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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.

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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.”

(left to right) Health Secretary Sajid Javid, Prime Minister Boris Johnson and Chancellor of the Exchequer Rishi Sunak look at a CT scanner during a visit to the New Queen Elizabeth II Hospital, Welwyn Garden City, Hertfordshire. Picture date: Wednesday April 6, 2022.
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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.

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Government ministers among eight killed in Ghana helicopter crash

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Government ministers among eight killed in Ghana helicopter crash

Ghana’s defence and environment ministers are among eight killed when a military helicopter crashed, the government has said.

The West African country’s military said the helicopter took off in the morning from the capital Accra and was heading northwest into the interior to the town of Obuasi when it went off the radar.

Footage of the crash site shows debris on fire in a forest as people circle around to help.

The cause of the crash was not immediately known. The military said an investigation was under way.

Defence minister Edward Omane Boamah and environment minister Ibrahim Murtala Muhammed were killed, along with the vice-chair of the National Democratic Congress ruling party, a top national security adviser and the helicopter’s three crew members.

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State media said the aircraft was a Z-9 helicopter, which is often used for transport and medical evacuation.

It was one of the worst air disasters in Ghana in more than a decade.

A service helicopter crashed off the coast in May 2014 and killed at least three people.

And in 2012 a cargo plane overran the runway in Accra and crashed into a bus full of passengers, killing at least 10 people.

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The new space race? NASA accelerates plan to put nuclear reactor on the moon

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The new space race? NASA accelerates plan to put nuclear reactor on the moon

NASA is accelerating plans to put a nuclear reactor on the moon, and they claim it could happen by 2030.

In a directive – a written or oral instruction issued by the US government – to NASA staff earlier this month, Sean Duffy, US transport secretary and the new interim administrator of the space agency, said it should be ready to launch a 100 kilowatt nuclear reactor in five years.

Plans to get a reactor on the lunar surface are not new. The NASA website states the space agency is working on the Fission Surface Power Project to create a system capable of generating at least 40 kilowatts of power – but that is less than half of what Mr Duffy has now proposed.

He also stressed the importance of America’s space agency deploying the technology before China and Russia.

“To properly advance this critical technology, to be able to support a future lunar economy, high power energy generation on Mars, and to strengthen our national security in space, it is imperative the agency move quickly,” the directive, which was first reported on by Politico, states.

Sean Duffy says NASA should be ready to launch a 100 kilowatt nuclear reactor in five years. Pic: Reuters
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Sean Duffy says NASA should be ready to launch a 100 kilowatt nuclear reactor in five years. Pic: Reuters

A nuclear reactor on the moon would be considered a key step towards building a permanent base for humans to live on the lunar surface.

But Mr Duffy warned that the first country to deploy a reactor “could potentially declare a keep-out zone” which he said could significantly inhibit NASA’s Artemis mission – the lunar exploration programme which aims to land astronauts back on the moon in 2027.

When quizzed about the plan on 5 August, he told reporters: “We’re in a race to the moon, in a race with China to the moon. And to have a base on the moon, we need energy.”

Why use a nuclear reactor?

Unlike solar power, which is used on the International Space Station, a small nuclear reactor can operate continuously, Dr Sungwoo Lim, a senior lecturer in space applications, exploration and instrumentation at the University of Surrey told Sky News.

This is critical for infrastructure on the moon, which spends two weeks in complete darkness as it slowly orbits the Earth.

Nuclear reactors therefore diminish the need for sunlight, and can be used to power life support, communications and other critical science instruments, even in darkness.

An artist impression of a nuclear reactor on the moon. Pic: NASA
Image:
An artist impression of a nuclear reactor on the moon. Pic: NASA

“In practice, this means astronauts could use a reactor to establish sustainable bases and extend exploration to places where solar energy is impractical,” Dr Lim adds, including in the moon’s permanently shadowed region, where scientists believe ice water exists.

Professor Mike Fitzpatrick, an expert in nuclear technology at Coventry University, adds that the proposal of a 100 kilowatt nuclear reactor, is relatively small compared to most that are built on Earth.

To put it in real terms, it takes around three kilowatts to power the kettle in your home.

But Prof Fitzpatrick says a smaller reactor could pose as “demonstrator technology”, something small and compact that makes it easier to transport it to the moon.

“Then you can have a whole array of them,” he says.

So, what’s the catch?

While scientists agree that nuclear energy seems like the necessary way to make progress on the moon, Prof Fitzpatrick says questions still remain about safety.

“Shipping the fuel to the moon is relatively safe, because at that point it is not particularly toxic, it is the highly reactive fission products that become the issue,” he says.

“What’s going to be the strategy for long-term storage and disposal on the moon after these plants have operated for certain periods of time? The sooner those conversations are had, and you have international consensus, the less likely it is you’ll get future friction.”

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Four astronauts launch to ISS after delay

Dr Lim also questioned Mr Duffy’s timescale of 2030, saying meeting the target depends heavily on the space agency’s budget.

NASA’s future funding is currently unknown after Donald Trump’s 2026 budget request sought a cut of $6bn (£4.5bn) and the termination of dozens of science programs and missions.

Over 2,000 agency employees are also set to voluntarily leave NASA in the coming months under the Trump administration’s “deferred resignation” programme.

Is this the new space race?

Last year, Russia’s space agency Roscosmos said it was planning to build a lunar nuclear reactor alongside China’s National Space Administration by 2035, in order to power the International Lunar Research Station (ILRS).

The collaboration was never formally announced by China but the joint plan was included in a presentation by Chinese officials in April this year, which outlined the 2028 Chang’e-8 lunar mission which aims to lay the groundwork for the ILRS.

“Duffy explicitly described it as a competition,” says Dr Lim, adding that the move towards lunar exploration signals a renewed moon or space race among major parties like China, Russia, India and the US to claim strategic lunar territory and technology.

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However, Rossana Deplano a professor of international space law at the University of Leicester, says there is a lot of misunderstanding around “keep out” or safety zones, which Mr Duffy’s directive mentions.

“Safety zones are explicitly recognised in the Artemis Accords,” she says.

“They are a notification and consultation zone to be declared in advance in order to avoid harmful interference.

“They must be temporary in nature and do not establish state jurisdiction, e.g. they cannot be enforced.”

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If the IDF has nothing to hide with its military and aid operation, it should allow international journalists into Gaza

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If the IDF has nothing to hide with its military and aid operation, it should allow international journalists into Gaza

Escalating Israel’s military operation in Gaza to the max – which is reportedly what Israel’s prime minister is leaning towards – will stretch an already exhausted army.

No wonder Eyal Zamir, Israel‘s chief of staff, is reportedly reluctant to go down that route, however much of the messaging from the top has been that the Israel Defence Forces (IDF) will follow whatever the political echelon decides.

No wonder, then, that IDF spokesperson Lieutenant Colonel Nadav Shoshani was reluctant to flesh out the implications of an expanded operation or what a full military “occupation” – touted now as having entered Benjamin Netanyahu‘s lexicon – will look like.

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IDF calls some aid site shootings ‘fake news’

As he pointed out, Hamas benefits from international outrage over the spectre of famine in Gaza.

It turns the tide of public opinion against Israel, taking the pressure off Hamas. That may be, in part, why the latest round of ceasefire talks collapsed.

The IDF refuses to accept responsibility for Gaza being on the brink of famine, instead accusing the UN of failing to do their part in an ongoing war of words, although Lt Col Shoshani acknowledged that distributing aid in a war zone is “not simple”.

That is why it should have been left to experts in humanitarian aid distribution – the UN and its agencies, not to US military contractors.

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Gaza airdrops: ‘No one has mercy’

Given the large number of aid-related deaths reported daily, not just by Gaza’s health ministry but also by doctors who are treating the injured and tying up the body bags, there should be greater accountability.

Lt Col Shoshani said the missing link is the proof that it is IDF soldiers doing the shooting. He is right.

If international journalists were granted access to Gaza, to support Palestinian colleagues whose every day involves both the danger of operating in a war zone and the search for food and supplies for their families, then there might be greater accountability.

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Full Israeli occupation of Gaza could massively backfire

Row over checks for Gazans who’ve earned places at UK unis
Sky News unveils pattern of deadly Israeli attacks on families

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It is not sufficient to claim that the IDF operates “in accordance with our values, with our procedures and with international law”, which is what Lt Col Shoshani told Sky News.

That may suffice for Israeli audiences who see very little on their screens of the reality on the ground, but it is not enough for the rest of us – not after 61,000 deaths.

If the IDF has nothing to hide, it should allow international journalists in.

That would alleviate the burden of reporting on Palestinian journalists, at least 175 of whom have lost their lives since the war began.

It would also allow a degree more clarity on what is happening and who is to blame for the hell inside Gaza now.

Journalists demand access in Gaza

More than 100 journalists, photographers and war correspondents have signed a petition demanding “immediate and unsupervised foreign press access to the Gaza Strip”.

Signatories include Sky News’ special correspondent Alex Crawford.

They are renewing calls for both Israel and Hamas to allow foreign journalists into Gaza to report independently on the war, something they have been barred from doing since the start of the latest conflict in 2023.

The petition goes further to say if “belligerent parties” ignore the appeal, media professionals will be supported to enter Gaza without consent “by any legitimate means, independently, collectively, or in coordination with humanitarian or civil society actors”.

Read the full story here.

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