The Prime Minister has announced that NHS England is to be scrapped and its functions will revert to democratic control under the relevant Minister. There are over 15,000 people employed in NHS England and this abrupt dismantling of a system introduced in 2012 to give more independence and hopefully improve the performance of the NHS is to be scrapped. It clearly has not helped and has led to duplication of functions and muddled responsibilities. But there are going to be large costs involved in reverting to political control of the NHS.
Such reorganisations of large bureaucracies cost money as some staff are made redundant and then simply rejoin a new organization doing similar jobs. Offices need to be closed and opened, staff relocated and new IT systems installed. In the short-term this change will cost many millions of pounds, not save it.
As a big user of the NHS I wonder how this will make my life better. I doubt it will. It’s surely a case of moving the deckchairs on the Titanic. Unless the management and culture are changed, nothing will be altered.
I spoke to my sister, Baroness Murphy, about this news and she was of the opinion that little would change. She used to chair an NHS Trust so has first-hand experience of the defects in the NHS bureaucracy. She happens to be in hospital at present – but not an NHS one of course.
There is more information on this change in a Guardian article here: https://www.theguardian.com/society/2025/mar/13/why-has-nhs-england-been-abolished-and-what-does-it-mean-for-patients . It includes a link to an NHS England article that explains what it does.
Fundsmith Equity Annual Meeting
Fundsmith recently held it’s Annual Meeting for shareholders. A recording is now available here: https://www.fundsmith.co.uk/tv/ . Fund manager Terry Smith is always worth listening to. Witty and informative at the same time.
As a holder of the Fundsmith Equity Fund I am happy to stick with it during the recent under-performance against the World MCSI index. The market is very distorted at present by the over-concentration on large tech stocks.
Terry quotes John Bogle about the distortions created by the increasing dominance of index funds. I am happy to stand back from this ill-informed popularity.
Roger Lawson (Twitter: https://x.com/RogerWLawson )
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