Trimming the Fat: Reforming the Department of Health and Social Care

The Adam Smith Institute’s latest discussion paper, written by Tim Ambler, proposes a number of reforms to improve the efficiency and value for money of the Department of Health and Social Care.

This paper is part of the Adam Smith Institute’s “Reforming the Civil Service” series.

  • The Department for Health and Social Care (DHSC) has responsibility for a number of functions that are currently performed inefficiently and represent poor value for taxpayer money;

  • The NHS should become a coherent entity with its own staff functions, removing DHSC interference except to the extent that any parent company supervises its subsidiaries;

  • Various arm’s length bodies (ALBs) should be privatised, merged or closed;

    • For example, there is significant overlap between the remits of the Medicines and Healthcare Products Regulatory Agency (MHRA) and the National Institute for Health and Care Excellence (NICE)—one agency could consider both safety and value perfectly well;

  • Whilst parts of the departmental core should be retained, others can be closed as they duplicate NHS functions or should not lie within DHSC’s remit;

  • Taken together, if all the recommendations within this paper were implemented, this would amount to a saving of 11,663 staff.

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Food for Thought: Reforming the Department for Environment, Food and Rural Affairs

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Unclear Benefits: Reforming the Department for Work and Pensions