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.”
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When Nigel Farage’s Reform UK is just one point behind you in the opinion polls, the last thing you want to be reminded about is Brexit.
If you’re Sir Keir Starmer, that is.
No doubt Poland’s prime minister, Donald Tusk, was trying to be friendly. After all, as Sir Keir said, they share a passion for Arsenal Football Club.
But when Mr Tusk declared at their joint news conference in Warsaw that his dream was “instead of a Brexit, we will have a Breturn”, Sir Keir visibly cringed.
Was it an ambush? Not quite. But it was certainly awkward for the UK prime minister. He stood stiffly and didn’t respond, not once uttering the word “Brexit”.
Mr Tusk, however, has form for bemoaning Brexit. He was, after all, the president of the European Council when the UK voted to leave the EU in 2016.
He might now be in his second spell as Poland’s PM, but his five years at the EU make him the ultimate Brussels insider, who’s never made any attempt to hide his feelings on Brexit.
Prior to the UK referendum, in September 2015, he said Brexit “could be the beginning of the destruction of not only the EU but also of western political civilisation in its entirety”.
His most outspoken attack on the UK’s Eurosceptics came in 2019 when the-then prime minister Theresa May was struggling to get a deal. He spoke of “what the special place in hell looks like for those who promoted Brexit“.
Sir Keir also visited Ukraine on his trip to Eastern Europe. Pic: PA
Standing alongside Sir Keir, he revealed that “for obvious reasons” they discussed co-operation between the UK and the EU. He recalled that his emotional reaction to the referendum in 2016 was “I already miss you”.
He went on: “This is not just about emotions and sentiments – I am aware this is a dream of mine, that instead of a Brexit we will have a Breturn.
“Perhaps I’m labouring under an illusion. I’d rather be an optimist and harbour these dreams in my heart – sometimes they come true in politics.”
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A dream? Or a calculated move? As a Brussels insider, was Mr Tusk speaking for the EU as a whole? Was he doing Brussels’ bidding?
He may have returned to lead his homeland, but he remains a key player in Brussels.
On becoming Poland’s PM in 2023, he ended a dispute with Brussels which unlocked billions of frozen EU funds for his country.
He also orchestrated the return of his centre-right ally Ursula von der Leyen as European Commission president.
And Poland has just taken over the rotating presidency of the EU, which means Mr Tusk will be hugely influential once again, chairing meetings and setting agendas.
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Poland is back in the European mainstream. It’s where Mr Tusk would like the UK to be as well.
It’s where, privately, Sir Keir would like the UK to be. It’s just that with Reform UK almost neck and neck with Labour in the polls, he daren’t say so.
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