A year after it ordered tens of thousands of job cuts in the NHS in England, MiP is urging the government to “come clean” about how the NHS will be run after the changes.

Health secretary Wes Streeting (pictured) has claimed the cuts—mainly aimed at managers and corporate staff at all levels of the system—were necessary to tackle “inefficient bureaucracy”. But MiP and many other stakeholders have criticised ministers for lacking a clear vision about how the NHS will work after the cuts.

“We’ve now passed a year since the government announced the biggest cut to NHS staffing in well over a decade, yet the government’s plan for running the NHS after the fallout is still not clear,” said MiP chief executive Jon Restell. “They owe it to staff to come clean about the aim of the changes. Public servants deserve competent management of system design and decency in the way organisational change is carried out.”

Urging the government to also “be honest” with patients, he added: “How will vital services continue while ICBs and other essential functions lose half their workforce?”

Staff are now taking voluntary redundancy and leaving the NHS, the union warns, before ministers have spelled out which parts of the system will run existing services and how new functions will operate. “This unnecessary risk will damage the quality of care the NHS provides”, said Restell. “Instead, minsters should get the structure in place and only think about headcount afterwards.”

MiP is also concerned that, despite the scale and speed of changes which have placed 30,000 NHS workers at risk of losing their jobs, there has been little scrutiny of the government’s plans. With no major legislation and few opportunities to debate the reforms in parliament, MiP says, many MPs are not even aware that the job losses extend beyond the national bodies to hit hospitals and other NHS providers in their constituencies.

Local government, including regional mayors and combined authorities, have also not been properly consulted about how the changes will affect local services and the local economy, the union says.

“These cuts were announced with no plan, no funding and no parliamentary scrutiny. This is no way to handle public service reform,” said Restell.

Ministers are expected to introduce a wide-ranging health bill into parliament this spring to formalise the abolition of NHS England, establish the new NHS structure and try to turn the Ten Year Health Plan into operational reality.

The legislation will be an opportunity to put the cuts on the political agenda and “highlight the harm they are doing to the NHS”, Restell said. “It’s time for parliament to take the lead on preventing another chaotic restructure, given the risks posed to the NHS model. For example, it could set tests to be met before system change is allowed in future.

“MiP will keep engaging with policymakers as the legislation progresses, but we need the help of our members. You see first-hand the impact this has on services, on patients and on you as working people,” he added. “We need your support as we campaign for an NHS that is stable, allows form to follow function and recognises the vital work of the NHS managers who make it all happen.” //