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Sir Keir Starmer has confirmed plans to abolish the “arms-length body” NHS England.

But what is the quango – and why is the prime minister scrapping it?

What is NHS England and how does it work?

NHS England was established in 2013 by former Tory health secretary Andrew Lansley to give the NHS greater independence and autonomy – with an intention for it to operate at arm’s length from the government.

It was set up as a quango – an organisation that is funded by taxpayers, but not controlled directly by central government – and is responsible for delivering high-quality care, supporting staff, and ensuring value for money.

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Its website states that it has a “wide range of statutory functions, responsibilities and regulatory powers”, which include working with the government to agree funding and priorities for the NHS and overseeing the delivery of safe and effective NHS services.

NHS England employs about 13,000 people.

As health is a devolved matter, the equivalent bodies for Scotland, Wales, and Northern Ireland cannot be abolished by the prime minister.

Why has it been scrapped?

The prime minister has said abolishing the body will bring management of the NHS “back into democratic control”.

This move will put the NHS “back at the heart of government where it belongs,” he said during a speech in east Yorkshire on Thursday, “freeing it to focus on patients, less bureaucracy, with more money for nurses”.

He added that the NHS will “refocus” on cutting waiting times at “your hospital”.

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PM to abolish NHS England

When answering a question from a cancer patient on how the decision would improve NHS services, Sir Keir said: “Amongst the reasons we are abolishing it is because of the duplication.

“So, if you can believe it, we’ve got a communications team in NHS England, we’ve got a communications team in the health department of government; we’ve got a strategy team in NHS England, a strategy team in the government department. We are duplicating things that could be done once.”

He said by stripping out the duplication, it allows the government to “free up that money to put it where it needs to be, which is the front line”.

The Health Secretary Wes Streeting said: “This is the final nail in the coffin of the disastrous 2012 reorganisation, which led to the longest waiting times, lowest patient satisfaction, and most expensive NHS in history.

“When money is so tight, we can’t justify such a complex bureaucracy with two organisations doing the same jobs. We need more doers, and fewer checkers, which is why I’m devolving resources and responsibilities to the NHS frontline.

“NHS staff are working flat out but the current system sets them up to fail. These changes will support the huge number of capable, innovative and committed people across the NHS to deliver for patients and taxpayers.

“Just because reform is difficult doesn’t mean it shouldn’t be done. This government will never duck the hard work of reform. We will take on vested interests and change the status quo, so the NHS can once again be there for you when you need it.”

What will happen now?

NHS England will be brought back into the Department of Health and Social Care (DHSC), it was announced, in order to end duplication.

The department said the reforms would reverse the 2012 reorganisation of the NHS “which created burdensome layers of bureaucracy without any clear lines of accountability”.

The government said the changes will also “give more power and autonomy to local leaders and systems – instead of weighing them down in increasing mountains of red tape”.

“Too much centralisation and over-supervision has led to a tangled bureaucracy, which focuses on compliance and box-ticking, rather than patient care, value for money, and innovation,” the government said.

Board members stepped down days before

In the days before Sir Keir’s announcement, NHS England said three leading board members were stepping down at the end of the month.

Chief Financial Officer Julian Kelly, NHS Chief Operating Officer Emily Lawson and Chief Delivery Officer and National Director for Vaccination and Screening Steve Russell will leave their roles in the coming weeks.

At the time, NHS chief executive Amanda Pritchard – who is also stepping down – said the board members made their decision based on the upcoming changes to the size and function of the centre.

Sir James Mackey, who will be taking over as transition chief executive of NHS England, said while he knows the announcement will “unsettle staff” it will also bring “welcome clarity” as the NHS focuses on “tackling the significant challenges ahead”.

Incoming NHS chair, Dr Penny Dash, added she will be working to “bring together NHSE and DHSC to reduce duplication and streamline functions”.

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Sir Keir Starmer to defend budget amid claims Rachel Reeves ‘lied’ about public finances

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Sir Keir Starmer to defend budget amid claims Rachel Reeves 'lied' about public finances

Sir Keir Starmer will deliver a speech today defending the decisions the government made in the budget, following criticisms of sweeping tax rises and accusations the chancellor lied to the country about the state of public finances.

The prime minister is expected to set out how the budget, which saw £26bn of tax rises imposed across the economy, “moves forward the government’s programme of national renewal”, and set “the right economic course” for Britain, Downing Street says.

He will also confirm that ministers will try again to reform the “broken” welfare system, after Labour MPs forced the government to U-turn on its plans to narrow the eligibility for Personal Independence Payments (PIP) earlier this year.

Sir Keir Starmer will give a speech later defending last week's budget. Pic: Reuters
Image:
Sir Keir Starmer will give a speech later defending last week’s budget. Pic: Reuters

‘Of course I didn’t’ lie about public finances, says Reeves

“We have to confront the reality that our welfare state is trapping people, not just in poverty, but out of work – young people especially. And that is a poverty of ambition,” Sir Keir will say.

“And so while we will invest in apprenticeships and make sure every young person without a job has a guaranteed offer of training or work, we must also reform the welfare state itself – that is what renewal demands.”

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Sky’s Ed Conway looks at the aftermath of the budget and explains who the winners and losers are

The prime minister will add: “This is not about propping up a broken status quo. Nor is it because we want to look somehow politically ‘tough’. The Tories played that game and the welfare bill went up by £88bn. They left children too poor to eat and young people too ill to work. A total failure.”

More on Budget 2025

Instead, he will argue it is about “potential”, saying: “If you are ignored that early in your career, if you’re not given the support you need to overcome your mental health issues, or if you are simply written off because you’re neurodivergent or disabled, then it can trap you in a cycle of worklessness and dependency for decades, which costs the country money, is bad for our productivity, but most importantly of all – costs the country opportunity and potential.

“And any Labour Party worthy of the name cannot ignore that. That is why we have asked Alan Milburn on the whole issue of young people, inactivity and work. We need to remove the incentives which hold back the potential of our young people.”

The announcement will come after the Conservative opposition described the budget as one for “benefits street”, following the chancellor’s decision to lift the two-child benefit cap from April, at a cost of £3bn.

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Prime Minister defends the budget

‘Government must go further and faster on growth’

The prime minister is also expected to launch a staunch defence of the budget overall, saying it will bear down on the cost of living through measures like money off energy bills and frozen rail fares; increase economic stability; and protect investment in public services and infrastructure that will drive economic growth.

He will argue that “economic growth is beating the forecasts”, but that the government must go “further and faster” to encourage it.

He will also reiterate his vow to scrap regulation across the economy, which he will argue is not only pro-business, but also a way to deal with the cost of living.

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How will your personal finances change following the budget announced by the chancellor?

“Rooting out excessive costs in every corner of the economy is an essential step to lower the cost of living for good, as well as promoting more dynamic markets for business,” the prime minister will say.

He will confirm reforms to the building of nuclear power plants, after the government’s nuclear regulatory taskforce found that “pointless gold-plating, unnecessary red-tape and well-intentioned, but fundamentally misguided environmental regulation had made Britain the most expensive place to build nuclear power”.

“We urgently need to correct this,” the prime minister will say.

Business secretary Peter Kyle will be tasked with applying the same deregulatory approach to major infrastructure schemes and to accelerate the implementation of Labour’s industrial strategy.

In response, Tory shadow chancellor Sir Mel Stride said: “It is frankly laughable to hear the prime minister say Rachel Reeves’s Benefits Street budget has put the country on the right course and that he wants to fix the welfare system.

“His chancellor has just hiked taxes by £26bn to pay for a welfare splurge, penalising people who work hard and making them pay for those who don’t work at all. And she misrepresented why she was doing it, claiming there was a fiscal black hole to fill that she knew didn’t exist.

“Labour’s leadership have repeatedly shown they lack the backbone to tackle welfare and instead are just acting to placate their left-wing backbenchers.”

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Rachel Reeves tells Sky News she did not lie about the state of the public finances

Chancellor accused of ‘lying’

Sir Mel is referring to the chancellor’s speech on 4 November in which she laid the ground for tax rises due to the decision by the independent Office for Budget Responsibility (OBR) to review and downgrade productivity over recent years, at a cost of £16bn, which led to a black hole in the public finances.

But the OBR revealed on Friday that it had told the Treasury days earlier that there was actually a budget surplus of £4.2bn, leading to outrage and claims that she misled the country about the state of the public finances.

Rachel Reeves was asked directly by Sky’s Trevor Phillips if she lied, and she replied: “Of course I didn’t.”

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Why did Reeves make the situation sound ‘so bleak’?

She said: “I said in that speech that I wanted to achieve three things in the budget – tackling the cost of living, which is why I took £150 off of energy bills and froze prescription charges and rail fares.

“I wanted to continue to cut NHS waiting lists, which is why I protected NHS spending. And I wanted to bring the debt and the borrowing down, which is one of the reasons why I increased the headroom.

“£4bn of headroom would not have been enough, and it would not give the Bank of England space to continue to cut interest rates.”

Ms Reeves also said: “In the context of a downgrade in our productivity, which cost £16bn, I needed to increase taxes, and I was honest and frank about that in the speech that I gave at the beginning of November.”

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Badenoch says Rachel Reeves should resign

But Tory leader Kemi Badenoch said: “I think the chancellor has been doing a terrible job. She’s made a mess of the economy, and […] she has told lies. This is a woman who, in my view, should be resigning.”

Report due on OBR breach

The tumultuous run-up to the 26 November budget culminated in the OBR accidentally publishing its assessment of the chancellor’s measures 45 minutes before the speech began, in what was an unprecedented breach of budget security.

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The chair of the OBR, Richard Hughes, apologised for the “error”, and announced an investigation into how it happened.

The chancellor has said that she retains confidence in him, despite the “serious breach of protocol”, and confirmed to Trevor that the investigation report will be delivered to her on Monday, although it is not clear when it will be published.

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China reaffirms crypto ban after noticing ‘speculation has resurfaced’

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China reaffirms crypto ban after noticing ‘speculation has resurfaced’

China’s central bank has flagged stablecoins as a risk and has promised to refresh its crackdown on crypto trading, which it has banned since 2021.

The People’s Bank of China said on Saturday, after a meeting with 12 other agencies, that “virtual currency speculation has resurfaced” due to various factors, posing new challenges for risk control. 

“Virtual currencies do not have the same legal status as fiat currencies, lack legal tender status, and should not and cannot be used as currency in the market,” the bank said, according to a translation of its statement. 

“Virtual currency-related business activities constitute illegal financial activities.”

China’s central bank banned crypto trading and mining in 2021, citing a need to curb crime and claiming that crypto posed a risk to the financial system. 

Bank says stablecoins of concern

China’s central bank highlighted stablecoins as a particular concern, stating that the tokens weren’t meeting legal requirements and were being used in criminal activities.

“Stablecoins are a form of virtual currency, and currently cannot effectively meet requirements for customer identification and Anti-Money Laundering, posing a risk of being used for illegal activities such as money laundering, fundraising fraud, and illegal cross-border fund transfers,” the bank said.

China, Peoples Bank of China, Stablecoin
The People’s Bank of China, headquartered in Beijing (pictured), noted stablecoins as a concern at an inter-agency meeting on Saturday. Source: Wikimedia

The bank said it would “persistently crack down on illegal financial activities” related to crypto to “maintain the stability of the economic and financial order.”

Related: South Korea targets sub-$680 crypto transfers in sweeping AML crackdown

The 13 agencies that attended the meeting stated that they would “deepen coordination and cooperation” in tracking down crypto users by strengthening information sharing and enhancing monitoring capabilities.

Reuters reported on Wednesday that China had the third-highest share of Bitcoin (BTC) mining, with its market share reaching 14% by the end of October.

In August, China’s financial regulators reportedly instructed brokers to cancel seminars and stop promoting research on stablecoins over concerns that it could be exploited as a tool for fraudulent activities.

Meanwhile, Hong Kong opened the doors to licensing stablecoin issuers in July, but some tech companies suspended plans to launch stablecoins in the region after Chinese regulators reportedly intervened to pause the offerings.

Magazine: Koreans ‘pump’ alts after Upbit hack, China Bitcoin mining surge: Asia Express