New-found freedom allows former health secretary Sajid Javid to talk honestly about NHS big picture
A politician for 12 years, in government for nine, and a secretary of state across six different departments, Sajid Javid has been at the top of the political tree in the UK for the best part of a decade, serving as our chancellor, home secretary and health secretary.
He knows a lot about government and a lot about what’s really going on behind closed doors – a seasoned political operator, he also knows how to dodge a question in an interview and when to toe the party line.
But now that he’s decided to quit politics in 2024, he used our conversation in Beth Rigby Interviews to do something quite different: speak honestly about the NHS and how he thinks it needs to change.
Politics latest: Cost of trip Liz Truss cut short to launch leadership bid revealed
Please use Chrome browser for a more accessible video player
‘Current NHS model is not sustainable’
When he was appointed health secretary in June 2021, no-one envied the job. He was tasked with trying to clear the NHS backlog that had ballooned during the COVID crisis.
When Mr Sajid took up the post, the waiting list was 5.3 million. It is now 7.2 million, and this former health secretary tells me that he thinks it will continue to go up for a while before it comes down.
But what the ex-minister wanted to use our interview for was to talk not about the immediate NHS pressures but the bigger picture.
Read more: Ex-health secretary issues warning over NHS
He told me that he “doesn’t think the NHS will survive many more years” in its current form unless there is fundamental reform, and said we cannot pretend that the current system is providing good healthcare for people when “everyone is queueing for everything”, from a doctor’s appointment to an ambulance or hospital bed.
“Having worked up close now with the health service, I don’t think the model of the NHS that was set up some 70 years ago is sustainable for the future,” he said.
“You know that the world has changed and the NHS has not moved with that. Even before the pandemic, it was moving in that direction.
“And because of the change in demography, people are living longer, therefore needing more health care, and social care for that matter, new medicines. And everyone rightly wants to get access to new medicines and treatments and also the changing burden of disease.
“You know, we have a lot more obese people today, we have a lot more problems with addiction. So the NHS needs to change… we need an honest debate about the future of the NHS.”
‘Keeping the show on the road’
Mr Javid told me that this debate is being stymied by politics, as politicians with skin in the game are unable to talk about the challenges of the NHS without it being used as an attack by their opponents.
He pointed to the recent furore in Scotland, where reports of discussions around asking the wealthy to pay for treatment provoked a furious backlash and were shut down before they even began.
But he, alongside some others on the backbenchers such as David Davis, wants to use his newfound freedom to open the discussion about how to fund the NHS while maintaining the principle of it being universal and free at the point of use.
Because the question of fundamental reform is a big and urgent one. The NHS now accounts for just over 40% of government spending but is struggling to meet demand, despite record levels of funding.
In the autumn statement, the government announced £6bn of extra funding over the next two years, but nearly all of this will be eaten up by costs of inflation and growing demand, with £800m left for improvement of services, according to Nuffield Trust analysis shared with Sky News.
Matthew Taylor, chief executive of the NHS Confederation, said the new money allocated in November wouldn’t do much more than allow the NHS to “just about keep the show on the road”.
Mr Javid didn’t want to be drawn on what sort of funding model he would recommend, but said it was time to look at the German and French systems to see how fellow Europeans do it.
“They seem to be doing better than we are at the moment, so we have got to ask ourselves how they managed to do that,” he said.
“And they are mostly funded by the taxpayer, but they also have some different models.”
Javid served as health secretary under Boris Johnson, while the new PM, Rishi Sunak, was chancellor
In Germany, there is a dual public-private system in which healthcare is funded by statutory contributions, with the additional option of taking out private health insurance to replace or top up state cover.
France, meanwhile, runs a statutory health insurance system, providing universal coverage for residents financed from four sources:
• Citizens pay obligatory health contributions levied on earned income, paid by employers, employees and the self-employed
• Contributions levied on unearned income
• Central government funding
• And users typically have to pay a small fraction of the cost of treatment they receive
Grasping the nettle on the NHS is, admits Mr Javid at the end of our interview, his unfinished business in politics.
“I would have in a way liked to have more time to look at reform and have that honest debate,” he told me.
But the political reality means that sort of debate is unlikely to happen this side of a general election.
Neither the Conservatives or Labour will want to risk doing anything that might be perceived in any way as creating a two-tier health service or threatening the principle of having an NHS that is free at the point of use.
For Labour, a party always trusted with the NHS, it is a boat Sir Keir Starmer will not want to rock, with Labour insiders telling me there is no way the leadership will open up any discussion about how the NHS funding model might change.
Instead, the shadow health secretary Wes Streeting will focus on how to better organise the NHS and shift attention towards preventive medicine and treatment.
As for Rishi Sunak, he hasn’t the bandwidth to be bold on fundamental reform as he struggles to keep his party even in the race for 2024.
‘Very bad period for country’
Even Mr Javid, perhaps more candid now he is out of cabinet, admitted the “odds are stacked against us” going into the 2024 and that the Liz Truss’s premiership “was a very bad period for our country”.
The former minister, who backed Ms Truss in the summer leadership campaign, said it was “obvious from the start, really, that she wasn’t going to be up for the job”.
Mr Javid told me that her decisions to side-line independent fiscal watchdog the Office of Budget Responsibility was “completely wrong”, as was the fighting with the Bank Of England and Ms Truss’s decision to fire the head of the Treasury as soon as she became prime minister.
“That was before the mini-budget and I think it got worse and worse at that point,” he added. “So I think it is something that was a very bad period for the country.”
A bad period, a bumpy 2023 ahead and a “tough battle” in the 2024 election, this former leading politician has decided it’s time to pursue a career outside politics once more.
He certainly won’t be the last big name Conservative to do so as the party eyes the opposition benches.
In mid-May, the World Health Organisation assessed that there were “nearly half a million people in a catastrophic situation of hunger, acute malnutrition, starvation, illness and death”.
“This is one of the world’s worst hunger crises, unfolding in real time,” its report concluded.
Warning: This article contains images of an emaciated child which some readers may find distressing
Israel‘s decision this week to reverse the siege and allow “a basic level of aid” into Gaza should help ease the immediate crisis.
But the number of aid trucks getting in, so far fewer than 100 per day, is considered dramatically too few by aid organisations working in Gaza, and the United Nations accuses Israel of continuing to block vital items.
Israel-Gaza latest: Gaza enduring ‘atrocious death and destruction’, UN boss warns
“Strict quotas are being imposed on the goods we distribute, along with unnecessary delay procedures,” said UN secretary general Antonio Guterres in New York on Friday.
“Essentials, including fuel, shelter, cooking gas and water purification supplies, are prohibited. Nothing has reached the besieged north.”
Nineteen of Gaza’s hospitals remain operational, all of them are overwhelmed with the number of patients and a lack of supplies.
Baby Aya at Rantisi hospital in northern Gaza is dangerously thin
“Today, we receive between 300 to 500 cases daily, with approximately 10% requiring admission. This volume of inpatient cases far exceeds the capacity of Rantisi hospital, as the facility is not equipped to accommodate such large numbers,” Jall al Barawi, a doctor at the hospital, told us.
At least 94% of the hospitals have sustained some damage, some considerable, according to the UN.
Jall al Barawi, a doctor at Rantisi hospital
Paramedic crews are close to running out of fuel to drive ambulances.
The lack of food, after an 11-week blockade, has left thousands malnourished and increasingly vulnerable to surviving injuries or recovering from other conditions.
Listen to The World with Richard Engel and Yalda Hakim every Wednesday
Children are the worst affected.
Our team in Gaza filmed with baby Aya at the Rantisi hospital in northern Gaza. She is now three months old and dangerously thin.
Her skin stretches over her cheekbones and eye sockets on her gaunt, pale face. Her nappy is too big for her emaciated little body.
Aya’s nappy is too big for her emaciated little body.
Lethal spiral
Her mother Sundush, who is only 19 herself, cannot get enough food to produce breastmilk. Baby formula is scarce.
Aya, like so many other young children, cannot get the vital nutrition she needs to grow and develop.
It’s a lethal spiral.
This is what Aya looked like shortly after she was born
“My daughter was born at a normal weight, 3.5kg,” Sundush tells us.
“But as the war went on, her weight dropped significantly. I would breastfeed her, she’d get diarrhoea. I tried formula – same result. With the borders closed and no food coming in, I can’t eat enough to give her the nutrients she needs.”
“I brought her to the hospital for treatment, but the care she needs isn’t available.
“The doctor said her condition is very serious. I really don’t want to lose her, because I lost my husband and she’s all I have left of him. I don’t want to lose her.”
Read more:
British doctor in Gaza describes horror
Shouts of ‘genocide’ in Commons
Aya and her mother Sundush
Some of the aid entering Gaza now is being looted. It is hard to know whether that is by Hamas or desperate civilians. Maybe a combination of the two.
The lack of aid creates an atmosphere of desperation, which eventually leads to a breakdown in security as everyone fights to secure food for themselves and their families.
Only by alleviating the desperation can the security situation improve, and the risk of famine abate.
World
Police launch ‘major operation’ after 12 people injured in knife attack at Hamburg train station
Twelve people are reported to have been injured after a knife attack at Hamburg’s central train station.
A “major operation” has been launched and a suspect was arrested, police said in a post on X.
The identity of the suspect has not been revealed.
Reports in Germany said the suspected attacker was a woman.
The fire service said six of the injured were in a life-threatening condition, three others were seriously hurt, and another three sustained minor injuries, news agency dpa reported.
Bild newspaper said the motive for the attack was so far unknown.
Hamburg is Germany’s second biggest city, with the train station being a hub for local, regional and long-distance trains.
Listen to The World with Richard Engel and Yalda Hakim every Wednesday
This breaking news story is being updated and more details will be published shortly.
Please refresh the page for the fullest version.
You can receive breaking news alerts on a smartphone or tablet via the Sky News app. You can also follow us on WhatsApp and subscribe to our YouTube channel to keep up with the latest news.
The man suspected of shooting dead two Israeli embassy workers in Washington DC leaned over and fired at them repeatedly after they fell to the ground, the FBI has said.
Elias Rodriguez, 31, has been charged with murdering Sarah Milgrim and her boyfriend Yaron Lischinsky, after they left an event at the Capital Jewish Museum on Wednesday night.
Israeli PM attacks Starmer – latest updates
Footage has showed Rodriguez, from Chicago, chanting “free, free Palestine” as he was arrested.
It later emerged Mr Lischinsky had bought a ring and planned to propose to Ms Milgrim.
Authorities are investigating the killings as both a hate crime against the Jewish community and terrorism.
Please use Chrome browser for a more accessible video player
Shootings suspect shouts ‘free Palestine!’
‘I did it for Gaza’
It comes as the FBI has said in a charging document on Thursday that surveillance footage shows how Ms Milgrim and Mr Lischinsky died.
Rodriguez is allegedly seen passing the couple after they left the museum before shooting them in the back.
The FBI says the footage then shows him leaning over the couple and firing at them several more times after they fell to the ground.
The video then shows Ms Milgrim attempting to crawl away before “(Rodriguez) followed behind her and fired again”, the charging document says.
The suspected gunman is then accused of reloading his weapon and firing at Ms Milgrim as she sat up.
According to the charging document, Rodriguez then jogged to the museum and once inside asked to speak to a police officer before stating that he “did it” and that he was unarmed.
He is then said to have told police: “I did it for Palestine, I did it for Gaza, I am unarmed.”
Please use Chrome browser for a more accessible video player
DC shooting: Father pays tribute to ‘perfect’ daughter
Suspect ‘expressed admiration’ for fatal protest
The court document also states that 21 expended 9mm bullet cases were found at the scene and the gun was slide-locked – meaning it was empty of ammunition.
An empty gun magazine was also recovered from the scene.
The FBI says it has obtained travel records which show Rodriguez flew from Chicago’s O’Hare International Airport to the Reagan National in Washington DC on Tuesday with the gun in his checked baggage.
Rodriguez had bought the weapon in the state of Illinois on 6 March 2020, according to the charging document.
The FBI has said that while Rodriguez was in custody he “expressed admiration” for a US Air Force member who set himself on fire in front of the Israeli embassy in Washington DC on 25 February 2024.
Aaron Bushnell died in the apparent act of protest against the war in Gaza.
Rodriguez also told police he bought a ticket to the museum around three hours before the event that was attended by Ms Milgrim and Mr Lischinsky.
Read more:
Why Trump will worry about attacker being glorified
Please use Chrome browser for a more accessible video player
Starmer ‘on wrong side of history’
During a brief court appearance at the E. Barrett Prettyman Federal Courthouse in Washington DC today, Rodriguez was charged with two counts of first degree murder and with the murder of foreign officials.
He has also been charged with causing the death of a person through the use of a firearm and discharge of a firearm during a crime of violence.
Rodriguez was told he could face life in prison or the death penalty if he is found guilty.
He remained calm throughout the hearing, paying attention to the proceedings throughout and confirmed that he is asking the court to appoint an attorney on his behalf.
He will next appear at a federal court in Washington DC on 18 June.
Murdered couple ‘were perfect for each other’
Meanwhile, Ms Milgrim’s father, Robert, says he feared his daughter might be in danger when he saw news alerts of a fatal shooting in Washington DC.
Ms Milgrim’s mother Nancy opened a phone locator app and saw Ms Milgrim was at the Capital Jewish Museum.
“Shortly after that, the Israeli ambassador called us on my wife’s phone,” Mr Milgrim told Sky News’ partner network NBC News, fighting back tears.
He added that it was the ambassador who told them Mr Lischinksy had bought a ring and was planning to propose to Ms Milgrim.
“They were perfect for each other, he said.
Mr Milgrim continued: “They just brought us joy, and her memory, which is a blessing, will continue to bring us joy – but it’s not the same as her not being here.”
-
Sports3 years ago‘Storybook stuff’: Inside the night Bryce Harper sent the Phillies to the World Series
-
Sports1 year agoStory injured on diving stop, exits Red Sox game
-
Sports2 years agoGame 1 of WS least-watched in recorded history
-
Sports2 years agoMLB Rank 2023: Ranking baseball’s top 100 players
-
Sports4 years ago
Team Europe easily wins 4th straight Laver Cup
-
Environment2 years agoJapan and South Korea have a lot at stake in a free and open South China Sea
-
Environment2 years agoGame-changing Lectric XPedition launched as affordable electric cargo bike
-
Business3 years agoBank of England’s extraordinary response to government policy is almost unthinkable | Ed Conway