As Starmer axes NHS England, is it time for another bonfire of the quangos?

No longer will the Department of Health and Social Care be able to use NHS England as a convenient shield, writes James Moore. Now – about the future of some of the government’s 304 other quangos...

Is another bonfire of the quangos coming? Keir Starmer has turned tough guy, promising to burn off the state’s flab. This is even though the Labour government has created, well, 20 quangos during its short time in office. But wait, the UK’s biggest – no, the world’s biggest – NHS England, is for the chop. So that’s telling ‘em.

The problem with quangos, which the government prefers to call “non-departmental public bodies” or “arm’s-length bodies” so there’s probably a quango in charge of official terms, is they have a habit of proliferating like maggots on dead meat.

True, at 304, there are not as many as the more than 800 there were at the quangocracy’s peak. There was a genuine bonfire under the Tory-Lib Dem coalition, which doesn’t elicit many fond memories but did manage to throttle 300 or so of them.

But as you can see from the figures, there is still an awful lot hanging around.

The prime function of some of the bigger quangos often seems to be to insulate ministers from taking account for their failures because life’s so much simpler if you can blame somebody else. This brings us back to NHS England.

Part of its role often seemed to be to give those of us attempting to hold government to account the runaround. If you were to ask NHS England a question, you would often be directed to the Department of Health and Social Care (DHSC) which would often then send you back to NHS England. It’s the magic quang-about.

Axing the organisation, which employs 13,000 paper pushers, and yes you read that right, will mean that the health secretary, Wes Streeting, will no longer be able to wag his finger should the health service continue to underperform or miss its targets. As it has been doing when it comes to A&E waiting times.

If this is the bonfire’s kindling, has anyone got some petrol we can pour on the flames, please? It would appear that there is ample scope. An analysis by the Cabinet Office found that in the year 2022-23 the 304 arm's-length bodies employed a staggering 390,808 full-time equivalent staff. The number has been fairly steady over the past few years. The public money sent the way of these bodies, meanwhile, amounted to £353bn.

True, they weren’t all funded by taxation. The Financial Conduct Authority, one of the City’s two main watchdogs, is an example. Its budget is provided by the fees paid by regulated firms. But the Charity Commission, another quango with the job of regulation, is funded by the Treasury.

‘Axing NHS England means that Wes Streeting will no longer be able to wag his finger should the health service continue to underperform or miss its targets’ (PA)

You can still have a lot of fun hunting for the weird and wonderful lurking in the guts of the government’s website. Did you know that there is a Company Names Tribunal on its listing of quangos, sorry, arm’s-length bodies? It deals with “complaints about cases where a company name is registered for the primary purpose of preventing someone else with legitimate interest from registering it”.

Imagine meeting a partner’s parents for the first time.

“So what do you do then?”

“I’m an administrator at the Company Names Tribunal.”

“Oh, erm, that’s nice.”

There’s also the Covent Garden Market Authority and the Plant Varieties and Seeds Tribunal. I’m disabled, so I ought to welcome the existence of the Disabled Persons Transport Advisory Committee, right? Except, I find myself wondering what purpose it serves because my experience would suggest that no one in government or the wider transport industry pays a blind (sorry) bit of attention to it.

There is the also Horserace Betting Levy Board, which funds the sport of kings, currently showcasing the stars of the national hunt code at Cheltenham. The government has been trying to get shot of it for as long as I can remember. It has proven to be remarkably resilient.

Want some others that won’t be much missed? Step forward OfWat, which oversees the privatised water industry. But not very well. Or perhaps the Environment Agency.

Feargal Sharkey, the former Undertones singer turned environmental campaigner, has lambasted the state of Britain’s rivers. He says that the “unforgivable lack of political oversight and failed regulation means [water companies] just game the system”. If you’ve been following this story, you would likely consider that to be a rather moderate statement. The state of our waterways demands an angry punk rock soundtrack with a chorus of four-letter words.

I’m not one to celebrate job losses anywhere. But it’s not just a communications team that both NHS England and the DHSC have doing the same jobs at a time when the government doesn’t have a pot to... you know. They both have strategy teams too. It’s a case of double up and then double again. That sort of duplication is simply unconscionable.

If this leads to more accountability and an improved NHS performance, so much the better. Goodness knows it’s needed. Axing NHS England is a bold decision. It is also the right one. But it is a risky one for the government, which won’t find it so easy to hide in future.