in the past few years and that’s not going to work if we’re going to turn the NHS around,” they said.

However, it was not looking to implement any top-down reorganisation within NHSE. Nor was it considering any changes regarding senior leadership or functions, the person added.