Amid political upheaval and the subsequent resignation of the health secretary, the king’s speech unveiled the NHS modernisation bill – the most significant overhaul of the health service in more than a decade.

By legally abolishing NHS England and bringing operational management directly into Whitehall, ministers say they are cutting bureaucracy and returning power to the frontline.

But with public satisfaction with the NHS only just beginning to recover from a record low, and more than 7 million people still waiting for “elective” (scheduled) treatment, the central question is whether structural reform of this kind actually improves patient care and outcomes. Or, as health-policy experts at the King’s Fund have asked, will scrapping NHS England make it any easier to get a GP appointment or reduce waiting times?

History offers little reassurance. Major health system reorganisations are often costly and disruptive. The 2012 Lansley reforms – the most recent comparable reform – cost the taxpayer £1.5 billion, a figure widely considered an underestimate.

Spending on management consultants spiked to nearly £600 million a year as the system absorbed the shock, and the King’s Fund later concluded that the upheaval “contributed to........

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