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 hostile environment era deportation policy for criminals is being expanded by the Labour government as it continues its migration crackdown.
The government wants to go further in extraditing foreign offenders before they have a chance to appeal by including more countries in the existing scheme.
Offenders that have a human right appeal rejected will get offshored, and further appeals will then get heard from abroad.
It follows the government announcing on Saturday that it wants to deport criminals as soon as they are sentenced.
The “deport now, appeal later” policy was first introduced when Baroness Theresa May was home secretary in 2014 as part of the Conservative government’s hostile environment policy to try and reduce migration.
It saw hundreds of people returned to a handful of countries like Kenya and Jamaica under Section 94B of the Nationality, Immigration and Asylum Act 2002, added in via amendment.
In 2017, a Supreme Court effectively stopped the policy from being used after it was challenged on the grounds that appealing from abroad was not compliant with human rights.
However, in 2023, then home secretary Suella Braverman announced she was restarting the policy after providing more facilities abroad for people to lodge their appeals.
Now, the current government says it is expanding the partnership from eight countries to 23.
Previously, offenders were being returned to Finland, Nigeria, Estonia, Albania, Belize, Mauritius, Tanzania and Kosovo for remote hearings.
Angola, Australia, Botswana, Brunei, Bulgaria, Canada, Guyana, India, Indonesia, Kenya, Latvia, Lebanon, Malaysia, Uganda and Zambia are the countries being added – with the government wanting to include more.
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Theresa May’s hostile environment policy proved controversial. Pic: PA
The Home Office claims this is the “the government’s latest tool in its comprehensive approach to scaling up our ability to remove foreign criminals”, touting 5,200 removals of foreign offenders since July 2024 – an increase of 14% compared with the year before.
Home Secretary Yvette Cooper said: “Those who commit crimes in our country cannot be allowed to manipulate the system, which is why we are restoring control and sending a clear message that our laws must be respected and will be enforced.”
Foreign Secretary David Lammy said: “We are leading diplomatic efforts to increase the number of countries where foreign criminals can be swiftly returned, and if they want to appeal, they can do so safely from their home country.
“Under this scheme, we’re investing in international partnerships that uphold our security and make our streets safer.”
Both ministers opposed the hostile environment policy when in opposition.
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In 2015, Sir Keir Starmer had questioned whether such a policy was workable – saying in-person appeals were the norm for 200 years and had been a “highly effective way of resolving differences”.
He also raised concerns about the impact on children if parents were deported and then returned after a successful appeal.
In today’s announcement, the prime minister’s administration said it wanted to prevent people from “gaming the system” and clamp down on people staying in the UK for “months or years” while appeals are heard.
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