Jeremy Hunt suggests NHS reform through devolution and target removal
8 reported
Former health secretary Jeremy Hunt wrote an opinion piece discussing potential NHS reforms if Andy Burnham becomes prime minister. Hunt noted that the UK spends the fifth most of any OECD economy on government health spending as a proportion of GDP, but productivity has lagged. He stated that since 2020, NHS England staff numbers grew by 20% while activity increased only 10%, contributing to high waiting lists. Hunt argued that the NHS is the most centralized and bureaucratic healthcare system in the world, with 1.5 million people micro-managed from London through numerous operational targets. He proposed scrapping all national targets and devolving responsibility for the NHS to locally elected mayors, following regional models used in Sweden and Denmark. Hunt acknowledged that a previous devolution attempt in Manchester in 2016 had limited impact because national targets remained. He concluded that such reforms could make the NHS more innovative without requiring additional funding.
What’s reported
The UK spends the fifth most of any OECD economy on government health spending as a proportion of GDP.
Since 2020, NHS England staff numbers grew by 20% but activity increased only 10%.
Hunt stated that progress in reducing waiting lists has partly come from "list cleaning" rather than actual increases in activity.
As chancellor, Hunt gave the NHS £3.4bn in his 2024 budget for a productivity plan including joining medical records and embracing AI.
The NHS has 18 monthly operational targets for hospitals and 44 QOF targets annually for GPs.
Hunt proposed scrapping all national targets and devolving NHS responsibility to locally elected mayors.
Hunt cited Sweden and Denmark as having universal systems with better outcomes than the NHS.
The "Devo Manc" devolution attempt in Manchester in 2016 had limited impact because national targets remained.
Key figures
Jeremy Hunt, former secretary of state for health and social care (2012-2018), former chancellor
Andy Burnham, former health secretary, mayor of Greater Manchester
Sources: The Guardian
