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”.
This is the highest stakes diplomacy via social media.
The American president just posted on his Truth Social platform: “We know exactly where the so-called ‘Supreme Leader’ is hiding.
“He is an easy target, but is safe there – We are not going to take him out (kill!), at least not for now. But we don’t want missiles shot at civilians, or American soldiers.
“Our patience is wearing thin. Thank you for your attention to this matter!”
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It was followed minutes later by “UNCONDITIONAL SURRENDER!”
In real-time, we are witnessing Donald Trump’s extreme version of maximum pressure diplomacy.
He’d probably call it the ‘art of the deal’, but bunker busters are the tool, and it comes with such huge consequences, intended and unintended, known and unknown.
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Nuclear sites targeted in Iran
There is intentional ambiguity in the president’s messaging. His assumption is that he can apply his ‘art of the deal’ strategy to a deeply ideological geopolitical challenge.
It’s all playing out publicly. Overnight, the New York Times, via two of its best-sourced reporters, had been told that Mr Trump is weighing whether to use B-2 aircraft to drop bunker-busting bombs on Iran’s underground nuclear facilities.
Meanwhile, Axios was reporting that a meeting is possible between Trump’s envoy Steve Witkoff and Iran’s foreign minister Abbas Araghchi.
The reporting came just as Mr Trump warned “everyone in Tehran to evacuate”. The nuclear sites being threatened with bunker busters are not in Tehran, but Trump’s words are designed to stoke tension, to confuse and to apply intense pressure.
His actions are too. He left the G7 in Canada early and asked his teams to gather in the White House Situation Room.
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Trump: ‘I want an end, not a ceasefire’
This is a game of smoke, mirrors, brinkmanship and – maybe – bluff. In Tehran, what’s left of the leadership is watching and reading closely as they consider what’s next.
Maybe the Supreme Leader and his regime’s days are numbered. Things remain very unpredictable.
Listen to The World with Richard Engel and Yalda Hakim every Wednesday
From history, though, regime change, even when it comes with a plan – and there is certainly not one here, spells civil war and from that comes a refugee crisis.
These are truly tense and chaotic times.
World
Ukraine war: 14 killed as Russian missile and drone attacks strike Kyiv – including American citizen
Russian missile and drone attacks have killed 14 people in Kyiv overnight, according to Ukrainian officials.
A 62-year-old US citizen who suffered shrapnel wounds is among the dead.
At least 99 others were wounded in strikes that hollowed out a residential building and destroyed dozens of apartments.
Pic: AP
Emergency workers were at the scene to rescue people from under the rubble.
Images show a firefighter was among those hurt, with injured residents evacuated from their homes.
President Volodymyr Zelenskyy described the attack as “one of the most terrifying attacks on Kyiv” – and said Russian forces had fired 440 drones and 32 missiles as civilians slept in their homes.
“[Putin] wants the war to go on,” he said. “It is troubling when the powerful of this world turn a blind eye to it.”
Pic: AP
Ukraine’s interior minister, Ihor Klymenko, said 27 locations across the capital have been hit – including educational institutions and critical infrastructure.
He claimed the attack, in the early hours of Tuesday morning, was one of the largest on the capital since Russia’s full-scale invasion began in February 2022.
Drones swarmed over the city, with an air raid alert remaining in force for seven hours.
One person was killed and 17 others injured as a result of separate Russian drone strikes in the port city of Odesa.
Pic: Reuters
It comes as the G7 summit in Canada continues, which Ukraine’s leader is expected to attend.
Volodymyr Zelenskyy was due to hold talks with Donald Trump – but the president has announced he is unexpectedly returning to Washington because of tensions in the Middle East.
Ukraine’s foreign minister says Moscow’s decision to attack Kyiv during the summit is a signal of disrespect to the US.
Moscow has launched a record number of drones and missiles in recent weeks, and says the attacks are in retaliation for a Ukrainian operation that targeted warplanes in airbases deep within Russian territory.
Kyiv’s mayor Vitali Klitschko says fires broke out in two of the city’s districts as a result of debris from drones shot down by the nation’s air defences.
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Pic: AP
On X, Ukraine’s foreign ministry wrote: “Russia’s campaign of terror against civilians continues. Its war against Ukraine escalates with increased brutality.
“The only way to stop Russia is tighter pressure – through sanctions, more defence support for Ukraine, and limiting Russia’s ability to keep sowing war.”
Olena Lapyshnak, who lived in one of the destroyed buildings, said: “It’s horrible, it’s scary, in one moment there is no life. I can only curse the Russians, that’s all I can say. They shouldn’t exist in this world.”
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