The 10 best HSJ comment pieces of 2025

Here’s my rundown of the 10 articles which I think made the strongest and most pertinent points in 2025. They are presented in time-honoured reverse order.

It is telling that seven of the 10 are directly critical of government policy and/or action – not what one would have expected from the first full year of a Labour administration.

10) How much should NHS staff be paid?

2025 was – among many other things – a year in which staff expectations about pay clashed directly with the views of the still relatively new government. Anita Charlesworth’s analysis from April remains the perfect primer on the subject.

9) Blood transfusion deaths are not just a historic tragedy, they are on the rise

The best comment pieces are usually those that tell you something new, rather than simply “enjoying the problem” – as is sadly the case with 90 per cent of NHS commentary. In June, Cheng Hock Toh and Nnenna Osuji showed the service still has a big problem with transfusions, decades after the infected blood scandal.

8) NHS staff are refusing vaccinations as a form of quiet protest

Also from June, this prescient piece explored a version of the quiet quitting trend peculiar to the NHS. Jahangir Alom suggested that plummeting morale was leading NHS staff to avoid annual vaccinations.

7) Ministers will learn the pain of legally rewiring the NHS

“Those that fail to learn from history are doomed to repeat it,” remarked Winston Churchill. The government’s plan for a new NHS Bill – which is due to be launched in 2026 – was critiqued by Bill Morgan, who as Andrew Lansley’s special adviser knows a legislative car crash when he sees one.

6) Political calls to cut immigration are a red flag for the NHS

As Reform rises ever higher in the polls, the anti-immigration rhetoric grows louder across the political spectrum. Bill Simms was one of many to raise the alarm about how this will negatively affect the health service.

5) Mackey’s subco plan is risky and unnecessary

A telling chapter in the messy attempts at reform which have made this year such a trial for many. In February, Sir Jim Mackey replaced Amanda Pritchard as NHS England CEO. Wes Streeting charged him with righting the NHS finances – and Sir Jim immediately instructed trusts to set up wholly owned subsidiaries to run their support services. The only problem was that no one had squared it with the unions, as Christina McAnea’s piece makes very clear. A month later, the health secretary killed the idea.

4) Leaders must be realistic as well as compassionate

From the very end of this most bruising year comes the brave piece by Steven McMillan on the dangers of leaders over-relying on compassion as a guiding star.

3) NHS leaders must speak out against the government’s welfare reforms

It is sometimes suggested that NHS leaders do not speak truth to power. This allegation has been disproven many times this year, but never more powerfully than by trust CEO Peter Reading in this piece on the government’s disability reforms.

2) Government reforms are leaving managers without a lifeline

The government’s approach to NHS reforms has undermined the service’s effectiveness. Nowhere has this been more clearly illustrated than in Colin Graham’s analysis of how the gutting of corporate services has left NHS leaders unable to carry out the very changes the government is insisting on.

1) The trust league tables are not robust, meaningful or fair

Most trust CEOs think they are nonsense and so do many leading figures in NHSE – but Mr Streeting had promised a “league table” of provider performance and so a bunch of government statisticians were told to produce one. Matthew Hankins and Jonathan Pearson-Studdard show the result was neither “robust, relevant or just”.