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.
At least 11 people have been killed and 63 injured in an Israeli strike on central Beirut, Lebanese authorities have said.
Lebanon‘s health ministry said the death toll could rise as emergency workers dug through the rubble looking for survivors. DNA tests are being used to identify the victims, the ministry added.
State-run National News Agency (NNA) said the attack “completely destroyed” an eight-storey residential building in the Basta neighbourhood early on Saturday.
Footage broadcast by Lebanon’s Al Jadeed station also showed at least one destroyed building and several others badly damaged around it.
The central Basta neighbourhood in Beirut, where four people were killed in an Israeli airstrike
The Israeli military did not warn residents to evacuate before the attack – the fourth targeting the centre this week.
At least four bombs were dropped in the attack, security sources told Reuters news agency.
The blasts happened at about 4am (2am UK time).
A seperate drone strike in the southern port cuty of Tyre this morning killed one person and injured another, according to the NNA.
The blasts came after a day of bombardment of Beirut’s southern suburbs and Tyre. The Israeli military had issued evacuation notices prior to those strikes.
Pic: AP
Israel has killed several Hezbollah leaders in air strikes on the capital’s southern suburbs.
Heavy fighting between Israel and Hezbollah is ongoing in southern Lebanon, as Israeli forces push deeper into the country since launching a major offensive in September.
Read more:
No 10 indicates Netanyahu would be arrested
‘Dozens’ of Palestinians killed in Israeli airstrike
US envoy Amos Hochstein was in the region this week to try to end more than 13 months of fighting between Israel and Hezbollah, ignited last October by the war in Gaza.
Mr Hochstein indicated progress had been made after meetings in Beirut on Tuesday and Wednesday, before going to meet Israeli Prime Minister Benjamin Netanyahu and defence minister Israel Katz.
According to the Lebanese health ministry, Israel has killed more than 3,500 people in Lebanon and wounded more than 15,000.
It has displaced about 1.2 million people – a quarter of Lebanon’s population – while Israel says about 90 soldiers and nearly 50 civilians have been killed in northern Israel.
World
Vladimir Putin vows to increase production of Russia’s ‘unstoppable’ missile – as NATO and Ukraine to hold talks
President Vladimir Putin has said Russia will ramp up the production of a new, hypersonic ballistic missile.
In a nationally-televised speech, Mr Putin said the intermediate-range Oreshnik missile was used in an attack on Ukrainian city Dnipro in retaliation for Ukraine’s use of US and British missiles capable of striking deeper into Russian territory.
Referring to the Oreshnik, the Russian president said: “No one in the world has such weapons.
“Sooner or later other leading countries will also get them. We are aware that they are under development.”
Please use Chrome browser for a more accessible video player
Putin’s warning to the West
Russia war latest: Long-awaited US air defences arrive in Ukraine
He added: “We have this system now. And this is important.”
Detailing the missile’s alleged capabilities, Mr Putin claimed it is so powerful that using several fitted with conventional warheads in one attack could be as devastating as a strike with nuclear weapons.
General Sergei Karakayev, head of Russia’s strategic missile forces, said the Oreshnik could reach targets across Europe and be fitted with either nuclear or conventional warheads – while Mr Putin alleged Western air defence systems will not be able to stop the missiles.
Mr Putin said of the Oreshnik: “There is no countermeasure to such a missile, no means of intercepting it, in the world today. And I will emphasise once again that we will continue testing this newest system. It is necessary to establish serial production.”
Read more from Sky News:
What are storm shadow missiles?
How bionic limps are helping Ukrainian troops
Testing the Oreshnik will happen “in combat, depending on the situation and the character of security threats created for Russia“, the president added, stating there is “a stockpile of such systems ready for use”.
NATO and Ukraine are expected to hold emergency talks on Tuesday.
Meanwhile Ukraine’s parliament cancelled a session as security was tightened following the strike on Dnipro, a central city with a population of around one million. No fatalities were reported.
EU leaders condemn Russia’s ‘heinous attacks’
Numerous EU leaders have addressed Russia’s escalation of the conflict with Poland’s Prime Minister Donald Tusk saying the war is “entering a decisive phase [and] taking on very dramatic dimensions”.
Please use Chrome browser for a more accessible video player
Russia’s new missile – what does it mean?
Speaking in Kyiv, Czech foreign minister Jan Lipavsky called Moscow’s strike an “escalatory step and an attempt of the Russian dictator to scare the population of Ukraine and to scare the population of Europe”.
At a news conference, Mr Lipavsky gave his full support for delivering the additional air defence systems needed to protect Ukrainian civilians from the “heinous attacks”.
-
Sports2 years ago‘Storybook stuff’: Inside the night Bryce Harper sent the Phillies to the World Series
-
Sports8 months agoStory injured on diving stop, exits Red Sox game
-
Sports2 years agoMLB Rank 2023: Ranking baseball’s top 100 players
-
Sports1 year agoGame 1 of WS least-watched in recorded history
-
Sports3 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
-
Business2 years agoBank of England’s extraordinary response to government policy is almost unthinkable | Ed Conway