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.
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.
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“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.”
Image: 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.
Gaza’s health ministry has removed 1,852 people from its official list of war fatalities since October, after finding that some had died of natural causes or were alive but had been imprisoned.
The list of deaths currently stands at 50,609 following the removals. Gaza’s health ministry records do not distinguish between civilians and combatants.
Almost all of the names removed (97%) had initially been submitted through an online form which allows families to record the deaths of loved ones where the body is missing.
The head of the statistics team at Gaza’s health ministry, Zaher Al Wahidi, told Sky News that names submitted via the form had been removed as a precautionary measure pending a judicial investigation into each one.
“We realised that a lot of people [submitted via the form] died a natural death,” Mr Wahidi said. “Maybe they were near an explosion and they had a heart attack, or [living in destroyed] houses caused them pneumonia or hypothermia. All these cases we don’t [attribute to] the war.”
Others submitted via the form were found to be imprisoned or to be missing with insufficient evidence that they had died.
Some families submitting false claims, Mr Wahidi said, may have been motivated by the promise of government financial assistance.
It is the largest removal of names from the list since the war began, and comes after 1,441 names were removed between August and October – 54% of them originating in hospital morgue records rather than the online form.
Mr Wahidi says his team audited the hospital data after receiving complaints from people who had ended up on the list despite being alive.
They found that hospital clerks, when operating without access to the central population registry and lacking full names or dates of birth for the dead, had marked the wrong people as dead in their records.
In total, 8% of people who were listed as dead in August have since been removed from the official death toll. Many of those may later be added back in, as the judicial investigations proceed.
‘It doesn’t look like manipulation’
Gabriel Epstein, a research assistant at US thinktank The Washington Institute for Near East Policy, said there’s no reason to think the errors are the result of deliberate manipulation intended to inflate the share of women and children among the dead.
“If 90% of the removed entries were men aged 18-40, that would look like manipulation,” he said. “But it doesn’t look like that.”
Of those entries removed since the start of the war and whose demographic information was recorded, 41% are men aged 18 to 60, while 59% are women, children and elderly people.
By comparison, 44% of remaining deaths are working-age men. This means that the removals have had the effect of slightly reducing the share of women and children in the official list.
Names were previously added to the list without verification
Until October, Mr Wahidi said, names submitted via the online form had been added to the official list of registered deaths before undergoing a judicial confirmation process.
The publication of unverified deaths submitted via the form had previously led to issues with the data, with 1,295 deaths submitted via the form being removed from the list prior to October. This included 474 people who were later added back again.
Sky News previously understood that names from the form were only published after undergoing judicial confirmation. However, Mr Wahidi says this practice only began in October.
“This does cause me to downgrade the quality of the earlier lists, definitely below where I thought they were,” said Professor Michael Spagat, chair of Every Casualty Counts, an independent civilian casualty monitoring organisation.
A Ministry of Health document from July 2024 confirms that names submitted through the online form were, at the time, included in the official fatality list before being verified.
These names “are initially included in the final count of martyrs, but verification procedures are undertaken afterward”, the document says.
“They basically said that they were posting these things provisionally pending investigation,” said Prof Spagat.
“There may have been literally zero people, including us, who actually absorbed this message, but they weren’t hiding it either.”
More than 1,200 Israelis have been killed in the 7 October attack and ensuing war.
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Global financial markets gave a clear vote of no-confidence in President Trump’s economic policy.
The damage it will do is obvious: costs for companies will rise, hitting their earnings.
The consequences will ripple throughout the global economy, with economists now raising their expectations for a recession, not only in the US, but across the world.
At least 19 people, including nine children, have been killed in a Russian attack on Volodymyr Zelenskyy’s home city, according to Ukrainian officials.
Around 50 people were also wounded in the attack, according to emergency services, and regional governor Serhiy Lysak said more than 30, including a three-month-old baby, were in hospital.
“Every missile, every strike drone proves that Russia only wants war.
“And only on the pressure of the world on Russia, on all efforts to strengthen Ukraine, our air defence, our forces – only on this does it depend when the war will end.”
Russia’s defence ministry claimed it had struck a military gathering – a statement denounced by the Ukrainian military as misinformation.
Mr Lysak wrote on the Telegram messaging app that 18 people were killed when a missile hit residential areas and sparked fires.
Later on Friday, Russian drones attacked homes and killed one person, Oleksandr Vilkul, the city’s military administrator, said.
Local authorities said the missile strike damaged about 20 apartment buildings, more than 30 vehicles, an educational building and a restaurant.
They said emergency responders were at the scene and psychologists were helping survivors.
Confirming the “high-precision strike”, the Russian defence ministry said on Telegram it targeted “a meeting of unit commanders and Western instructors” in a city restaurant.
“As a result of the strike, enemy losses total up to 85 servicemen and officers of foreign countries, as well as up to 20 vehicles,” the ministry added.
Image: Pic: Telegram/Zelenskyy
Image: Pic: Telegram/Zelenskyy
US ‘not interested in negotiations about negotiations’
It comes after the US secretary of state issued a veiled threat to Russia as talks about a ceasefire with Ukraine continue.
Speaking in Brussels during a NATO meeting, Marco Rubio said the US was “not interested in… negotiations about negotiations”.
“We’re testing to see if the Russians are interested in peace. Their actions – not their words, their actions – will determine whether they’re serious or not, and we intend to find that out sooner rather than later,” he said.
Since then, the warring countries have accused each other of violating the energy ceasefire.
UK Foreign Secretary David Lammy, who was also in Brussels on Fridaym said Vladimir Putin “continues to obfuscate, continues to drag his feet” on ceasefire talks.
He added that while the Russian president should be accepting a ceasefire, “he continues to bombard Ukraine, its civilian population, its energy supplies”.
“We see you, Vladimir Putin. We know what you are doing,” he said.