Britain, Government, Health, NHS, Politics

The abolition of NHS England

HEALTH

Intro: The Labour Government’s shake-up of the NHS in England aims to cut waste and shift resources, but the looming funding gap raises doubts about its impact

THE UK Government’s decision to abolish NHS England – the world’s largest quango – was cast as a bold strike against bureaucracy. The move is designed to cut waste, “shift money to the frontline”, and by placing the NHS in England under direct democratic control. It is a declaration of intent from Sir Keir Starmer who wants Labour not to be the party of bigger government but the party of smarter government. That’s the theory, at least. The reality, as with most things in government, is more complicated.

The announcement happens to be less of a grand health reform and more a strategic positioning exercise. Wes Streeting, the Health Secretary, and the architect of this plan, is engaged in a delicate balancing act: convincing the Treasury that the NHS can stay within budget, while simultaneously lobbying for more money that he knows the health service will inevitably require. The cull of NHS England is a useful and headline-grabbing moment. It is one that will allow Mr Streeting to claim that he is shifting cash from managers to patient care, a necessary concession when preparing to argue for more Treasury investment.

The problem is that the numbers don’t add up. The savings from axing NHS England will be modest. The organisation’s cost to the Treasury is £2bn, a tiny fraction of the NHS’s £183bn budget for 2025/26. Of this, about £400m is spent on staff who work directly with local NHS bodies, and these roles will probably continue in some form. The savings come nowhere near enough to fill next year’s estimated £6.6bn funding gap. At best, it frees up a few hundred million pounds. At worst, it shifts costs elsewhere while causing months of upheaval in an already overstretched system.

The NHS faces mounting pressure to cut costs, with the Chancellor, Rachel Reeves, insisting that it must live within its means. Hospital trusts will need to tighten their belts even further. It does not take a health economist to recognise that when resources are cut, patient demand does not magically disappear – it simply resurfaces elsewhere. If community services shut-down to balance the books, then the pressure on GPs and A&E departments will only intensify. If the health service is told to do more with less, the risk is that it simply ends up doing less with less.

Sir Keir’s embrace of Mr Streeting’s reform agenda is a calculated gamble. The PM is backing an NHS overhaul that may not deliver as promised. His endorsement, however, bolsters Mr Streeting’s standing with the Treasury, which faces a looming fiscal shortfall. With tax rises off the table, and Ms Reeves’ fiscal straitjacket firmly in place, spending cuts after 2025/26 seem an inevitability.

The NHS may have won big in the last budget, but as the Darzi report warned, it remains in “serious trouble”. Years of under-investment and overcrowded hospitals, with no relief from an overstretched social care system, have left it desperately struggling. Without greater funding, it cannot meet the rising demand of an ageing population, let alone expand its workforce. The Health Secretary must keep pressing the Treasury for the resources he needs, cloaking each plea for cash in the fashionable language of “modernising reform”.

Such rhetorical agility is a skill that Westminster normally rewards. Consider, for example, how Universal Credit came into being. But whether he delivers on his three big shifts – moving care out of hospitals, prioritising prevention, and digitising the NHS – remains to be seen. If the health service deteriorates further, the government will soon find that it has not only failed to fix the NHS in England but has taken ownership of its decline.

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Britain, Defence, Europe, European Union, France, Government, NATO, Politics, Russia, Society, Ukraine, United States

Europe can deal with America’s perfidy

A NEW WORLD ORDER

Intro: Europe is stepping up. If it perseveres, and its leaders keep their promises, then it will be better able to deter Russia on its own – and survive in a reordered and more hostile world

A WATERSHED moment is upon us as Britain and the entire European continent faces a turning point, a second Zeitenwende, and a new world order. Whichever turn of phrase best describes the dramatic shifts unfolding since Donald Trump began his second US presidential term in January, one thing is certain: nothing will be the same again. The key question now is what, in practical terms, Europe can and will do to meet this challenge. Is this paradigm shift in the world order Europe’s moment, when it finally comes of age as a global player? Or will the EU and its close neighbours collectively fail to rise to the occasion, condemning their citizens to an era of domination by bigger and more determined rapacious powers?

With incautious recklessness, Donald Trump is in the process of attempting to do three extraordinary things. First, he is trying to force Ukraine, which has spent more than three years under murderous assault, to accept a “peace deal” on inimical terms dictated by himself and the aggressor, Vladimir Putin’s Russia. Second, in a stunning reversal of US policy, he is seeking a rapprochement with Moscow that includes re-establishing full political and diplomatic relations, lifting sanctions and launching joint economic partnerships. Third, he is telling Europeans they must henceforth defend themselves; that the US, in effect, is no longer a loyal, reliable partner or even necessarily a friend, and that NATO, for 76 years the solid bedrock of transatlantic security, is dispensable.

European leaders are broadly united in their alarm at all three of these unwise, irrational, and dangerous interventions. At the same time, most accept that even if Trump didn’t hold office, a change in the balance of US-Europe relations is inescapable and more than overdue. In a national address, Emmanuel Macron, France’s president, summed up the position well: “Europe’s future should not be decided in Washington or Moscow,” he said. “The war in Ukraine… continues with the same intensity [but] the US, our ally, has changed its position.” As a result, Europe was entering a new era of self-reliance.

Mr Macron, like many others, was accused of appeasing Putin in 2022. He has learned better since. He warns now that Russian imperialist aggression “knows no borders”, directly threatening France and Europe. This is not just talk. He has shown imaginative leadership, producing a tentative plan for a staged ceasefire that has Ukrainian support, lobbying, flattering, and even correcting Trump to his face in the Oval Office. The French president has also been promoting an Anglo-French proposal to deploy a European “assurance force” in Ukraine composed of a so-called coalition of the willing.

There has been repeated recourse in recent days for Europe to “step up” as a matter of urgency. Germany surprised many with a positive leap into the future. A country that nurtures visceral horror of debt announced a spectacular U-turn of its own – the amending of its Basic Law to permit multibillion-euro investments in defence and national infrastructure. Quite remarkable given that Friedrich Merz, the Christian Democrat who held off the far-right to win last month’s federal election, has a reputation as a fiscal conservative. Not any more. And he has gone further even than Macron in urging Europe’s “independence” from the US and pledging ongoing, expanded military aid for Kyiv. Other European leaders, notably Donald Tusk, have “stepped up” in commendable ways, too. Poland’s prime minister is in an unenviable position. A strong adherent in the transatlantic alliance, he, like so many others, now must feel utterly betrayed by Trump. There is a real sense of perfidy in the air. NATO is a crucial shield for Poland, as it is for the three neighbouring Baltic republics.

Keir Starmer also recognises the historic nature of this moment, and has risen to meet it. He has worked assiduously and with due care to restrain Trump’s worst instincts. His evident contempt, displayed in the House of Commons, for the ignorant comments of US vice-president JD Vance about “random countries” showed he is not afraid to push back. The PM’s collaboration with EU leaders is a very welcome post-Brexit development that should be extended beyond defence and security. Yet like them, the UK faces daunting hurdles.

These challenges – on reducing Europe’s reliance on America, boosting its defences, and maintaining support for Ukraine – were the focus of the emergency EU summit. As is often the case in Brussels, the results were mixed. New overall defence spending of £670bn was agreed. But whether it ever materialises will depend on national governments’ willingness to borrow. The usual divisions were apparent – such as Hungary blocking a joint statement on Ukraine. Within NATO, most member states, like Britain, are now committing to higher spending. Non-EU countries, such as Norway, are also piling in. Oslo is belatedly, yet commendably, doubling its aid to Kyiv.

Europe is stepping up. If it perseveres, and its leaders keep their promises, then it will be better able to deter Russia on its own – and survive in a reordered and more hostile world. But how effective Europe can be in rescuing Ukraine in the short term from a developing Trump-Putin axis is in serious doubt. Trump still refuses to provide Kyiv with meaningful post-war security guarantees. His suspension of military aid, mapping, and intelligence assistance is encouraging Russia to intensify attacks. More civilians are dying each day because of Trump’s treachery. With each passing day, Ukraine is further brutalised and degraded. A just peace looks further away than ever. 

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Britain, Government, Politics, Society, United States

Vilifying Trump will backfire

TRUMP’S SECOND PRESIDENCY

IT is truly amazing that with a population of 335million, the United States could not find two better presidential candidates than Donald Trump and Kamala Harris.

How dispiriting it must have been to choose between a narcissistic 78-year-old convicted criminal and a deeply unconvincing vice president.

But that was the choice in the run-off for the White House and the voters have spoken. In the final reckoning, they elected Mr Trump as their 47th President – perhaps the most dramatic comeback in the nation’s political history – who romped him with a landslide victory. Both the Senate and House of Representatives will now be controlled by the Republicans.

After he was removed from office in 2020 his supporters attacked the Capitol and he has since been found guilty of multiple felonies.

Mr Trump’s reputation seemed to lie in tatters, yet the majority of Americans have given him a second chance. He has confounded his enemies, who desperately hoped his previous term had been an aberration from which the American people would awake.

Democrats will be feeling lost and bewildered at how their nation could have put such a man in power again. Practically every major institution – from Hollywood to the achingly liberal media – denigrated him.

Yet the voters defied them, showing once again just how far out of touch these powerful elites have become with ordinary people. 

Instead of asking themselves how on earth America could have voted for Trump, they should be asking why the masses didn’t back Ms Harris.

Her campaign was a clinical study in negativity. Preposterously, she described her opponent as a fascist – and by implication tarred his supporters with the same brush. Nor could she separate herself from the unpopular President Joe Biden. His handling of the economy has been hopeless, with inflation and rising prices hammering family budgets.

The Democrats failed to listen to anger at mass immigration. And it is in thrall to the radical race-based progressive policies that alienate so much of Middle America.

Yes, Donald Trump threw his fair share of brickbats and derisory comments, but he also offered optimism and is a known quantity. In his first term, he oversaw impressive economic growth, started no wars, and stood up to Iran and China.

So, in the end, the election wasn’t the tighthead finish all of the pollsters had predicted. It was a resounding and thumping victory, giving Mr Trump huge power to push through his policy agenda. Particularly now that the Republicans have control of both Houses on Capitol Hill.

In many ways, Britain ought to be well positioned after his victory. With a Scottish heritage and investments here, he has far more affection for these islands than Kamala Harris does.

Labour’s student politics will soon put paid to any goodwill. Mr Trump was angered by the party sending staff to campaign for the Democrats, and he will be aware that Labour politicians have hurled gross insults at him. Most notable was David Lammy, now British Foreign Secretary, who, as a backbencher, described Mr Trump as “a woman-hating, neo-Nazi sympathising sociopath”.

In opposition, these remarks were ill-advised. Now he is holding one of the most important Office’ of State, they look indefensible and deeply damaging.

The UK-US “Special Relationship” has always ebbed and flowed, but if Labour doesn’t mature it will wither on the vine.

Sir Keir Starmer’s statist tax rises, failure to properly fund defence, and the headlong dash for Net Zero are already misaligned with US policy. If the PM doesn’t tread carefully, the rift with Mr Trump could damage Britain’s economy and security. The President-Elect has already said that Labour is “too Left”.

The UK and the world need to show restraint and generosity towards the next president – vilifying him out of hand will surely backfire.

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