The HSJ Health Check podcast is tracking development of the government’s planned Health Bill. This week we talk to Ian Dodge, who shaped several major pieces of NHS legislation as a national director at NHS England and the Department of Health.

Mr Dodge reflects on the lessons that can be learned from two decades of NHS restructure Acts: They rarely succeed in transforming services, take longer and are more complex than thought, and open the door to a range of unpredictable challenges from outsiders and political opponents.

We talk about where these attacks might come, and the dilemmas facing goverment itself about what to include. 

Mr Dodge says ministers have already missed the chance of sticking to a very slim piece of legislation, abolishing NHS England as straightforwardly as possible. “The 10-Year Plan blew that out of the water with a whole heap of things that the government decided to abolish,” he said. “Already this thing has ballooned.”

On timing, NHSE is unlikely to be abolished until “sometime between 1 October 2027 or 1 April 2028… and it will take up a vast amount of time and effort.”

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