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.
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‘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.
World
Hamas releases last hostages included in first phase of ceasefire – as hundreds of Palestinian prisoners are freed
Hamas has handed the last four Israeli hostage bodies that were included in the first phase of the ceasefire deal to the Red Cross.
The bodies of four Israeli men have been handed over in exchange for the release of more than 600 Palestinian prisoners.
A Red Cross convoy carrying dozens of released prisoners has been seen leaving Israel’s Ofer prison in the West Bank before arriving in the Palestinian city of Ramallah.
The group got off the bus to cheers from hundreds congregated outside, with some of the released men – clad in green jackets and keffiyehs – hoisted aloft by the crowd.
It was not immediately clear when the next detainees would be released.
Meanwhile, the office of Israeli Prime Minister Benjamin Netanyahu confirmed the country had received the four bodies.
It said in a statement: “The coffins were handed over to the IDF at the Kerem Shalom crossing through Egyptian mediation. An initial identification process has now begun on Israeli territory.
“The families of the abductees are being continuously updated on the situation and will be given an official notification at the end of the full identification process.
“The public is asked to respect the families’ privacy and refrain from spreading rumours and information that is not official and well-founded. We will continue to update with reliable information in the future.”
The handover would complete both sides’ obligations under the Gaza ceasefire’s first phase, during which Hamas agreed to return 33 hostages, including eight bodies, in exchange for nearly 2,000 Palestinian prisoners.
Palestinian prisoners released from West Bank
Hours before the four bodies were transferred on Wednesday, the family of hostage Tsachi Idan said in a statement: “Our family has received with great sadness Hamas’s announcement that our beloved Tsachi is no longer alive and that his body will be returned to Israel during the night.”
It continued: “Since Tsachi was kidnapped, we received several signs of life, and in the previous deal last November, Tsachi was alive and expected to be released.
“We appreciate the tremendous love and support we are receiving from the citizens of Israel, the media, and the Nahal Oz community.”
The body of Tsachi Idan has been handed over. Pic: Bring Them Home
Egyptian mediators had earlier confirmed that they secured a breakthrough that would allow the handover of the final four hostage bodies due in the first phase of the deal after a days-long impasse.
Hamas said an agreement had been reached for the exchange of hostages for prisoners, but said their release would be conducted under a new mechanism.
It said the European Hospital in Khan Younis in southern Gaza was preparing to receive prisoners after their release.
Israel had previously refused to release more than 600 Palestinian prisoners and detainees on Saturday after accusing Hamas of breaching the ceasefire deal by staging what it considered an offensive public handover of hostages in Gaza.
The staged ceremonies in which living hostages and coffins containing hostage remains were displayed on stage before a crowd in Gaza drew strong criticism, including from the United Nations.
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Gaza hostage family mourned in Israel
Days earlier, the ceasefire deal which came into effect on 19 January was held up briefly when Hamas handed over the remains of an unidentified woman instead of mother-of-two Shiri Bibas before delivering the correct body the next day.
With the 42-day truce due to expire on Saturday, it also remains unclear whether an extension will be agreed or whether negotiations can begin on a second stage of the deal, which would see the release of the final 59 hostages left in Gaza.
Read more:
Trump shares bizarre AI video of Gaza vision
Brother of former hostage says he was tortured
Hamas said that, so far, it had not received any proposal for the second stage.
Despite numerous hiccups, the ceasefire deal has so far held up.
But moving to a second phase would require agreements on issues that have proved impossible to bridge in the past, including the post-war future of Gaza and Hamas, which Israel has vowed to eliminate as a governing force.
Underlining the precariousness of the ceasefire, the Israeli military said a projectile was fired from Gaza but fell within
the enclave. It said it was investigating the incident.
The exchange comes on the same day as the funeral for Ms Bibas and her two sons – four-year-old Ariel, and nine-month-old Kfir – who came to symbolise the trauma felt by many Israelis after the 7 October attack.
Donald Trump has said he will impose 25% tariffs on the EU “very soon” and claimed the bloc was “formed in order to screw the United States”.
The US president made the remarks while holding his first cabinet meeting at the White House since his inauguration in January.
The world’s richest man Elon Musk, who leads the US Department of Government Efficiency but is not a cabinet member, was among those present.
During his second term as president, Mr Trump has sparked fears of a global trade war by either imposing, or threatening to impose, high tariffs on both America’s allies and geopolitical rivals.
Earlier this month the US government imposed 25% tariffs on goods imported from Canada and Mexico and a 10% tariff on imports from China.
Beijing retaliated by imposing 10% duties on many US imports and 15% tariffs on coal and liquefied natural gas.
Meanwhile, the 25% tariffs on Mexico and Canada were paused after agreements were reached on border security.
‘They’ve taken advantage of us’
Asked whether he had made a decision about imposing tariffs on the European Union, Mr Trump said: “We have made a decision, we’ll be announcing it very soon and it will be 25% generally speaking and that will be on cars and all other things.
“The European Union is a different case than Canada, a different kind of case, they’ve really taken advantage of us in a different way.
“They don’t accept our cars, they don’t accept essentially our farm products. They use all sorts of reasons why not, and we accept everything from them, and we have about a $300bn (£237bn) deficit with the European Union.”
He added: “The European Union, it was formed in order to screw the United States.
“Let’s be honest – the European Union was formed in order to screw the United States, that’s the purpose of it, and they’ve done a good job of it, but now I’m president.”
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Putin is ‘very cunning’
Asked what he will do if the EU retaliates, Mr Trump said: “They can’t, I mean, they can try, but they can’t.”
He added: “They can retaliate, but it cannot be a successful retaliation, because we just go cold turkey, we don’t buy anymore.
“If that happens, we win.”
The threat of tariffs comes at a time of fragile relations between the US and Europe as the Trump administration appears to favour Moscow over Kyiv as it tries to bring about peace in Ukraine.
Mr Trump shocked European leaders last week by calling Ukrainian President Volodymyr Zelenskyy a “dictator with no elections”.
Mr Zelenskyy accused the US president of living in a Russian-made “disinformation space”.
Read more:
Trump shares bizarre AI video of Gaza vision
What minerals does Ukraine have?
White House responds to speculation over bruise on Trump’s hand
Elon Musk speaks at the cabinet meeting. Pic: AP
Ukraine to sign ‘very big’ deal
Asked at the cabinet meeting about security guarantees the US might be willing to offer Ukraine as part of peace negotiations, Mr Trump said: “I’m not going to make security guarantees beyond very much.
“We’re going to have Europe do that, because we’re talking about Europe as the next-door neighbour.”
Mr Trump also said Mr Zelenskyy will visit the US on Friday to sign a “very big” minerals deal.
The US president views the transaction with Ukraine as a fair way to recoup the billions of dollars that America has given Kyiv – via weapons and financial support – to help in their fight against Russia.
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Mr Trump went on to describe Russian President Vladimir Putin as a “very smart” and “very cunning person” during the cabinet meeting.
He said: “I think he wanted the whole (of Ukraine) when I got elected, (then) we spoke, and I think we’re going to have a deal.”
Ukraine NATO membership ruled out
Mr Trump also said he believes Mr Putin would never have invaded Ukraine if he was US president at the time.
Asked whether Ukraine could gain NATO membership, the US president said: “You can forget about it. That’s probably the reason the whole thing started.”
Mr Trump declined to comment when asked about whether he would ever allow China to take control of Taiwan by force.
“I never comment on that,” said. “I don’t want to ever put myself in that position.”
Mr Musk spoke briefly at the start of the meeting to explain why he believes the controversial cost-cutting measures his department has been carrying out have been necessary.
Cabinet members were then asked by reporters if they were happy with Mr Musk and how he has been carrying out his role.
Mr Musk started to answer the question, but Mr Trump interjected and said he might want to let cabinet members answer, before joking that if anyone disagreed, he might “throw them out”.
World
Trump shares AI video of Gaza vision featuring golden statues, bearded belly dancers and Netanyahu on a sunbed
Donald Trump has shared a bizarre AI-generated video on his Truth Social platform showcasing what appears to be a vision of Gaza under his proposed plan.
The footage, which the 78-year-old shared without comment, shows the war-ravaged territory before a caption appears: “Gaza 2025… What’s Next?”
It then goes on to show the area transformed into a Middle Eastern paradise with exotic beaches, Dubai-style skyscrapers, luxury yachts and people partying.
Pic: TruthSocial/@donaldtrump
Pic: TruthSocial/@donaldtrump
Pic: TruthSocial/@donaldtrump
It includes a “Trump Gaza” tower and a gigantic, golden statue of the US president – with miniature versions on sale in a souvenir gift shop.
A child is also shown walking in a street, holding a huge, golden balloon of the president’s head.
The video also features the world leader dancing with a scantily clad belly dancer in a bar – and sunbathing and sipping cocktails by a hotel resort pool with Israeli Prime Minister Benjamin Netanyahu.
Elon Musk appears in the footage several times – sitting on a beach eating humous with flatbreads as bearded belly dancers perform on the sand.
The billionaire boss of X, Tesla and SpaceX – who also leads the US Department of Government Efficiency (DOGE) which has been tasked with cutting government spending – is also shown throwing dollar bills in the air for people.
Pic: TruthSocial/@donaldtrump
Pic: TruthSocial/@donaldtrump
A song written for the video also plays in the background.
The lyrics go: “Donald’s coming to set you free, bringing the light for all to see, no more tunnels, no more fear: Trump Gaza’s finally here.
“Trump Gaza’s shining bright, golden future, a brand new life.
“Feast and dance the deal is done, Trump Gaza number one.”
Sky News has established the video was first shared online in early February by accounts with no apparent connection to the White House.
Read more from Sky News:
Large bruise on Trump’s hand prompts speculation over health
What you need to know about Trump’s Gaza plan
Mr Trump announced his plan – for when the war between Israel and Hamas ends – earlier this year.
It includes relocating two million Gazans to neighbouring Arab countries and developing the territory into the “Riviera of the Middle East“.
He described Gaza as a “demolition site” where “virtually every building is down”.
Pic: TruthSocial/@donaldtrump
Pic: TruthSocial/@donaldtrump
Laying out his idea of what would happen beyond an Israel-Hamas ceasefire, he proposed: “The US will take over the Gaza Strip and we will do a job with it too.”
He said America would be “responsible for dismantling all of the dangerous unexploded bombs and other weapons on the site”, before it would “get rid of the destroyed buildings”, and “level it out”.
“Everybody I’ve spoken to loves the idea of the United States owning that piece of land, developing and creating thousands of jobs,” he added.
The White House described the proposal as “out-of-the-box” and “visionary” – but it was condemned as the effective “ethnic cleansing” of Palestinians from Gaza.
Hamas described the proposals as “ridiculous and absurd” in a statement from one of its officials.
Egypt, Jordan, and Saudi Arabia, which as fellow Arab nations support the Palestinian cause, also rejected Mr Trump’s plan.
Read more:
Analysis: Trump’s Gaza plan is so outrageous it might be something bigger
There was a mixed reaction to the video in the comments section below.
One person wrote: “I don’t think that’s funny or cool. Sorry. Am I missing something??? I hope it’s a joke a bad joke..”
“I hate this. I love our president, but this is horrible,” said another.
One Truth Social user wrote: “Mr President while I appreciate what you do, is not about you. To God be the glory and the honor, for without Him, you couldn’t have accomplished anything. The statue is a symbol of the antichrist, please humble yourself to God. Jesus is king and only Him.”
“You’re doing great Mr President. But don’t let it get to your head. God put you in that position for His Glory, not yours,” said another.
“Can we transform our US cities to look like this 2025 vision first? Our cities are dumps with ugly buildings and homeless people,” wrote one user.
“Everything looks good, just stay away from these guys,” said another, reposting a screengrab of the bearded belly dancers.
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