NHS league tables and cancelled pay rises for managers among government health reforms
NHS league tables revealing failing NHS trusts and cancelled pay rises or dismissal for managers who don’t turn things around are to form part of the government’s plans to improve the health service.
Health Secretary Wes Streeting is confirming new measures he hopes will boost failing hospital trusts and encourage successful ones.
The changes form part of the Labour government’s strategy to reduce waiting lists “from 18 months to 18 weeks”.
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Health and the state of the NHS were consistently among the most important issues for voters at this year’s general election – with Labour blaming the Conservatives for “breaking” it.
As health is a devolved area, any reforms proposed in Westminster would only apply to England.
Chief among Mr Streeting’s proposals is a “league table” for NHS trusts.
An announcement from the Department for Health and Social Care said: “NHS England will carry out a no-holds-barred sweeping review of NHS performance across the entire country, with providers to be placed into a league table.
“This will be made public and regularly updated to ensure leaders, policy-makers and patients know which improvements need to be prioritised.”
It also promises to replace “persistently failing managers” – with “turn around teams” being sent in to improve trusts running sizeable deficits or offering poor service to patients.
The government says “senior managers” who fail to make progress will not be eligible for pay rises.
There will be “financial implications” for more senior figures such as chief executives if their trust does not improve.
On the flip-side, those trusts that are deemed to be “high-performing” will get “greater freedom over funding and flexibility”.
Senior leaders at these trusts will also be “rewarded”.
The government says the current system is not incentivising trusts to run a budget surplus, as they cannot benefit from it.
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Mr Streeting said: “The budget showed this government prioritises the NHS, providing the investment needed to rebuild the health service.
“Today we are announcing the reforms to make sure every penny of extra investment is well spent and cuts waiting times for patients.
“There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.
“Our health service must attract top talent, be far more transparent to the public who pay for it, and run as efficiently as global businesses.
“With the combination of investment and reform, we will turn the NHS around and cut waiting times from 18 months to 18 weeks.”
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Concerns from health representatives
Amanda Pritchard, the chief executive of NHS England, said: “While NHS leaders welcome accountability, it is critical that responsibility comes with the necessary support and development.
“The extensive package of reforms, developed together with government, will empower all leaders working in the NHS and it will give them the tools they need to provide the best possible services for our patients.”
Further plans on how monitoring will be published by the start of the next financial year in April 2025, the government said.
Matthew Taylor, the chief executive of the NHS Confederation – a body that represents all NHS trusts – said healthcare leaders welcome the “government’s ambition”.
However, he said he was concerned league tables and reducing pay may “strip out” the nuance of what’s going on.
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Mr Taylor said: “NHS staff are doing their very best for patients under very challenging circumstances and we do not want them feeling like they are being named and shamed.
“League tables in themselves do not lead to improvement, trusts struggling with consistent performance issues – some of which reflect contextual issues such as underlying population heath and staff shortages – need to be identified and supported in order to recover.”
A group of US Senate Democrats known for supporting the crypto industry have said they would oppose a Republican-led stablecoin bill if it moves forward in its current form.
The move threatens to stall legislation that could establish the first US regulatory framework for stablecoins, according to a May 3 report from Politico.
Per the report, nine Senate Democrats said in a joint statement that the bill “still has numerous issues that must be addressed.” They warned they would not support a procedural vote to advance the legislation unless changes are made.
Among the signatories were Senators Ruben Gallego, Mark Warner, Lisa Blunt Rochester and Andy Kim — all of whom had previously backed the bill when it passed through the Senate Banking Committee in March.
The bill, introduced by Senator Bill Hagerty, is formally known as the Guiding and Establishing National Innovation for US Stablecoins (GENIUS) Act.
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The Senate is expected to begin floor consideration of the bill in the coming days, with the first vote potentially taking place next week.
The bill has been championed by the crypto industry as a landmark step toward regulatory clarity. However, the Democrats’ about-face reflects growing unease within the party.
Although revisions were made to the bill after its committee approval to address Democratic concerns, the lawmakers said the changes fell short. They called for stronger safeguards related to Anti-Money Laundering, national security, foreign issuers, and accountability measures for noncompliant actors.
The statement was also signed by Senators Raphael Warnock, Catherine Cortez Masto, Ben Ray Luján, John Hickenlooper and Adam Schiff.
Senator Kirsten Gillibrand and Senator Angela Alsobrooks were absent from the list, who co-sponsored the bill alongside Hagerty.
Despite their objections, the Democratic senators emphasized their commitment to shaping responsible crypto regulation. They reportedly said they “are eager to continue working with our colleagues to address these issues.”
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Crypto needs a stablecoin bill
On April 27, Caitlin Long, founder and CEO of Custodia Bank, criticized the US Federal Reserve for quietly maintaining a key anti-crypto policy that favors big-bank-issued stablecoins, despite relaxing crypto partnership rules for banks.
Long explained that while the Fed recently rescinded four prior crypto guidelines, a Jan. 27, 2023, statement was left intact in coordination with the Biden administration.
The guidance, according to Long, blocks banks from engaging directly with crypto assets and prohibits them from issuing stablecoins on permissionless blockchains.
However, Long noted that once a federal stablecoin bill becomes law, it could override the Fed’s stance. “Congress should hurry up,” she urged.
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Bitcoiners and United States government officials have criticized Arizona Governor Katie Hobbs’s decision to veto a bill that would have allowed the state to hold Bitcoin as part of its official reserves.
“This will age poorly,” Casa co-founder and cypherpunk Jameson Lopp said in a May 3 X post. Bitcoin (BTC) entrepreneur Anthony Pompliano said, “Imagine the ignorance of a politician to believe they can make investment decisions.”
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“If she can’t outperform Bitcoin, she must buy it,” Pompliano said. Crypto lawyer Andrew Gordon said, “We need more elected officials who understand that Bitcoin and crypto are the future.”
Wendy Rogers, who co-sponsored the bill with State Representative Jeff Weninger, also voiced her disappointment.
“Politicians don’t understand that Bitcoin doesn’t need Arizona. Arizona needs Bitcoin,” Rogers said.
On May 2, Hobbs vetoed the Arizona Strategic Bitcoin Reserve Act, which would have permitted Arizona to invest seized funds into Bitcoin and create a reserve managed by state officials. “Today, I vetoed Senate Bill 1025. The Arizona State Retirement System is one of the strongest in the nation because it makes sound and informed investments,” Hobbs said.
Rogers said she would refile the bill during her next session. Rogers also pointed out that Arizona’s state retirement system already holds stocks of Michael Saylor’s Strategy (MSTR).
“Which is basically a leveraged Bitcoin ETF. Arizona’s Strategic Bitcoin Reserve bill will be back. HODL,” Rogers said. The stock price of Strategy rose 32% in April, the most significant monthly gain since November 2024.
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However, well-known crypto skeptic Peter Schiff sided with Hobbs. “The government should not be making decisions to use public funds to speculate in cryptocurrencies,” Schiff said.
Arizona would have become the first US state to establish a Bitcoin Strategic Reserve if it had passed.
Arizona joins several other US states where similar efforts have failed. Similar proposals in Oklahoma, Montana, South Dakota and Wyoming have stalled or been withdrawn recently.
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