Streeting's Plan To Cut NHS Clinical Staff And Replace with AI

Outgoing Health Secretary Wes Streeting's parting act was to oversee the drafting of a workforce plan that would fundamentally reshape the NHS — reducing its reliance on human staff on a scale that goes well beyond anything proposed by the previous Conservative government, and relying instead on artificial intelligence to fill the gap.

The Scale of the Cuts
A leaked workforce plan, being finalised by health officials, says the NHS in England will have to rely on technology to get by with hundreds of thousands fewer staff than the previous Conservative government had planned.

The context for this is significant.

 

In 2023, NHS bosses set out a ten-year staffing plan that it said would put the workforce on a "sustainable footing" after years of chronic shortages, with staffing levels planned to grow from 1.4 million to 2.3 million by the mid-2030s, with annual increases of 2.6 to 2.9 per cent. Streeting's revised plan dramatically scales that back. Under the current 2025 plan there will be an increase of only about 50,000 nurses and up to 380,000 fewer staff will be working in the NHS by 2035. Annual staffing increases would be cut to between 1.1 and 2 per cent.

The Role of AI
A draft of the plan seen by the Financial Times says using technology and treating more patients in local clinics or at home rather than in hospital will mean the NHS "does not need anything like the growth rate [in staff numbers]" set out in its 2023 workforce plan.

The plan does not simply propose AI as a supplementary tool. The document to be published in June will feature a major expansion of AI for the health service, including in "instances where technology can completely substitute for a role", particularly for admin and clerical tasks.
At the heart of the government's 10-year health plan is a major upgrade to the NHS App, which will become the digital front door. The plan outlined a future where patients can access a wide range of healthcare services and advice at the touch of a button. The app will also offer 24/7 AI-driven advice for non-urgent care, helping patients get the right support faster. Clinicians will also see changes, including AI scribes to take notes and generative AI to draft care plans — innovations expected to save the NHS £200 million over three years.

The Rationale
The government's stated justification rests on a productivity argument. The draft plan promises a "fundamentally different approach", arguing that a 50 per cent increase in doctors in the NHS over the past decade "has not led to better access, experience or outcomes for citizens" and has instead seen productivity fall.

The plan also frames the cuts partly as financial necessity. The plan sought to address the view that the 2023 plan overestimated the workforce that the NHS required. It also restated that the focus of NHS recruitment would move away from its dependency on international recruitment, towards its own communities, with the ambition to reduce international recruitment to less than 10 per cent by 2035.

Reaction and Criticism
The response from the medical profession has been sharp. The BMA warned new Health Secretary James Murray not to contemplate reducing the number of doctors in the forthcoming plan. Dr Amit Kochhar, chairman of the BMA's representative body, said: "It is crushingly disappointing to see government apparently planning to simply accept that the low number of doctors we have in this country is just a fact of life. No one disputes that AI can be helpful to doctors. What they do dispute is the idea that doctors can be replaced by it. A chatbot cannot look after a patient."

The Society of Occupational Medicine has also raised concerns. A study published in its journal found that without appropriate training and robust IT support, digital innovations risk increasing workload, contributing to burnout, and potentially worsening mental health outcomes for NHS staff.

Independent economists have questioned whether the plan will even deliver savings. Paul Johnson, former head of the Institute for Fiscal Studies, cautioned that the new plan is unlikely to allow a reduction in spending, suggesting NHS budgets would continue to rise in line with previous trends. He criticised the "chopping and changing" of strategies and said hopes of transforming the NHS through AI had to be met with "a degree of scepticism about the capacity of an organisation that struggles to use 2005 technology, let alone anything more recent."

What Happens Next
The BMA has warned James Murray, Streeting's successor, not to press ahead with the reduction in doctor numbers, and the plan is due to be formally published in June. Murray has so far given no firm public indication of whether he intends to adopt, amend, or reject his predecessor's proposals.

 

Source: FT / KONP