{"id":81631,"date":"2025-04-14T08:05:50","date_gmt":"2025-04-14T07:05:50","guid":{"rendered":"https:\/\/www.taxresearch.org.uk\/Blog\/?p=81631"},"modified":"2025-04-14T08:06:07","modified_gmt":"2025-04-14T07:06:07","slug":"streetings-nhs-madness","status":"publish","type":"post","link":"https:\/\/www.taxresearch.org.uk\/Blog\/2025\/04\/14\/streetings-nhs-madness\/","title":{"rendered":"Streeting&#8217;s NHS madness"},"content":{"rendered":"<p><em>I tried to work out how to summarise <a href=\"https:\/\/myemail.constantcontact.com\/Do-it-again.html?soid=1102665899193&amp;aid=I85zECcSHz8\" target=\"_blank\" rel=\"noopener\">Roy Lilley's morning email this morning<\/a> on the madness that Wes Streeting is unleashing on the NHS, and failed. So I am copying it with a suggestion that this is well worth subscribing to:<\/em><\/p>\n<hr \/>\n<p>When the prime minister and chancellor say the world has changed, mostly for the worse\u00a0there's a certain type of person who takes that as permission to do the big and ugly things voters would never vote for a Labour government to do.<\/p>\n<p>It\u2019s happening to the NHS, right now.<\/p>\n<p>Who and how was it decided that NHSE would go, budgets would be cut by 50% and the upshot\u2026 thousands of people sacked?<\/p>\n<p>Where is the strategic analysis? The Board decision? The Bill? The risk assessment? The analysis?\u00a0 The impact statement? The plan? The license from the voters to demolish parts of their NHS?<\/p>\n<p>Capricious decisions, erratic, volatile and like a ticking time-bomb smuggled deep into the foundations of the service.<\/p>\n<p>As Isabel Hardman\u00a0<a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisTrx21JOl8rNszKqt2cIP57CqZhlDij8MpqAFLXBfgONjLbhf1hZBxvWl3j3faKPkVHhzSvNsTlzyHxUl_ToV8dd65ASzLRtBzdUZycAZxy-1JlKWghf_HR0LBVPQA2eLrW4dFuj9WhwfjWtwSr4OCPVxdj2ZVR2-&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisTrx21JOl8rNszKqt2cIP57CqZhlDij8MpqAFLXBfgONjLbhf1hZBxvWl3j3faKPkVHhzSvNsTlzyHxUl_ToV8dd65ASzLRtBzdUZycAZxy-1JlKWghf_HR0LBVPQA2eLrW4dFuj9WhwfjWtwSr4OCPVxdj2ZVR2-%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw3VPZoUWfi0gW_nGpZXJ3KR\">comments in the iNewspaper<\/a>; Wes Streeting has a chainsaw but no vision for the NHS.\u00a0She is right about the vision and the chainsaw but not the person wielding it.<\/p>\n<p>Tell me decisions weren't arrived at on the hoof over a weekend, by Alan Milburn egging on Silly Boy and announced the following Monday.<\/p>\n<p>The cunning plan; slash the budgets, stand back and let the service fight itself for survival; forcing a reduction in headcount, without wasting time on analysis or permission.<\/p>\n<p>You\u2019ll have to go some to tell me that the poor-man\u2019s Elon Musk, Alan Milburn doesn\u2019t own the chainsaw.<\/p>\n<p>Some of the impact;<\/p>\n<ul>\n<li>Reduce corporate\u00a0function costs by half.\u00a0Between 41,100 and 150,700 people across 215 trusts, dumped.<\/li>\n<li>Halving\u00a0NHSE\u2019s workforce,\u00a0<a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisT-kpl8b0Kzld17c-T7Xs58wjBwv2YrpbGNeqvZKDJdlLC8V8eSnEGQ6cWF1_3n2U-0tN9-OEAaUOZCzlZPMyTRJHVfDoozj0x9eesK1LIC20bpZb6V9BKX5SNSYETOf8uY4hChLQQWlVJy4-0QfLQF56agJ0cvUCOA3oFPdVrBnVrRegZt4kRIFPGvo84pkzQklOsyfxgrKXJd8FbPqZfw==&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisT-kpl8b0Kzld17c-T7Xs58wjBwv2YrpbGNeqvZKDJdlLC8V8eSnEGQ6cWF1_3n2U-0tN9-OEAaUOZCzlZPMyTRJHVfDoozj0x9eesK1LIC20bpZb6V9BKX5SNSYETOf8uY4hChLQQWlVJy4-0QfLQF56agJ0cvUCOA3oFPdVrBnVrRegZt4kRIFPGvo84pkzQklOsyfxgrKXJd8FbPqZfw%3D%3D%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw2iZBQ6vgK3MIT-LfE65vpb\">slashing<\/a>\u00a06,500 jobs.<\/li>\n<li>Redundancy\u00a0<a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7kSGGqlHn7F7_S9_xB1cpQo77twgo37VYGEOf0YPcoCiR119FOa8YJM3YJxuHUvlgh-CKtWRkZWXPS2kBdr14wi9LVEqQMEclFuj-Ci2OiP4RHlDqCX0BDl6R5mjdE3GUriiPXq3Wm6y2xgrbDhexOEzZD2tduvFWoUK81689U7mJhGsQddyTALRNnoQY2KaXinpUQ0vnQgSW_7cvjpXt-C6B-9GIG3huVbc9qvPcOzIOl9yGYmJQKk=&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7kSGGqlHn7F7_S9_xB1cpQo77twgo37VYGEOf0YPcoCiR119FOa8YJM3YJxuHUvlgh-CKtWRkZWXPS2kBdr14wi9LVEqQMEclFuj-Ci2OiP4RHlDqCX0BDl6R5mjdE3GUriiPXq3Wm6y2xgrbDhexOEzZD2tduvFWoUK81689U7mJhGsQddyTALRNnoQY2KaXinpUQ0vnQgSW_7cvjpXt-C6B-9GIG3huVbc9qvPcOzIOl9yGYmJQKk%3D%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw3WI7srWNKcF3lWuSm58KnJ\">costs<\/a>\u00a0around \u00a31 billion.<\/li>\n<li>Northern Care Alliance\u00a0to\u00a0<a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7Wis07zZFcFKKdCEy_X8dswA2qjkX7sn91uZwDMRTXieptXhh9aFCLK3tXGzU3aveJz1YVY23FQcxCHT351KllXu_D5aMhaIAxP1jIdTWt8jxm02Gx93QD_8hpWhIJ8sOduauzHI5vrzXRWlpzT37XShf9sS61ZqtsGff0fGGtuPGaZH7yUIpMtLd0S-BYsQnkW4Z_EpKvt5XMW_1P6_fCHdPuSaRhnAUnCK&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7Wis07zZFcFKKdCEy_X8dswA2qjkX7sn91uZwDMRTXieptXhh9aFCLK3tXGzU3aveJz1YVY23FQcxCHT351KllXu_D5aMhaIAxP1jIdTWt8jxm02Gx93QD_8hpWhIJ8sOduauzHI5vrzXRWlpzT37XShf9sS61ZqtsGff0fGGtuPGaZH7yUIpMtLd0S-BYsQnkW4Z_EpKvt5XMW_1P6_fCHdPuSaRhnAUnCK%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw1XP321u26j_0QoAX7rengo\">cut<\/a>\u00a0approximately 14% of its corporate workforce .<\/li>\n<li>Mid and South Essex Trust,\u00a0<a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisthRlIiNVmtBoHGHSFZPRAdSB7WJc7On6pZzWxFmH06vHIxm0NoYM5QSnfX1bbGvNadgCe6gRf6m1_X7Obu2rx2UAJoX45nvTOuzvaePf4I57JWFAL6ThfmayiGx9Iv9ATtwoI7zSKjQjt6SQVOd420cowcGg-3EN&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisthRlIiNVmtBoHGHSFZPRAdSB7WJc7On6pZzWxFmH06vHIxm0NoYM5QSnfX1bbGvNadgCe6gRf6m1_X7Obu2rx2UAJoX45nvTOuzvaePf4I57JWFAL6ThfmayiGx9Iv9ATtwoI7zSKjQjt6SQVOd420cowcGg-3EN%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw1H8UWOPCrD-npl0cyDO3ly\">cut<\/a>\u00a0150 non-frontline, clinical posts.<\/li>\n<li>East Suffolk and North Essex FT, approximately 350\u00a0<a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7Wis8AR5VMRV556qfQthlNQkebYj-0jWg3RRJ0dh1Ex0dT8V0fSYmjoL0-f-Gjpt_psnKo0DJ66Ofh0S1Pdz-UAZ8DhlvB6xifiC_jfbHk5pIEI_Z-9S6xFgQvzd-SSAWxatxpVLsb78wPxdiAtj8F1RXYltP1wSbdcZlVTNgassPZsyDU1Vz7fHbybCm7Im5mW8IwhA1k4_dPli6jBNvltVlCHr2GdLMDL097e5wS20RQeDHffpgVDbFsloySs5SWKn&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7Wis8AR5VMRV556qfQthlNQkebYj-0jWg3RRJ0dh1Ex0dT8V0fSYmjoL0-f-Gjpt_psnKo0DJ66Ofh0S1Pdz-UAZ8DhlvB6xifiC_jfbHk5pIEI_Z-9S6xFgQvzd-SSAWxatxpVLsb78wPxdiAtj8F1RXYltP1wSbdcZlVTNgassPZsyDU1Vz7fHbybCm7Im5mW8IwhA1k4_dPli6jBNvltVlCHr2GdLMDL097e5wS20RQeDHffpgVDbFsloySs5SWKn%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw1aIvUG2DmX9gdu9Bbk9tJq\">jobs to go<\/a>\u00a0to the private sector.<\/li>\n<li>Royal Derby Hospital,\u00a0<a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisH9MT5btUKbAUQody4bE-9kS3yzKrhTFoNvpwrm4GRdicwoJcFDiSFD6TU8Ml8Tuf-M4NwHKRceIT-_iX6wM6i8Zy_YdVeucIr-VA1bCR7ia-tNW9bBu9ayxscMI0EetfOaOTxinJ5FZlWAkGOYE9GGQ82aa41RyF&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisH9MT5btUKbAUQody4bE-9kS3yzKrhTFoNvpwrm4GRdicwoJcFDiSFD6TU8Ml8Tuf-M4NwHKRceIT-_iX6wM6i8Zy_YdVeucIr-VA1bCR7ia-tNW9bBu9ayxscMI0EetfOaOTxinJ5FZlWAkGOYE9GGQ82aa41RyF%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw252bPlaV9sG1entWsL4WNA\">introduced<\/a>\u00a0Mutually Agreed Resignation Scheme (MARS) offers severance pay to non-clinical staff.<\/li>\n<li>Glenlyn Medical Centre\u00a0(Surrey), salaried GPs were invited to\u00a0<a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WishAXJNSESSV2v8m0LQ824BDi6DB0MQifLQZpctkNwz73vWiSwJtl7f87ekaKzi5Q4snBWpl9nTAQmTeFBa0BRQZUaREQoMVNBgGJUly99CabgnT1f8tZs1FtJg6O38rMcy_M6LmbcthMxymSdricc0lMhgkSxQ2WwQT-QV6cjXZ8=&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WishAXJNSESSV2v8m0LQ824BDi6DB0MQifLQZpctkNwz73vWiSwJtl7f87ekaKzi5Q4snBWpl9nTAQmTeFBa0BRQZUaREQoMVNBgGJUly99CabgnT1f8tZs1FtJg6O38rMcy_M6LmbcthMxymSdricc0lMhgkSxQ2WwQT-QV6cjXZ8%3D%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw0-eUMnIn3JvlsTVGaZc155\">apply<\/a>\u00a0for voluntary redundancy. Three doctors set to leave as a result.<\/li>\n<li>Nottingham University Trust, where 'staff can't sleep with worry',\u00a0<a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisSl9ReQFV-KM76Du-QHR-B3U1t2JRfREHQB2j6vmzCFL_u8fDwsJOJy3W4m1Zy0ZksyAjfRSd0OEG6U2Mz4PBjfQ8wIMaSbrfmhqLGJe8B8v2mFF0ksXCrOQF7uxHx0IBepRPWUMT6Gez9ssZgnnSaiE-zRno0FbWhQFgRi0JWvOI0e6yjI2m6duFIQtEpKzjK9bdER7XI0mycbf9XA7OxJtfI15B88Mw&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisSl9ReQFV-KM76Du-QHR-B3U1t2JRfREHQB2j6vmzCFL_u8fDwsJOJy3W4m1Zy0ZksyAjfRSd0OEG6U2Mz4PBjfQ8wIMaSbrfmhqLGJe8B8v2mFF0ksXCrOQF7uxHx0IBepRPWUMT6Gez9ssZgnnSaiE-zRno0FbWhQFgRi0JWvOI0e6yjI2m6duFIQtEpKzjK9bdER7XI0mycbf9XA7OxJtfI15B88Mw%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw33BnjqUENnMg3FTb9-Kjoc\">outsource parts<\/a>\u00a0of its finance department approximately 80 administrative staff at risk of redundancy.\u00a0Plus, a MARS option. \u200b<\/li>\n<li>Southampton University Hospitals Trust,\u00a0<a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisfDdb-1lZccnIT23K5AlHYDdS1-eRQ-i997zVufTnKEne_fvdK_5T29m5nsaSdJDSWViV7NwMyT0XphCizJ5oeexjcxX7Is0qP66NYlbyn3S5xQ9rhe_CEFQnzUA2tCXv76nNqLn7BCptZIjadszTpgLmqaoDAVsVSE5f0ldo6DULLrT4k7XS6w==&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisfDdb-1lZccnIT23K5AlHYDdS1-eRQ-i997zVufTnKEne_fvdK_5T29m5nsaSdJDSWViV7NwMyT0XphCizJ5oeexjcxX7Is0qP66NYlbyn3S5xQ9rhe_CEFQnzUA2tCXv76nNqLn7BCptZIjadszTpgLmqaoDAVsVSE5f0ldo6DULLrT4k7XS6w%3D%3D%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw2GPT1T75ujQnQRz1pWwuQ-\">plans<\/a>\u00a0to make 100 job cuts; administrative, clerical, and management roles.<\/li>\n<\/ul>\n<p>There\u2019ll be more this week.<\/p>\n<p>If MARS is a personnel strategy it would have been cobbled together by Del-Boy, on the back of a fag packet, in the Nag's Head.<\/p>\n<p>It's just a way to \u2018get rid of people\u2019.<\/p>\n<p>More expensive than statutory redundancy, but the key benefit, it avoids consultation.<\/p>\n<p>MARS is arbitrary and open to favouritism.<\/p>\n<p>Recipients cannot receive unemployment benefits after leaving, as their dismissal is \u2018agreed\u2019.<\/p>\n<p>It\u2019s bad management.\u00a0Not a serious long-term solution.<\/p>\n<p>People are just tipped-out with no thought other than to reduce headcount and cut spending.\u00a0It does not address the harder decisions around tackling structural problems in service delivery;<\/p>\n<ul>\n<li>the future of work;<\/li>\n<li>how it will be done,<\/li>\n<li>who does it\u2026<\/li>\n<\/ul>\n<p>\u2026 neither, does it fix the root cause of the NHS doing more work than it\u2019s funded for.<\/p>\n<p>Worse, it only appeals to people with long-service.\u00a0Dump them and you dump, knowledge, legacy, skills and the organisation's memory.<\/p>\n<p>MARS\u00a0=\u00a0Management that\u2019s\u00a0Arbitrary and\u00a0Really\u00a0Stupid.<\/p>\n<p>And, there\u2019s this\u2026<\/p>\n<ul>\n<li>the Darzi Report, accepted and agreed by Charmer and Silly Boy as the new testament, which warns:<\/li>\n<li>management capability is still behind where it was in 2011' (<a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisZPnhkM0kb5xUQl604oqoA-N9n3HQrx9ISJPp5F1C5DkhIxFnh84IUipGh2GAhqNujG6MFIovK2xq-Ro2HVCkpW7S6EZ_FZEkZRKuayiX_M4QLnxGlSgPajEqn1_1IjH_HTr7baR5xwmfK9SPqUmjWEVkQp4u_RKNrmE5L0pzXe3JH5nvgFlBbqPWmy1XA9xvjeYG3vWvnFIX3gKuMZE-j2sCT_qoen6n8oozfjnCDQmVgg8UrtXYFfXAFBfVC8RXfTeKlx4nx6d0e2US_q20RZpKkl6l5qzbxiyySjopLmQtvVOdc9ImcPtcKzhjiw_n1-pYMHiTrqo=&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisZPnhkM0kb5xUQl604oqoA-N9n3HQrx9ISJPp5F1C5DkhIxFnh84IUipGh2GAhqNujG6MFIovK2xq-Ro2HVCkpW7S6EZ_FZEkZRKuayiX_M4QLnxGlSgPajEqn1_1IjH_HTr7baR5xwmfK9SPqUmjWEVkQp4u_RKNrmE5L0pzXe3JH5nvgFlBbqPWmy1XA9xvjeYG3vWvnFIX3gKuMZE-j2sCT_qoen6n8oozfjnCDQmVgg8UrtXYFfXAFBfVC8RXfTeKlx4nx6d0e2US_q20RZpKkl6l5qzbxiyySjopLmQtvVOdc9ImcPtcKzhjiw_n1-pYMHiTrqo%3D%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw3g6UNFzH3wX4LiAK5Bk63I\">Para 21<\/a>)<\/li>\n<li>and emphasises the critical role of management in driving effective reform.<\/li>\n<\/ul>\n<p><a href=\"https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f=0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisDxvS-ue8Gxj4CEjwqdb27RCQnOGIccqBngm8fllbekc4Tg1txqNeS2fcDGa1oFWG2kxRNC9_R3u0hHyASxMgGQ2T_G7KLRtNFfXSTzMYvxm9ztrvMRLZnXWr61HZc0MdIJjfjbk27uQYxqsKF-kzaK3rOMrRvnXtTN3YTaTOy70gVlyQd75HM4iBjnNL-qadSw3eBYOsbgP3jg7QP29fsOiOu0PqXH9TWdvTMowsmHc=&amp;c=EjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg==&amp;ch=dgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ==\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/zfxea5cab.cc.rs6.net\/tn.jsp?f%3D0013n4b5pWeEjzthXVlz828v1i1vynOaVkaZ1AiSy6zaeDA0DT4VkbT7lq1TgTU7WisDxvS-ue8Gxj4CEjwqdb27RCQnOGIccqBngm8fllbekc4Tg1txqNeS2fcDGa1oFWG2kxRNC9_R3u0hHyASxMgGQ2T_G7KLRtNFfXSTzMYvxm9ztrvMRLZnXWr61HZc0MdIJjfjbk27uQYxqsKF-kzaK3rOMrRvnXtTN3YTaTOy70gVlyQd75HM4iBjnNL-qadSw3eBYOsbgP3jg7QP29fsOiOu0PqXH9TWdvTMowsmHc%3D%26c%3DEjRs5jnbsFtRovBtqR5SwDISPtYoGQLoHYrAp3p6SVXSIrKnStEmAg%3D%3D%26ch%3DdgNzg6RhuksaV_XIIGjBVJvZpN7FfjgzZZEf1R3U3B_3PbFYDbPZJQ%3D%3D&amp;source=gmail&amp;ust=1744697385219000&amp;usg=AOvVaw20SiEmz8ymYFkZKcEcJwWg\">Analysis<\/a>\u00a0by the Chartered Management Institute and the Social Market Foundation agrees.\u00a0Their research indicates;<\/p>\n<blockquote><p>'... management capability has regressed... primarily due to prolonged restructuring and austerity measures.'<\/p><\/blockquote>\n<p>Skilled managers are essential for implementing reforms and keeping the show on the road.<\/p>\n<p>An organisation can only do a few things well, at once. \u2018Try to do everything, and you\u2019ll end up achieving nothing\u2019\u2026 so said the guru\u2019s guru, Sir John Harvey-Jones.<\/p>\n<p>The NHS is trying to;<\/p>\n<ul>\n<li>Cut waiting lists, a political priority<\/li>\n<li>Reorganisation and restructuring<\/li>\n<li>ICBs slashed, smashed and crashed<\/li>\n<li>NHS England, dumped<\/li>\n<li>New Ten-Year Plan, any time soon.<\/li>\n<li>Workforce reform and redundancies.<\/li>\n<li>Savings programme and financial pressures to find \u00a3illions.<\/li>\n<li>Service consolidation.<\/li>\n<li>The potential for more strikes by junior doctors.<\/li>\n<li>Digital transformation, roll-out shared care records,<\/li>\n<li>Adopt AI in diagnostics and admin.<\/li>\n<li>Public health and prevention; obesity, smoking, alcohol, and mental health being targeted all at once.<\/li>\n<li>Primary care reform, fewer full-time doctors, rows about PAs, rising demand, new GP contract, expanding roles for pharmacists and other professionals.<\/li>\n<\/ul>\n<p>\u2026 do all that with managers who have no idea if they will be in a job this time next year.<\/p>\n<p>This is total, unadulterated, copper-bottom, 24ct gold, big-time, bigly bonkersness.<\/p>\n<p>Milburn madness.<\/p>\n<p>Everything the capricious, mercurial Milburn did for Blair, from markets and PCTs to Foundation Trusts was eventually dumped and disowned by the Labour Party.<\/p>\n<p>Don\u2019t let him do it again.<\/p>\n<hr \/>\n<p><em>With apologies, Roy, but it's really spot on.\u00a0<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I tried to work out how to summarise Roy Lilley&#8217;s morning email this morning on the madness that Wes Streeting is unleashing on the NHS,<br \/><a class=\"moretag\" href=\"https:\/\/www.taxresearch.org.uk\/Blog\/2025\/04\/14\/streetings-nhs-madness\/\"><em> Read the full article&#8230;<\/em><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35,87,118,128],"tags":[],"class_list":["post-81631","post","type-post","status-publish","format-standard","hentry","category-economics","category-health","category-labour","category-nhs"],"_links":{"self":[{"href":"https:\/\/www.taxresearch.org.uk\/Blog\/wp-json\/wp\/v2\/posts\/81631","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.taxresearch.org.uk\/Blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.taxresearch.org.uk\/Blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.taxresearch.org.uk\/Blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.taxresearch.org.uk\/Blog\/wp-json\/wp\/v2\/comments?post=81631"}],"version-history":[{"count":3,"href":"https:\/\/www.taxresearch.org.uk\/Blog\/wp-json\/wp\/v2\/posts\/81631\/revisions"}],"predecessor-version":[{"id":81634,"href":"https:\/\/www.taxresearch.org.uk\/Blog\/wp-json\/wp\/v2\/posts\/81631\/revisions\/81634"}],"wp:attachment":[{"href":"https:\/\/www.taxresearch.org.uk\/Blog\/wp-json\/wp\/v2\/media?parent=81631"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.taxresearch.org.uk\/Blog\/wp-json\/wp\/v2\/categories?post=81631"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.taxresearch.org.uk\/Blog\/wp-json\/wp\/v2\/tags?post=81631"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}