Move represents final step toward replacement of NATIONAL Health Service with 42 ‘Integrated Care Boards’ incentivised to close hospitals and ration treatment
The Starmer government’s announcement that it is abolishing its ‘quango’ NHS England, unsurprisingly given the ties of Starmer and Health Secretary Wes Streeting to private health cash, is a scam.
Presented as an efficiency move, to get rid of duplicate layers of management within the NHS, it is in fact a move to complete the long-underway break-up of the National Health Service into 42 autonomous ‘Integrated Care Boards’ (ICBs) that will each independently commission services – and will be incentivised not to treat people, by giving ICBs a share of the ‘savings’ generated by rationing or withholding care.
ICBs and the ‘Integrated Care System’ that they form are a rebranding of ‘Accountable Care Organisations’ (ACOs) – a copy of the US ACO system that has has for decades impoverished US patients and refused care to those uninsured and unable to pay. UK ACOs were rebranded to ICS after information about the reality of what US ACOs mean began to percolate into the awareness of the British public.
In fact, the ‘National’ in NHS disappeared early in this process, beginning before and then accelerated through the 2012 Health and Social Care Act and 2022 Health and Care Act. The 2012 Act abolished the responsibility of the Health Secretary for the health of the UK people, abolished Primary Care Trusts and Strategic Health Authorities and transferred tens of billions of pounds a year to so-called ‘Clinical Commissioning Groups’. The 2022 act put ICS into statute law.
The creation of ICBs – in separate commissioning boards – completed the process, and the removal of so-called ‘NHS England’ has removed even the notional idea of any national umbrella that it represented and the Starmer government is forcing ICBs to include private health companies on their boards and privatisers’ cash in their funding, as NHS campaigner Jenny Shepherd has accurately pointed out:
NHS England is really called the NHS Commissioning Board. Pretty much all its NHS commissioning functions have been handed to the 42 Integrated Care Boards.
Streeting has told integrated Care Boards to accommodate private providers of NHS clinical services on their Boards so they have commissioning roles – ie they can commission themselves.
He has also told ICBs to raise private capital funding. The govt has thus completed the abolition of the NHS and its replacement by 42 public/private partnerships. Which is what the 2022 Health and Care Act set out to do. Well done Labour.
NHS expert and campaigner Dr Bob Gill agrees that Starmer’s announcement means the end of the NHS in any meaningful form and that the new fragmented structure is designed to ensure private companies and investors are positioned to profit, including but not limited to replacing fully qualified doctors with ‘associates’ (PAs) who are not medically qualified. He said:
The NHS has been killed off folks. NHSE has served its purpose. Control has been outsources to 42 ICBs. The new legal entities are public-private partnerships given public funds and autonomy to decide which treatments are provided and by whom, public or private.
GP substitution by PAs is part of the repurposing of NHS from public service to for-profit, corporate controlled system. A US-style managed care model maximising profit through denial of care and minimising staff cost ie FEWER QUALIFIED AND COMPETENT STAFF.
Celebrating the demise of NHSE is missing the point. Much of the senior staff will drift seamlessly into ICB jobs after collecting payouts from NHSE. Lower level admin staff have served their purposes and will be discarded.
Physician associates and anaesthetist associates (PAs and AAs) receive only a fraction of the training of real doctors, but are being used to replace doctors and presented by trusts/ICBs to patients as if they are actual doctors. Started by the Tories, Starmer in so-called ‘opposition’ moved to kill any actual opposition to the plan to expand their use and is now carrying it through in government.
Patients have already died as a result of misdiagnosis by associates and the Starmer government’s own analysis shows using associates is highly dangerous to patients, but Starmer and Streeting are pressing ahead regardless, as part of Streeting’s ‘slash and burn’ ten-year plan, along with hospital closures and even self-treatment, written by health privatisers, for the NHS.
The General Medical Council (GMC), which along with the Royal College of GPs is collaborating with the government in this expansion, has told doctors who raised concerns about the misuse of these pseudo-doctor roles and its impact on patient safety to mind their own business and not to be ‘insufficiently flexible’ in expecting trusts to follow a national safety standard, put patient safety first and use qualified doctors.
Now NHS England – always a tool and interim step for the privatisation and break-up of the NHS – is being killed off and the reality of a largely-privatised, entirely fragmented non-National Health Service is laid bare, except that of course the government, its mates in the media and the small cadre of collaborators in the Great NHS Rip-Off will not mention it.
Skwawkbox needs your help. The site is provided free of charge but depends on the support of its readers to be viable. If you’d like to help it keep revealing the news as it is and not what the Establishment wants you to hear – and can afford to without hardship – please click here to arrange a one-off or modest monthly donation via PayPal or here to set up a monthly donation via GoCardless (Skwawkbox will contact you to confirm the GoCardless amount as it has to be entered by us). Alternatively, if you prefer to make a one-off or recurring donation by simple card payment, please use the form below:
Make a one-time donation
Make a monthly donation
Make a yearly donation
Choose an amount
Or enter a custom amount
Your support is hugely appreciated.
Your support is hugely appreciated.
Your support is hugely appreciated.
DonateDonate monthlyDonate yearlyThanks for your solidarity so Skwawkbox can keep doing its job of inconveniencing the right and helping to build the left!
If you wish to republish this post for non-commercial use, you are welcome to do so, but please include the donor information above – see here for more.
The Starmer Junta, proud to be Continuity Conservatives.
No wonder Sunak wanted out:
https://x.com/ABridgen/status/1789726877839405417?lang=en-GB
Unum life policy’s just had a debs delight
If this is “bringing management of the NHS back into democratic control” I wish Leanne Mohamad got just one extra vote against Streeting at GE24. Wes Streeting is serving as Slasher Starmer’s disruptor-general of the NHS.
Even Starmer-supporting Sharon Graham called the announcement “an ill-thought-out strategy that could end up meaning front-line healthcare staff struggle to do their jobs effectively…”.
Jeremy Hunt thoroughly approves, of course. Farage and Liz Truss, too.
As E M Forster observed, “Only Connect”.
“To the last Ukrainian” is going to be replaced by “To the last European’* – which includes the UK – in both the physical and economic senses.
*But not ever the families of those comprador paid politicians and media whores and their cheerleaders who want to rid themselves of what they consider to be their deplorable populace in order to enrich themselves and massage their own ego;s
I’m a little confused after having read this, then an article in The Guardian this morning. The headline of which is ‘30,000 jobs could go in radical overhaul of NHS’.
“Sir Jim Mackey, NHS England’s incoming new chief executive, has told the ICBs to cut their running costs by 50% by the end of the year. “Given ICBs employ 25,000 people, that means that half of them are going to go,” a senior NHS official said. That could lead to 12,500 posts being lost.” (Elsewhere in the piece it says there has already been a 20% cut…)
So this indicates there is going to be little left of the ICB’s?
Whatever, it doesn’t change the implications for the ‘NHS’ of the future. What an utter little **** Streeting is. He lied last year when asked if there were plans to radically overhaul the NHS in the government’s first term, and denied it again as recently as 31 January this year. We are told that a projected overspend of £6million for 2025/26 “scared the daylights” out of the Government which has led to this week’s events. So we are expected to believe all these plans have been made on the back of a fag packet in the barely two months since January 31st!
I hope everyone in Ilford who voted for him are going to be happy with the medical care they are going to receive….or not receive as is more likely. Likewise, all the Starmerites urging us non believers “Be patient, get Labour into power, see what Starmer does then hold his feet to the fire” need to have a bloody good talk to themselves.
https://www.theguardian.com/politics/2025/mar/14/30000-jobs-could-go-in-labours-radical-overhaul-of-nhs