Two bombshells this week for a doctor. First, the shock news that NHS England – at a single swipe of Keir Starmer’s red-tape-slashing chainsaw – is to be no more. Second, the startlingly unpleasant, almost Trump-like rhetoric with which the Prime Minister chose to break the news. Are the 15,000 people who work in NHS England really a “cottage industry of checkers and blockers”?
Many of them could earn significantly more in the private sector but choose not to, presumably because they’re committed to public service – something Starmer just trashed for cheap headlines. No wonder many staff were in tears. Then there was the final, populist flourish – that this wasn’t merely a means of waging war on waste, but necessary to bring the NHS “back into democratic control”, as though the staff of NHS England were secretly hell-bent on subverting the will of the people. Why not just go full Daily Mail, I thought, and brand civil servants, like judges, the “enemies of the people”?
In axing “the world’s largest quango”, Starmer sounds gung-ho. But his numbers don’t add up. At best, the dissolution of NHS England could free up around £175m, which is a drop in the ocean compared to the £6.6bn financial deficit that NHS trusts are anticipating next year.
No doubt Wes Streeting will continue to slam trusts for being “addicted to overspending”, but no matter how many times he orders the NHS to do more with less, he can’t make patient demand magically disappear. And if reform, as he insists, is the answer, then why has he launched a massive, top-down, reorganisation of the health service at exactly the time it’s meant be focused on developing a ten-year plan to transform patient care? This is a hugely distracting power grab – and no one has a clue how it will end.
Trump and Putin: the wheeler-dealers
Power grabs of a more sinister kind haunt me in the small, dark hours. I have tried to ration my news intake since inauguration day, but Donald Trump keeps needling my soul, particularly his approach to Ukraine. The latest headlines reveal that he and Putin will discuss “land and power plants” and that his negotiators have already talked about “dividing up certain assets”.
For a moment, that phrase took my breath away. I’ve visited Ukraine four times since the Russian invasion. I help train local palliative care teams through a charity, Hospice Ukraine, I co-founded with the neurosurgeon Henry Marsh. On our latest visit, in January, I stood ankle deep in snow in a forest before the mass graves of Izium, a previously Russian-occupied town where mass graves – including one containing 445 bodies – were uncovered. Izium, Irpin, Mariupol, Bucha – the names in a bloody roll-call of rape, torture, murder, war crimes.
Yet here is the American president, no less, thinking only of how much he can exploit the situation to get rich quick. Screw morality. Screw decency. Wheel-and-deal with a man like Putin. Trump is nothing but greed personified, a grubby little gangster in office.
Radical altruism reigns supreme
Happily, most people, most of the time, are decent, and they try to be good. I’m reminded of this on a visit to Brighton to speak at this year’s British Transplantion Society conference. I took part in a masterclass about the lessons we can learn from the story of Max Johnson and Keira Ball, two nine-year-olds who changed British legal history. After she sustained catastrophic head injuries, Keira’s heart saved the life of Max, who had been waiting, close to death himself, for more than nine months on the transplant list. The story led to a change in UK law governing organ donation in 2020.
The audience of transplant specialist nurses, coordinators, surgeons and physiotherapists listened rapt as Keira and Max’s teams recounted the tale. For the centrepiece of every transplant is an act of radical altruism – the decision by the donor or the donor’s family to give another human being a chance of life, for no personal enrichment of any kind. Simple, spectacular human kindness. We are a species hard-wired for good.
Behold the bullfinch
In dark times, moments of beauty sing. I spend Sunday morning tramping through the woods with my sister and our two young Labradors. As they rabidly seek out every rabbit, deer and trace of fox poo, a flash of sheer brilliance snags our eyes. It’s a male bullfinch, in full pomp in the sunshine, thrusting his dazzling coral chest skywards. This was once a common sight in my childhood, but I haven’t seen one for a decade or more. Bittersweet, but still utterly glorious. We find ourselves laughing with joy.
[See also: Why Britain isn’t working]
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This article appears in the 19 Mar 2025 issue of the New Statesman, The Golden Age