Sir Keir Starmer has said he was “heavily focused” on world affairs before he was forced to U-turn on his welfare bill after rebellion by MPs.

In a piece in The Sunday Times, Sir Keir said he was occupied with the G7 and NATO summits and the escalating tensions in the Middle East for much of the past two weeks.

His “full attention really bore down” on the welfare bill on Thursday, he added.

It comes after the government was forced to U-turn on plans to cut sickness and disability benefits after significant rebellion by Labour MPs earlier this week.

The government has since offered concessions ahead of a vote in the Commons on Tuesday, including exempting existing Personal Independence Payment claimants (PIP) from the stricter new criteria, while the universal credit health top-up will only be cut and frozen for new applications.

Sir Keir defended the U-turn by saying: “Getting it right is more important than ploughing on with a package which doesn’t necessarily achieve the desired outcome.”

He said all the decisions were his and that “I take ownership of them”.

There have been reports that rebel MPs blamed Sir Keir’s chief of staff Morgan McSweeney for the government’s approach.

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Sir Keir said: “My rule of leadership is, when things go well you get the plaudits; when things don’t go well you carry the can.

“I take responsibility for all the decisions made by this government. I do not talk about staff and I’d much prefer it if everybody else didn’t.”

Sir Keir said on Saturday that fixing the UK’s welfare system is a “moral imperative”.

Speaking at Welsh Labour’s annual conference in Llandudno, North Wales, Sir Keir said: “Everyone agrees that our welfare system is broken, failing people every day.

“Fixing it is a moral imperative, but we need to do it in a Labour way, conference, and we will.”

NHS funding could be linked to patient feedback under new plans, with poorly performing services that “don’t listen” penalised with less money.

As part of the “10 Year Health Plan” to be unveiled next week, a new scheme will be trialled that will see patients asked to rate the service they received – and if they feel it should get a funding boost or not.

It will be introduced first for services that have a track record of very poor performance and where there is evidence of patients “not being listened to”, the government said.

This will create a “powerful incentive for services to listen to feedback and improve patients’ experience”, it added.

Sky News understands that it will not mean bonuses or pay increases for the best performing staff.

NHS payment mechanisms will also be reformed to reward services that keep patients out of hospital as part of a new ‘Year of Care Payments’ initiative and the government’s wider plan for change.

Speaking to The Times, chief executive of the NHS Confederation Matthew Taylor expressed concerns about the trial.

He told the newspaper: “Patient experience is determined by far more than their individual interaction with the clinician and so, unless this is very carefully designed and evaluated, there is a risk that providers could be penalised for more systemic issues, such as constraints around staffing or estates, that are beyond their immediate control to fix.”

He said that NHS leaders would be keen to “understand more about the proposal”, because elements were “concerning”.

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Health Secretary Wes Streeting said: “We will reward great patient care, so patient experience and clinical excellence are met with extra cash. These reforms are key to keeping people healthy and out of hospital, and to making the NHS sustainable for the long-term as part of the Plan for Change.”

In the raft of announcements in the 10 Year Health Plan, the government has said 201 bodies responsible for overseeing and running parts of the NHS in England – known as quangos – will be scrapped.

These include Healthwatch England, set up in 2012 to speak out on behalf of NHS and social care patients, the National Guardian’s Office, created in 2015 to support NHS whistleblowers, and the Health Services Safety Investigations Body (HSSIB).

The head of the Royal College of Nursing described the move as “so unsafe for patients right now”.

Professor Nicola Ranger said: “Today, in hospitals across the NHS, we know one nurse can be left caring for 10, 15 or more patients at a time. It’s not safe. It’s not effective. And it’s not acceptable.

“For these proposed changes to be effective, government must take ownership of the real issue, the staffing crisis on our wards, and not just shuffle people into new roles. Protecting patients has to be the priority and not just a drive for efficiency.”

Elsewhere, the new head of NHS England Sir Jim Mackey said key parts of the NHS appear “built to keep the public away because it’s an inconvenience”.

“We’ve made it really hard, and we’ve probably all been on the end of it,” he told the Daily Telegraph.

“The ward clerk only works nine to five, or they’re busy doing other stuff; the GP practice scrambles every morning.”

Carrie Johnson – the wife of former prime minister Boris Johnson – has revealed she was admitted to hospital with severe dehydration, as she offered advice to other breastfeeding mothers in the hot weather.

Mrs Johnson, 37, posted a picture of herself and her newborn daughter Poppy Eliza Josephine on Friday in a hospital bed.

“Being hospitalised for two nights for severe dehydration was not on my postpartum bingo card,” she captioned the Instagram post.

Mrs Johnson urged other “breastfeeding mums” to make sure they eat and drink enough “in this heat”, especially those who are “clusterfeeding”.

Poppy was born on 21 May, becoming the couple’s fourth child after their son Frank, born in July 2023, daughter Romy, born in December 2021, and son Wilfred, born in April 2020.

In a separate Instagram story, Mrs Johnson described an “honestly brutal week”.

“Mastitis (me), reflux (her), dehydration (me). What a pair we are!,” she said.

“But thank you for all the kind messages, especially all the brilliant advice on reflux. Really appreciate it and made me feel way less alone going thru (sic) it all. And as ever, thanks to our amazing NHS.”

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The NHS recommends drinking plenty of fluids while breastfeeding – and avoiding caffeine and alcohol to stop their effects being passed on to the baby.

Having a drink nearby when mothers stop to feed is advised, as is water, lower-fat milk, and low-sugar drinks.

The UK Health Security Agency (UKHSA) has issued an amber heat health alert for the next four days.

Although not a public weather warning, it advises health and social care organisations of possible dangers to their patients and facilities.

Temperatures could reach 34C on Monday – with a 20% chance of beating the hottest June day on record of 35.6C from 1976.

The likelihood of record-breaking temperatures could increase over the weekend as the day approaches.