DAUK notes with serious concern the Government’s announcement more than 200 arms-length bodies are to be abolished under Labour’s forthcoming 10-year NHS plan.
These bodies include Healthwatch England, the National Guardian’s Office, and the Health Services Safety Investigations Body (HSSIB).
While we share the desire to reduce bureaucratic duplication and redirect resources toward frontline care, it is essential to ask: who will be left to speak up when care is unsafe, and who will listen?
Whistleblower protections
Abolishing the National Guardian’s Office (NGO) — the only dedicated NHS body for supporting whistleblowers and embedding a ‘speak up’ culture — risks further silencing the clinicians who raise alarms about patient harm.
The idea that app-based patient feedback can substitute robust, independent safety structures is not only reductive but dangerously naïve.
DAUK has long supported NHS whistleblowers who have faced retaliation, career derailment, and mental health crises after exposing unsafe care.
It is profoundly disheartening that no replacement framework for supporting staff who speak up appears to have been announced alongside the abolition of the NGO.
Learn not blame
Equally troubling is the closure of the HSSIB. The HSSIB is an organisation with a statutory remit to conduct independent, learning-based safety investigations without blame.
This loss risks taking the NHS backwards to a time when system failures were buried rather than understood.
Health Secretary Wes Streeting says these reforms will “hold a megaphone up to patients’ lips.”
But we ask: who will be holding the megaphone for staff — especially those raising uncomfortable truths about failing services or leadership malpractice?
We therefore call on the Government to urgently clarify:
What new, independent structure will protect NHS staff who speak up about unsafe care, discrimination, or malpractice?
How patient safety investigations will be preserved with the loss of HSSIB’s statutory function?
Safeguards
What safeguards will exist to ensure this reform does not weaken NHS transparency or accountability?
DAUK supports reforms that genuinely streamline care and empower patients and staff alike. But stripping out safety oversight without clear replacements is not reform, it is risk.
We urge the Government to meet with frontline representatives, including whistleblowers and patient safety advocates, before pressing ahead.
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