Labour Health Secretary Wes Streeting is bringing US President Donald Trump and his right-hand billionaire Elon Musk’s DOGE programme to Britain beginning with an assault on the National Health Service (NHS).

Streeting announced last Thursday that he would be abolishing “the world’s largest quango”, NHS England—a government-funded but independent body running health services in the country. Up to 10,000 administrative jobs will go as the organisation is folded into the Department of Health and Social Care (DHSC), a cull worth roughly £400 million a year.

The Murdoch press’s Sun newspaper immediately understood what was afoot. “We couldn’t be happier,” wrote the paper’s editors: “For years we have demanded a bonfire of the quangos—largely useless bloodsucking state-funded bureaucracies”.

Labour had “done what the Tories should have sorted long ago” and Prime Minister Sir Keir Starmer was “living the Tories’ dream.”

Streeting’s announcement went totally unopposed by the Conservatives, with former health secretary Jeremy Hunt praising his “boldness”, health minister under Boris Johnson Lord Bethell declaring, “I wish we’d had the guts to do this,” shadow foreign secretary Andrew Mitchel admitting himself “very supportive” and one-time Tory leadership candidate Robert Jenrick arguing, “I think we should back him.”

With such strong support from parliament’s vultures, the Sun urged, “the PM must now take his chainsaw to hundreds more quangos.”

The Labour government has not been slow to answer. The next day, Streeting made clear that 20-30,000 jobs were actually at risk. The NHS’s 42 integrated care boards—which allocate the NHS budget locally and commission services—would be expected to cut running costs by half. Its 220 trusts—which provide medical care—would be told to slash roles in HR, finance and communications. These cuts would amount to upwards of an extra £750 million a year.

Streeting is beginning with NHS England in an attempt to benefit from popular dissatisfaction with what has always been seen as a bureaucratic weight on the genuine care work of the health service.

There is good reason for this, but not the one Streeting gives. NHS England was set up in 2013 by Tory Health Secretary Andrew Lansley—closely connected with the private healthcare lobby—as part of a disguised privatisation drive within the NHS.

At the time, it was considered politically impossible to openly discuss an increased role for the private sector in the NHS, or to openly and directly attack the health service. NHS England was Lansley’s solution, created to oversee an internal market regime providing ever-expanding opportunities for private providers, which could proceed formally independent of the government and out of the spotlight.

Not only did the privatisation of health services rapidly increase, but large sums of money came to be spent on the NHS England stalking horse—which in many cases duplicated functions performed with the DHSC.

Streeting, with his own extensive ties to the private health lobby, has seized an opportunity. He came into power with the Labour government pledging to increase the involvement of the private sector in the NHS and attacking it in terms no shadow or government health secretary in British political history—Tory or Labour—has ever used. He is perfectly prepared to dispense with the layer of deniability offered by NHS England.

He can do so while claiming to be cutting a bureaucratic drain on health spending. The reality is that the arms-length privatisation agenda pursued through NHS England is being brought in house, to proceed at breakneck speed under the health secretary’s whip.

Streeting’s intention in slashing jobs is not to cut “waste” or to reduce “micromanagement”—his continual demands for “productivity” increases from an exhausted workforce will bear down on health workers harder than ever. He wants fewer government administrative workers because he expects less work for them to manage once large chunks of the NHS are handed over to private companies—with more ways to leech money out of the health service, in profits, bonusses, outsourcing contracts, dividends and all the rest.

The second pillar of this agenda is slashing public funding. Streeting told the Sunday Telegraph that Jim Mackey—CEO of NHS England until its dissolution—would be “gripping NHS finances and putting an end to the deficit-by-default culture that has consumed our health service.” Streeting will do the same at the DHSC, “going through budgets line by line”.

Mackey told Integrated Care Board (health service commissioning groups—set up as part of the former privatisation by stealth initiative) and NHS Trust (ditto) leaders that his work was being done to “reset” NHS finances and prevent it “overspending by the £6.6bn in 2025-26 that initial estimates said was likely,” according to the Guardian.

An earlier round of cuts already took 20 percent out of ICB budgets. The paper reports: “Senior figures running ICBs say the order to halve their running costs will make it impossible for them to undertake the full range of their activities, which include funding vaccination programmes, offering blood pressure checks and improving children’s dental health.”

One leader explained, “In our ICB we have no more ‘fat’ to trim. It’s very difficult to see how, if implemented in a blanket way, this doesn’t lead to service cuts.”

To drive this agenda forward, Streeting told the Telegraph Labour would be “introducing league tables, so we can see which providers are cutting waiting times and managing their finances responsibly, and which are failing. Those at the top will be incentivised to go further, faster, while those at the bottom will be paid a visit by turn around teams to whip them into shape.”

This was just “the beginning, not the end,” he declared, with the Telegraph writing, “Wes Streeting has warned that hundreds of official bodies are ‘cluttering’ up the health system as he prepares to axe more health quangos.”

More than the health service is at stake. Starmer used Streeting’s announcement Thursday as an occasion to publish another article in the Telegraph which its deputy political editor summed up in the words, “Starmer: I will tackle our flabby state”.

The prime minister complained of having “left tax and spending at, or close to, historic highs” and of a state that “employs more people than it has in decades… We don’t want bigger state, or an intrusive state, an ever-expanding state.”

Just as with the NHS, criticisms of “bureaucracy” and “inefficiency” will be used to justify slashing swathes of the civil service as part of plans to drastically reduce social services. Labour is already preparing billions of pounds in welfare cuts as part of its upcoming Spring Statement.

Meanwhile, “enterprise”, Starmer’s word for big business, will be given free rein. “We will pull every lever to unleash it,” he writes, announcing, “a new target across government to cut administrative costs of regulation by 25 percent.”

The Telegraph asked Steve Baker, a leading figure on the Tory right, for his opinion on the last few days’ announcements. The former RAF officer and Lehman Brothers financier answered, “with a tone of admiration in his voice,” the paper reports, “It should be humbling for every Tory thinker that we have been outflanked on the Right by Labour.”