Patients should be charged for GP appointments and A&E visits to ease waits, Sajid Javid says
Sajid Javid has said patients should be charged for GP appointments and A&E visits, as he called the current model of the NHS “unsustainable”.
Writing in an op-ed for The Times, the former health secretary said “extending the contributory principle” should be part of radical reforms to combat growing waiting times.
He also called for a “grown-up, hard-headed conversation” about revamping the health service, noting that “too often the appreciation for the NHS has become a religious fervour and a barrier to reform”.
Downing Street said the prime minister is not “currently” considering the proposals.
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Prime Minister Rishi Sunak had previously set out plans to fine patients who missed their GP and hospital appointments £10 as he was campaigning for the Tory leadership.
But he scrapped the idea following widespread criticism by health leaders.
Mr Javid proposed that the NHS should replace making people wait with means-tested fees, while “protecting those on low incomes”.
“We should look, on a cross-party basis, at extending the contributory principle,” he wrote.
“This conversation will not be easy, but it can help the NHS ration its finite supply more effectively.”
The Bromsgrove MP, who will not stand at the next election, highlighted Ireland’s “nominal” 75 euro (£66) fees for going to an injury unit without a referral, and £20 fees for GP appointments in Norway and Sweden as possible models.
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“Too often the appreciation for the NHS has become a religious fervour and a barrier to reform,” the Bromsgrove MP also said.
“We need to shake off the constraints of political discourse and start having a grown-up, hard-headed conversation about alternatives.”
Mr Javid argued in the piece that “the 75-year-old model of the NHS is unsustainable”.
His proposal comes amid increased calls for an overhaul of the NHS, and not just from within the Tory party.
Labour’s shadow health secretary Wes Streeting told The Guardian: “Reform is not a Conservative word.
“In recent elections, the left has given a lot of people the impression the answer to everything is to pour more money in. Of course investment is needed in the NHS, but ask any patient about their miserable experiences and it’s partly about culture and systems. That’s got to change too.”
It comes after the PM repeatedly refused over the past week to answer whether he uses the NHS or pays for private healthcare, before revealing he is registered with an NHS GP but has used private healthcare “in the past”.
Pakistan has launched attacks on “multiple targets” across India, according to the media wing of Pakistan’s military.
Pakistan said in a statement that retaliatory attacks are underway in response to what it called “continuous provocation” by India, which fired missiles at three air bases inside Pakistan.
“Multiple targets in this operation are being engaged all across India,” the statement from Pakistan Armed Forces (PAF) said.
Pakistan’s military said it used medium-range Fateh missiles to strike more than 25 military sites, including airbases and weapons depots in the Indian states of Gujarat, Punjab and Rajasthan, as well as locations in India-administered Kashmir.
Pakistan’s military posted footage on X showing missiles being fired from what appeared to be a mobile launcher.
Pic: MilitaryPakISPR
The AP news agency also said loud explosions have been heard in India-administered Kashmir, in the disputed region’s two big cities of Srinagar and Jammu, and the garrison town of Udhampur.
Meanwhile, an Indian military source told Reuters that India has launched air operations in Pakistan, although no further details were given.
The operations mark the latest escalation in a conflict between the two nuclear-armed rivals, triggered by a deadly attack last month in India-administered Kashmir.
Most of the 26 civilians killed were Hindu Indian tourists. India blames Pakistan for backing the assault, an accusation Islamabad rejects.
Pakistan’s Prime Minister Shehbaz Sharif has called a meeting of the National Command Authority, the body which takes security decisions, including those related to the country’s nuclear arsenal.
State-run Pakistan television said three air bases were struck by India on Friday, although Pakistan insisted most of the missiles had been intercepted.
Despite the military offensive, PAF also posted a message on X in what appeared to represent an opportunity to de-escalate the situation.
“Now that a response has been given we hope the neighbour [India] will move to dialogue and diplomacy like Civilized Nations,” it said.
In recent days, both countries have launched a series of missile and drone strikes, although the scale and impact have been consistently questioned by each other.
On Wednesday, India conducted airstrikes on several sites in Pakistani territory. Pakistan said it shot down five Indian fighter jets.
On Thursday, India claimed to have repelled drone and missile attacks at military targets in more than a dozen cities and towns, including Jammu in India-administered Kashmir. Meanwhile, India claimed it struck Pakistan’s air defence systems and radars close to the city of Lahore.
A damaged house in Jammu, in Indian-administered Kashmir, after a Pakistani drone attack. Pic: AP
The Indian army said on Friday that Pakistan fired about 300 to 400 drones, targeting military installations along the western borders – a claim strongly denied by Pakistan.
The G7 group of advanced economies, which includes Canada, France, Germany, Italy, Japan, the US and Britain, urged maximum restraint from both India and Pakistan.
“We call for immediate de-escalation and encourage both countries to engage in direct dialogue towards a peaceful outcome,” a statement issued on Friday said.
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World
European leaders to meet in Ukraine for ‘coalition of the willing’ talks – and issue call to Russia
Sir Keir Starmer will join other European leaders in Kyiv on Saturday for talks on the “coalition of the willing”.
The prime minister is attending the event alongside French President Emmanuel Macron, recently-elected German Chancellor Friedrich Merz and Polish Prime Minister Donald Tusk.
It will be the first time the leaders of the four countries will travel to Ukraine at the same time – on board a train to Kyiv – with their meeting hosted by President Volodymyr Zelenskyy.
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Sir Keir Starmer, Emmanuel Macron and Friedrich Merz travelling in the saloon car of a special train to Kiev. Pic: Reuters
Military officers from around 30 countries have been involved in drawing up plans for the coalition, which would provide a peacekeeping force in the event of a ceasefire being agreed between Russia and Ukraine.
Ahead of the meeting on Saturday, Sir Keir, Mr Macron, Mr Tusk and Mr Merz released a joint statement voicing support for Ukraine and calling on Russia to agree to a 30-day ceasefire.
Sir Keir and Volodymyr Zelenskyy during a meeting in March. Pic: AP
“We reiterate our backing for President Trump’s calls for a peace deal and call on Russia to stop obstructing efforts to secure an enduring peace,” they said.
“Alongside the US, we call on Russia to agree a full and unconditional 30-day ceasefire to create the space for talks on a just and lasting peace.”
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The leaders said they were “ready to support peace talks as soon as possible”.
But they warned that they would continue to “ratchet up pressure on Russia’s war machine” until Moscow agrees to a lasting ceasefire.
“We are clear the bloodshed must end, Russia must stop its illegal invasion, and Ukraine must be able to prosper as a safe, secure and sovereign nation within its internationally recognised borders for generations to come,” their statement added.
“We will continue to increase our support for Ukraine.”
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The European leaders are set to visit the Maidan, a central square in Ukraine’s capital where flags represent those who died in the war.
They are also expected to host a virtual meeting for other leaders in the “coalition of the willing” to update them on progress towards a peacekeeping force.
This force “would help regenerate Ukraine’s armed forces after any peace deal and strengthen confidence in any future peace”, according to Number 10.
World
Ten explosions near international airport in India-administered part of Kashmir, officials say
Ten explosions have been heard near Srinagar International Airport in India-administered parts of Kashmir, officials have told Reuters news agency.
The blasts followed blackouts caused by multiple projectiles, which were seen in the sky above the city of Jammu earlier on Friday.
Explosions were also heard in the Sikh holy city of Amritsar, in the neighbouring Punjab state, according to Reuters.
An Indian military official told the agency that “drones have been sighted” and “they are being engaged”.
It comes as tensions between India and Pakistan across the line of control around the region of Kashmir have boiled over this week, leading to fears of a wider conflict.
On Wednesday morning, India carried out missile strikes in Pakistan and Pakistan-administered parts of the disputed region.
The retaliation came weeks after 26 people, mainly Indian tourists, were shot dead by gunmen in an India-administered part of Kashmir last month.
The government in India said it hit nine “terrorist infrastructure” sites, while Pakistan said it was not involved in the April attack and the sites were not militant bases.
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Explained: India-Pakistan conflict
Around 48 people have been killed since Wednesday, according to casualty estimates on both sides – which have not been independently verified.
India also suspended its top cricket tournament, the Indian Premier League, as a result of rising tensions, while the Pakistan Super League moved the remainder of its season to the United Arab Emirates.
Meanwhile, White House press secretary Karoline Leavitt said at a conference on Friday that the US is in constant contact with both India and Pakistan.
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