New-found freedom allows former health secretary Sajid Javid to talk honestly about NHS big picture
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.
Read more: Ex-health secretary issues warning over NHS
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.”
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.
Russia has launched a “massive” drone and missile attack on the Ukrainian capital overnight, after Moscow itself was targeted.
Amid flailing peace talks, the Kremlin’s nightly attacks on Ukraine continued.
Ukraine war – follow the latest updates
A large-scale Russian attack through the night into Sunday injured at least 11 in Kyiv and killed three people in towns surrounding the capital.
There were attacks elsewhere as well, including drone strikes in Mykolaiv, where a residential building was hit.
An apartment building destroyed after a Russian attack in Mykolaiv. Pic: State Emergency Service of Ukraine
‘Massive’ attack
In Kyiv, the city’s administration warned “the night will be difficult”, as people were urged to remain in shelters.
The city’s mayor Vitaliy Klitschko described it as a “massive” attack.
He said: “Explosions in the city. Air defence forces are working. The capital is under attack by enemy UAVs. Do not neglect your safety! Stay in shelters!”
It came after at least 15 people were injured in attacks the night prior.
Russia claimed it also faced a Ukrainian drone attack on Sunday, and that it intercepted and destroyed around 100 of them near Moscow and across Russia’s central and southern regions.
A municipality worker cleans up after a Russian drone strike on Kyiv. Pic: Reuters
Russia ‘dragging out the war’
Meanwhile, Russia and Ukraine continued a prisoner exchange, marking a rare moment of cooperation in the war.
Amid the most recent attacks, Ukrainian President Volodymyr Zelenskyy repeated his calls for sanctions on Russia.
Russia “fills each day with horror and murder” and is “simply dragging out the war”, he said.
A resident looks at an apartment building that was damaged in a Russian drone strike. Pic: Reuters
“All of this demands a response – a strong response from the United States, from Europe, and from everyone in the world who wants this war to end,” Mr Zelenskyy added.
Every day “gives new grounds for sanctions against Russia”, he said, and each day without pressure proves the “war will continue”.
Ukraine, meanwhile, is ready for “any form of diplomacy that delivers real results”.
Nine of a doctor’s 10 children have been killed in an Israeli missile strike on their home in Gaza, which also left her surviving son badly injured and her husband in a critical condition.
Warning: This article contains details of child deaths
Alaa Al Najjar, a paediatrician at Al Tahrir Clinic in the Nasser Medical Complex, was at work during the attack on her home, south of the city of Khan Younis in southern Gaza, on Friday.
Graphic footage shared by the Hamas-run Palestinian Civil Defence shows the bodies of at least seven small children being pulled from the rubble.
Rescuers can be seen battling fires and searching through a collapsed building, shouting out when they locate a body, before bringing the children out one by one and wrapping their remains in body bags.
In the footage, Dr Al Najjar’s husband, Hamdi Al Najjar, who is also a doctor, is put on to a stretcher and then carried to an ambulance.
The oldest of their children was only 12 years old, according to Dr Muneer Alboursh, the director general of Gaza’s health ministry, which is run by Hamas.
Nine children were killed in the strike. Pic: Palestinian Civil Defence
“This is the reality our medical staff in Gaza endure. Words fall short in describing the pain,” he wrote in a social media post.
“In Gaza, it is not only healthcare workers who are targeted – Israel’s aggression goes further, wiping out entire families.”
Pic: Palestinian Civil Defence
British doctors describe ‘horrific’ and ‘unimaginable’ attack
Two British doctors working at Nasser Hospital described the attack as “horrific” and “unimaginable” for Dr Al Najjar.
Speaking in a video diary on Friday night, Dr Graeme Groom said his last patient of the day was Dr Al Najjar’s 11-year-old son, who was badly injured and “seemed much younger as we lifted him on to the operating table”.
Hamdi Al Najjar, Dr Al Najjar’s husband who is also a doctor, was taken to hospital. Pic: Palestinian Civil Defence
The strike “may or may not have been aimed at his father”, Dr Groom said, adding that the man had been left “very badly injured”.
Dr Victoria Rose said the family “lived opposite a petrol station, so I don’t know whether the bomb set off some massive fire”.
Pic: Palestinian Civil Defence
‘No political or military connections’
Dr Groom added: “It is unimaginable for that poor woman, both of them are doctors here.
“The father was a physician at Nasser Hospital. He had no political and no military connections. He doesn’t seem to be prominent on social media, and yet his poor wife is the only uninjured one, who has the prospect of losing her husband.”
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Nineteen of Gaza’s hospitals remain operational, all of them are overwhelmed with the number of patients and a lack of supplies
He said it was “a particularly sad day”, while Dr Rose added: “That is life in Gaza. That is the way it goes in Gaza.”
Sky News has approached the Israeli Defence Forces for comment.
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Israel’s war against Hamas in Gaza began when the militant group stormed across the border into Israel on 7 October 2023, killing some 1,200 people, most of them civilians, and abducting 251 others.
Israel’s military response has flattened large areas of Gaza and killed more than 53,000 Palestinians, mostly women and children, according to Gaza’s Hamas-run health ministry, which does not differentiate between civilians and combatants in its count.
World
UN’s Antonio Guterres condemns ‘teaspoon’ of aid allowed into Gaza after dozens die in airstrikes
The head of the UN has said Israel has only authorised for Gaza what amounts to a “teaspoon” of aid after at least 60 people died in overnight airstrikes.
UN secretary general Antonio Guterres said on Friday the supplies approved so far “amounts to a teaspoon of aid when a flood of assistance is required,” adding “the needs are massive and the obstacles are staggering”.
He warned that more people will die unless there is “rapid, reliable, safe and sustained aid access”.
A woman at the site of an Israeli strike in Jabalia, northern Gaza. Pic: Reuters
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Gaza: ‘Loads of children with huge burns’
Israel says around 300 aid trucks have been allowed through since it lifted an 11-week blockade on Monday, but according to Mr Guterres, only about a third have been transported to warehouses within Gaza due to insecurity.
The IDF said 107 vehicles carrying flour, food, medical equipment and drugs were allowed through on Thursday.
Many of Gaza’s two million residents are at high risk of famine, experts have warned.
Meanwhile, at least 60 people have been killed by Israeli airstrikes across Gaza overnight.
Ten people died in the southern city of Khan Younis, and deaths were also reported in the central town of Deir al-Balah and the Jabaliya refugee camp in the north, according to the Nasser, Al-Aqsa and Al-Ahli hospitals where the bodies were brought.
A body is carried out of rubble after an Israeli strike in Jabalia, northern Gaza. Pic: Reuters
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‘Almost everyone depends on aid’ in Gaza
The latest strikes came a day after two Israeli embassy workers were killed in Washington.
The suspect, named as 31-year-old Elias Rodriguez from Chicago, Illinois, told police he “did it for Gaza”.
Israeli Prime Minister Benjamin Netanyahu accused Sir Keir Starmer, Emmanuel Macron and Mark Carney of fuelling antisemitism following the shootings.
The leaders of the UK, France and Canada are “on the wrong side of humanity and (…) history”, he said, after they threatened “concrete action” against Israel this week if it continues its “egregious” military operations in Gaza.
Mr Netanyahu also accused Sir Keir, Mr Macron and Mr Carney of siding with “mass murderers, rapists, baby killers and kidnappers”.
Palestinians search for casualties in Jabalia, northern Gaza. Pic: Reuters
But UK government minister Luke Pollard told Sky News on Friday morning he “doesn’t recognise” Mr Netanyahu’s accusation.
Earlier this week, Mr Netanyahu said he was recalling negotiators from the Qatari capital, Doha, after a week of ceasefire talks failed to bring results. A working team will remain.
The war in Gaza began when Hamas-led militants attacked southern Israel on 7 October 2023, killing some 1,200 people, mostly civilians, and kidnapping 251 others.
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The militants are still holding 58 captives, around a third of whom are believed to be alive, after most of the rest were returned in ceasefire agreements or other deals.
Israel’s offensive, which has destroyed large swaths of Gaza, has killed more than 53,000 Palestinians, mostly women and children, according to Gaza’s Hamas-run health ministry.
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