Labour's strategy to dismantle NHS England (NHSE) has encountered significant criticism, with Health Secretary Yvette Cooper announcing the establishment of a new entity, the 'Special Health Authority,' intended to manage the process of abolishing the existing quango. This move has been characterized as creating a new quango to scrap an old one.
Thousands of NHSE staff are slated to be transferred to this new authority to meet the government's deadline for abolishing NHSE. The initial plan, announced by former health secretary Wes Streeting in March 2025, aimed to reintegrate NHSE's functions into the Department of Health and Social Care (DHSC). However, this faced obstacles due to significant pay disparities, as NHSE bureaucrats can earn up to £45,000 more than their counterparts in Whitehall, which would necessitate Treasury approval for each individual salary exceeding civil service pay scales.
Cooper stated that plans to abolish NHSE and absorb its functions into the DHSC by April are still progressing, despite missing an earlier October 2026 target. Initially, approximately 9,000 staff, or 50% of NHSE's workforce, were expected to lose their positions. It remains unclear if these reductions will still occur or if staff will simply be reassigned.
The Special Health Authority is described by Cooper as a "temporary arrangement that will support the transition to a more devolved model." However, shadow health secretary Damian Hinds criticized Labour's approach, asserting that the abolition of NHSE is being pursued "without a thought-through plan," leading to missed deadlines and increased costs.
Hinds questioned the feasibility of completing these changes within the remaining five months and argued that "what the NHS needs is focus on patients - to get the waiting lists down and A&E performance up." He added that "the disruption of a constantly shifting re-re-organisation inevitably takes attention away from this core need."
Despite coming to power in 2024 with a pledge to reduce bureaucracy, the Labour government has been noted for establishing new quangos. The creation of the OneGov Delivery Agency in September to reform the civil service is another example. Under the current plan, the NHS chief executive role will be maintained, and an 'NHS Group' will be established within the DHSC to handle the majority of NHSE's national delivery functions.
NHS regional teams are expected to support the transition with their local knowledge, but they will not be transferred into DHSC on April 1, 2027. Cooper mentioned that a consultation with NHSE staff and trade unions is scheduled to conclude in January. Furthermore, in contrast to promises of reduced bureaucracy, a new 'Patient Experience Director' role and a 'Clinical Council' of senior clinicians will be established to advise ministers.