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Labour peer and professor Lord Winston has admitted he is “not optimistic” about the future of the NHS as the health service celebrates its 75th anniversary.

The distinguished professor said he did not believe enough money was being spent organising how the NHS is run and that “national poverty” was undermining the delivery of the health service.

“We’ve got the largest employer, perhaps in the world…and the amount of money spent on the administration is absolutely insignificant,” he told Sky News presenter Mark Austin.

“And actually, the need to administer that far more effectively is really clear – it doesn’t matter whether that is in the health service or general practice or certainly in social care, but I think that’s one thing we need to keep in mind.”

Lord Winston, who is one of Britain’s leading medical experts on the study of fertility, said an increase in funding for primary care in recent years had “not actually helped the health service that much” because the key issue was “national poverty”, which he described as a “massive problem in Britain”.

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“We are a poor country because we’ve not managed our finances,” he said, adding that poverty had also had a knock-on effect on education and the environment.

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The Emeritus Professor of Fertility Studies at Imperial College London appeared alongside Dame Clare Gerada, president of the Royal College of General Practitioners, who also said the NHS was picking up wider problems in society.

“Over the last 10-15 years we have seen social determinants of health get worse – green spaces, homelessness, poor housing, poor nutrition – and the NHS is picking up those issues,” she said.

“We’ve also seen our economy go down.

“It’s very complex. If you are saying to me should the NHS change, then yes of course it should change.

“We need to be delivering much more care – in primary care, in general practice and in the community.”

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Lord Winston ‘not optimistic on NHS’

Dame Clare said that unless there were three major shifts – in prevention, personalised care and shifting resources in primary care, “then I do fear for the future of the NHS”.

Lord Winston and Dame Clare made the remarks in a special programme by Sky News to mark the 75th anniversary, asking the central question: can we mend the NHS?

As well as Lord Winston, other NHS experts have cast doubt over the future of the health service.

In a speech to mark the anniversary of its creation, Amanda Pritchard, the head of the NHS in England, warned the service faced a future of “enormous challenges” as a “cornerstone of national life” in Britain.

She said its staff were battling a combination of COVID backlogs and record demand for services – challenges that workers were ready to meet “head on”.

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The state of the NHS explained

Meanwhile, other experts warned that the NHS – created in July 1948 – may not reach its 100th birthday without more resources and fundamental reforms.

The warning, by three leading thinktanks – the King’s Fund, the Health Foundation and the Nuffield Trust – blamed short-term policymaking and a decade of underinvestment, which they said had left the NHS in a “critical condition”.

Separately, NHS Providers – which represents hospital trusts – warned of “enormous pressures” amid a record rise in demand for care and “the biggest financial squeeze in its history”.

Last week, Rishi Sunak unveiled the NHS workforce plan, which would see £2.4bn funnelled into solving the severe staffing crisis in NHS England.

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NHS in ‘critical condition’ at 75 years

Ministers are also aiming to more than halve the number of NHS staff being recruited from abroad in the next 15 years, in order to train more NHS staff domestically to “reduce reliance on international recruitment and agency staff”.

Read more:
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Health secretary refuses to accept austerity cuts contributed to NHS woes

Staffing vacancies currently stand at 112,000, with fears shortfalls could grow to 360,000 by 2037.

The additional funding will help train “record numbers of doctors, nurses, dentists, and other healthcare staff” in England, with plans to employ 300,000 extra staff in the coming years. The funding works out at approximately £21,000 per vacancy.

Asked about the NHS workforce plan announced by the prime minister last week, Lord Winston warned it will take at least a decade to have an impact, especially because the NHS was “losing people all the time” due to disenchantment and early retirement.

“That’s an issue which the government has failed completely to tackle,” he said.

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Rohingya refugees in Bangladesh being forced to fight for same military accused of genocide against their people

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Rohingya refugees in Bangladesh being forced to fight for same military accused of genocide against their people

Cox’s Bazar in Bangladesh is a sprawling mass of humanity. 

It’s a sea of makeshift bamboo shelters, home to more than one million Rohingya refugees – a mainly Muslim minority from Rakhine state in Myanmar.

Some 700,000 fled their homeland back in 2017 – after the Myanmar military massacred thousands.

The army was accused of genocide by the United Nations.

The Rohingya refugees didn’t escape danger though.

Right now, violence is at its worst levels in the camps since 2017 and Rohingya people face a particularly cruel new threat – they’re being forced back to fight for the same Myanmar military accused of trying to wipe out their people.

A child at the refugee camp in Cox's Bazar
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A child at the refugee camp in Cox’s Bazar

Militant groups are recruiting Rohingya men in the camps, some at gunpoint, and taking them back to Myanmar to fight for a force that’s losing ground.

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Jaker is just 19.

We’ve changed his name to protect his identity.

He says he was abducted at gunpoint last year by a group of nine men in Cox’s.

They tied his hands with rope he says and took him to the border where he was taken by boat with three other men to fight for the Myanmar military.

“It was heartbreaking,” he told me. “They targeted poor children. The children of wealthy families only avoided it by paying money.”

And he says the impact has been deadly.

“Many of our Rohingya boys, who were taken by force from the camps, were killed in battle.”

Jaker speaks to Sky's Cordelia Lynch
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Jaker speaks to Sky’s Cordelia Lynch

An aerial view of the refugee camp in Cox's Bazar
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An aerial view of the refugee camp in Cox’s Bazar

The situation in Cox’s is desperate.

People are disillusioned by poverty, violence and the plight of their own people and the civil war they ran from is getting worse.

In Rakhine, just across the border, there’s been a big shift in dynamics.

The Arakan Army (AA), an ethnic armed group has all but taken control of the state from the ruling military junta.

Both the military and the AA are accused of committing atrocities against Rohingya Muslims.

And whilst some Rohingya claim they’re being forced into the fray – dragged back to Myanmar from Bangladesh, others are willing to go.

Read more from Sky News:
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Inside Bangladesh’s ‘death squad’ jails

Sri Lanka rescues more than 100 people believed to be Rohingya refugees

Teknaf in Cox's Bazar - where refugees arrive from Myanmar after crossing the Naf River
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Teknaf in Cox’s Bazar – where refugees arrive from Myanmar after crossing the Naf River

Some are so aggrieved with the AA, they’re willing to support their former persecutors.

Abu Zar is one of those willing to take up arms.

But not for the military or AA, he says.

Everyone praying in the mosque with him is prepared to go back to protect their own cause he says – not anyone else’s.

“We want to fight for our rights because we have been demanding justice for a long time. But the situation has become unbearable,” he tells me.

Abu Zar has said he is willing to take up arms for his own cause
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Abu Zar has said he is willing to take up arms for his own cause

It’s estimated between 3,000 and 5,000 Rohingya have joined armed groups from this camp.

But the fight they are joining has become increasingly bloody.

In a cramped shelter, we meet Safura.

Safura came under fire as she fled Myanmar
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Safura came under fire as she fled Myanmar

Safura's son Aman had his foot blown off
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Safura’s son Aman had his foot blown off

Five days ago she managed to get out of Myanmar but she had to be carried part of the way.

Her legs are riddled with bullet wounds and the pain is severe.

Her son, Aman, who lies on the floor next to her, has had his foot blown off.

They were injured she said, during an attack on her family home in the middle of the night.

“They entered our house and shot all my family members. My husband and mother-in-law were killed on the spot.”

The military denies forcing Rohingya to the battlefield. But the camps tell a different story- one of surging violence and vulnerability.

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Trump tells Gazans ‘you are dead’ if Israeli hostages are not immediately handed over

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Trump tells Gazans 'you are dead' if Israeli hostages are not immediately handed over

US President Donald Trump has told Gazans to hand over Israeli hostages or “you are dead”.

The threat, made over social media, came hours after the White House confirmed that US officials had broken with tradition to hold direct talks with Hamas.

The US has previously avoided direct contact with the group owing to Washington’s longstanding position not to negotiate with terrorists – with Hamas having been designated as a terrorist group in the US since 1997.

In a press conference on Wednesday, White House press secretary Ms Keavitt said there had been “ongoing talks and discussions” between the US officials and Hamas.

President Donald Trump addresses a joint session of Congress. Pic: AP
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File pic: AP

But she would not be drawn on the substance of the talks – taking place in Doha, Qatar – between US officials and Hamas, but said Israel had been consulted.

Ms Leavitt continued: “Dialogue and talking to people around the world to do what’s in the best interest of the American people, is something that the president has proven is what he believes is a good faith, effort to do what’s right for the American people.”

There are “American lives at stake,” she added.

Adam Boehler, Mr Trump’s pick to be special envoy for hostage affairs, participated in the direct talks with Hamas.

A spokesperson for Benjamin Netanyahu’s office said Israel had “expressed to the United States its position regarding direct talks with Hamas”.

Hours later, Mr Trump warned Hamas to hand over Israeli hostages or “it’s over for you” – adding: “This is your last warning”.

Hamas militants on the day of a hostage handover in Gaza. Pic: Reuters
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Hamas militants on the day of a hostage handover in Gaza in February. Pic: Reuters

On his Truth Social platform, Mr Trump wrote: “Release all of the hostages now, not later, and immediately return all of the dead bodies of the people you murdered or it is over for you.

“Only sick and twisted people keep bodies and you are sick and twisted. I am sending Israel everything it needs to finish the job, not a single Hamas member will be safe if you don’t do as I say.”

Mr Trump met with freed Israeli hostages on Wednesday, something he referenced in his social media post, before adding: “This is your last warning. For the leadership of Hamas, now is the time to leave Gaza, while you still have a chance.

“Also, to the people of Gaza, a beautiful future awaits, but not if you hold hostages. If you do, you are dead. Make a smart decision. Release the hostages now, or there will be hell to pay later.”

Israel estimates about 24 living hostages, including American citizen Edan Alexander, and the bodies of at least 35 others, are still believed to be in Gaza.

Donald Trump welcomes Benjamin Netanyahu to the White House. Pic: Reuters
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Donald Trump with Benjamin Netanyahu in February. Pic: Reuters

The US has a long-held policy of not negotiating with terrorists – which it is breaking with these talks as Hamas has been designated a foreign terrorist organisation by the US government’s National Counterterrorism Center since 1997.

The discussions come as a fragile Israel-Hamas ceasefire continues to hold, but its future is uncertain.

Palestinians walk among the rubble of buildings, amid a ceasefire between Israel and Hamas, in Khan Younis, in the southern Gaza Strip, February 27, 2025. REUTERS/Ramadan Abed
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Palestinians amid the rubble in the southern Gaza strip. Pic: Reuters

Mr Trump has signalled he has no intention of pushing the Israeli prime minister away from a return to combat if Hamas does not agree to terms of a new ceasefire proposal – which, Israel says, has been drafted by US Middle East envoy Steve Witkoff.

The new plan would require Hamas to release half its remaining hostages – the group’s main bargaining chip – in exchange for a ceasefire extension and a promise to negotiate a lasting truce.

Read more:
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Israel has made no mention of releasing more Palestinian prisoners, a key component of the first phase.

Fighting in Gaza has been halted since 19 January.

Hamas has exchanged 33 Israeli and five Thai hostages for some 2,000 Palestinian prisoners and detainees.

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Trump admits tariffs ‘disturbance’ as China says it is ‘ready for any type of war’ with US

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Trump admits tariffs 'disturbance' as China says it is 'ready for any type of war' with US

Donald Trump has admitted his tariffs on major trading partners will cause “a little disturbance” – as China said it was “ready” for “any type of war” with the US.

The US president made his comments in an address to Congress, hours after the levies on imports came into effect.

Producers in Mexico and Canada have been hit with a 25% tax on items they export to the US, while a 20% tariff has been applied to Chinese imports.

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Donald Trump and Xi Jinping.
Pic:Reuters/AP
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Donald Trump and Chinese President Xi Jinping. The US president has admitted his tariffs will cause ‘a little disturbance’ – as China responds. Pic: Reuters/AP

Stock markets, which Mr Trump is said to pay close attention to, slid on the tariffs news.

Exporters in the affected countries as well as businesses in the US and economists have raised concerns about the potential price-raising impact of the tariffs.

Making imports more expensive will likely make goods more expensive and could push prices up across the board.

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Trump’s Congress speech unwrapped

Concern over threat to interest rates

A cycle of high inflation could lead to interest rates being higher for longer in the US, the world’s largest economy, which could dampen economic activity.

A slowed US economy would have global consequences but even without a hit to the States, there are fears of a global trade war – in which countries add their own trade barriers in the form of tariffs.

The Chinese embassy in the US posted on X: “If war is what the US wants, be it a tariff war, a trade war or any other type of war, we’re ready to fight till the end.”

China imposes retaliatory tariffs

The president, however, said he was “just getting started” after 43 days into his second term.

China and Canada have retaliated with their own tariffs against the US.

From next week China will add its own 15% levy on a range of agricultural products such as chicken, wheat, corn and cotton.

An extra 10% will be added to soya beans, pork, beef, fruit, vegetables and dairy products imports.

The country has also raised additional complaints against the US with the World Trade Organisation (WTO).

Read more:
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‘Dumb’: Canadian PM criticises Trump over tariffs
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Speaking to Sky News presenter Yalda Hakim the US former deputy national security advisor Matt Pottinger said Chinese president Xi Jinping was turning the Chinese economy “into a wartime economy”

“He’s preparing his economy for war so that it can withstand the shocks of war,” he said on The World with Richard Engel and Yalda Hakim podcast

“That means he’s willing to undergo massive inefficiencies in the economy. He’s willing to stockpile food that otherwise would flow easily and more cheaply in from foreign vessels.”

“He’s stockpiling copper and all kinds of inputs into the economy. He is making sure that the private sector is wholly aligned with his broad goals, which are about increasing the Chinese Communist Party’s control over the economy and creating a bigger, better defence industrial base,” Mr Pottinger said.

“He’s preparing for war.”

👉Listen to The World with Richard Engel and Yalda Hakim on your podcast app👈

Compromise ‘as early as Wednesday’?

Canada’s prime minister Justin Trudeau said his country was launching its own WTO challenge and described the US tariffs as a “dumb thing to do”.

He also warned the move by the Trump administration would impact American workplaces and add to inflation in the US.

Addressing the American public, he said: “We don’t want this… but your government has chosen to do this to you.”

Canada has announced the imposition of 25% tariffs on US imports worth C$30bn (£16.3bn).

But US commerce secretary Howard Lutnick struck a different note on tariffs and on Monday said the president will “probably” announce a compromise with Canada and Mexico as early as Wednesday.

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