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.
Politics latest: Cost of trip Liz Truss cut short to launch leadership bid revealed
Please use Chrome browser for a more accessible video player
‘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.
Benjamin Netanyahu has said he will convene his security cabinet to discuss how to instruct Israel’s military to proceed in Gaza to meet all of his war goals.
“We must continue to stand together and fight together to achieve all our war objectives: the defeat of the enemy, the release of our hostages, and the assurance that Gaza will no longer pose a threat to Israel,” the Israeli prime minister told his cabinet.
It came after indirect ceasefire talks with Hamas, which had aimed to agree on a US-backed proposal for a 60-day truce, during which aid would be flown into Gaza and half of the hostages Hamas is holding would be freed in exchange for Palestinian prisoners jailed in Israel, fell apart.
Mr Netanyahu is believed to be leaning towards expanding the offensive in Gaza and seizing the entire enclave, according to Israel’s Channel 12, which cited an official from his office.
He will convene his cabinet on Tuesday to make a decision, Israeli media reported.
Palestinians carry aid supplies. Pic: Reuters
Former Israeli prime minister Ehud Barak told Sky News chief presenter Mark Austin the war in the last several months has been “a war of deception”.
“It’s nothing to do with the security in Israel, and it has nothing to do with the future of the hostages. It’s basically a war to hold together the coalition and to save Netanyahu from the day of reckoning that will come inevitably when the war stops, when these criminal court cases of corruption will be accelerated. Basically, it’s totally unjustified.”
A group of around 600 retired Israeli security officials have written to Donald Trump to urge the US president to pressure Israel to bring the war to an immediate end.
“It is our professional judgement that Hamas no longer poses a strategic threat to Israel,” the letter said. “Your credibility with the vast majority of Israelis augments your ability to steer Prime Minister [Benjamin] Netanyahu and his government in the right direction: End the war, return the hostages, stop the suffering.”
Please use Chrome browser for a more accessible video player
Gaza: A war of ‘deception’
Meanwhile, at least 40 Palestinians were killed by Israeli gunfire and airstrikes in Gaza on Monday, including 10 seeking aid, local medics said. Another five died of starvation, they added.
Aid groups say Israel’s latest measures to allow aid into the besieged enclave are not enough.
Read more:
Over 100 journalists demand ‘immediate and unsupervised’ access to Gaza
Smoke rises after an explosion in Gaza. Pic: Reuters
Several hundred Palestinians have been killed by Israeli fire since May as they headed towards food distribution sites and aid convoys, according to witnesses, local health officials and the UN human rights office.
Israel’s military says it has only fired warning shots and disputes the number killed.
Palestinians rush to collect humanitarian aid in Gaza. Pic: AP
Several countries have been airdropping aid to Gaza, though the UN and aid groups warn such drops are costly and dangerous for residents, and deliver less aid than trucks.
COGAT, the Israeli military agency that coordinates aid, said during the past week, more than 23,000 tons of humanitarian aid in 1,200 trucks had entered Gaza, but hundreds had yet to be driven to aid distribution hubs by UN and other international organisations.
Palestinian and UN officials said Gaza needs around 600 aid trucks to enter each day to meet its humanitarian requirements – the number Israel used to allow in before the war.
The war began when Hamas-led militants killed 1,200 people and took 251 hostage in an attack on southern Israel on 7 October 2023.
Israel’s offensive has since killed more than 60,000 Palestinians, according to the Hamas-backed health ministry, which does not differentiate between civilians and combatants in its count.
Israeli officials say 50 hostages remain in Gaza, with only 20 of those believed to still be alive.
The Kremlin has urged caution in nuclear rhetoric, responding for the first time to US President Donald Trump’s announcement that the US is repositioning nuclear submarines.
Kremlin spokesman Dmitry Peskov played down the significance of Mr Trump’s comments, saying on Monday that US submarines are already on combat duty and that Moscow does not want to comment further.
Mr Trump said last Friday that he had ordered two submarines to be moved to “the appropriate regions” in response to remarks from former Russian president Dmitry Medvedev about the risk of war between the nuclear-armed powers.
“In this case, it is obvious that American submarines are already on combat duty. This is an ongoing process, that’s the first thing,” Mr Peskov told reporters.
“But in general, of course, we would not want to get involved in such a controversy and would not want to comment on it in any way,” he said. “Of course, we believe that everyone should be very, very careful with nuclear rhetoric.”
Mr Peskov said Moscow did not view Mr Trump’s statement as an escalation in nuclear tension.
“We do not believe that we are talking about any escalation now. It is clear that very complex, very sensitive issues are being discussed, which, of course, are perceived very emotionally by many people,” he said.
He declined to answer directly whether Mr Medvedev, who currently serves as deputy chairman of the Security Council of Russia, was advised to tone down his online altercation with Mr Trump.
The spat between former Russian president Dmitry Medvedev and Donald Trump intensified over nuclear rhetoric. Pic: Reuters
“Listen, in every country, members of the leadership… have different points of view on events that are taking place, different attitudes. There are people who are very, very tough-minded in the United States of America and in European countries, so this is always the case,” Mr Peskov said.
“But the main thing, of course, is the position of President (Vladimir) Putin. You know that in our country, foreign policy is formulated by the head of state, that is, President Putin.”
The spat between Mr Trump and Mr Medvedev flared up after the US president said he is reducing his 50-day deadline for Russia to end its war in Ukraine to less than two weeks.
Mr Medvedev posted on social media that Mr Trump was “playing the ultimatum game with Russia… Each new ultimatum is a threat and a step towards war”.
The US president responded: “Tell Medvedev, the failed former Russian president who thinks he is still in power, to be careful what he says. He is entering very dangerous territory.”
A Russian air strike has set cars on fire and damaged buildings in Ukraine’s Kharkiv region. Pic: Sofiia Gatilova/Reuters
Medvedev’s following post mentioned “Dead Hand,” the automatic nuclear retaliation system created during the Soviet era.
Ukraine and Russia continue attacks amid stalled talks
Meanwhile, Russia and Ukraine continue exchanging strikes as peace talks to end the conflict remain stalled.
Ukraine’s security service said on Monday that its drones have attacked a Russian military airfield in Crimea, damaging several planes.
US Special Envoy Steve Witkoff meets Vladimir Putin in the Kremlin.
The Ukrainian military also claimed it had attacked a Russian fuel depot at Sochi airport the previous day. Russian officials reported on Sunday that an overnight Ukrainian drone attack on an oil depot near the Black Sea resort of Sochi caused a large fire, which prompted authorities to halt flights from the airport.
Ukraine said on Monday its forces neutralised 161 out of 162 Russian drones launched overnight.
As the US deadline for the Russian president to agree to a ceasefire in Ukraine approaches, Mr Trump’s Special Envoy Steve Wikoff will be travelling to Moscow on Wednesday for talks.
Ukrainian President Volodymyr Zelensky said Sunday that Ukraine and Russia have agreed to exchange 1,200 prisoners following their latest round of negotiations in Istanbul in July.
Mr Zelensky also said that his office is in communication with US partners and that “pressure on Russia can truly work – in a way that makes them feel the consequences of prolonging the war”.
World
‘It is truly monstrous’: Inside the besieged Sudanese city where families are forced to eat animal feed to live
Al Fashir is being suffocated to death.
The paramilitary Rapid Support Forces (RSF) has held the capital of North Darfur hostage in a 14-month siege – blocking food or fuel from entering the locality and forcing starvation on its 900,000 inhabitants.
The entire city is currently a militarised zone as Sudan‘s army and the Darfur Joint Protection Force fend off the RSF from capturing the last state capital in the Darfur region not currently under their control.
Rare footage sent to Sky News from inside al Fashir town shows streets emptied of cars and people.
The city’s remaining residents are hiding from daytime shelling inside their homes, and volunteers move through town on donkey carts distributing the little food they can find.
Al Fashir is the capital of North Darfur
‘It is truly monstrous’
Journalist Muammer Ibrahim sent Sky News voice notes from there.
“The situation is monstrous,” he says. “It is truly monstrous.
“The markets are emptied of food and partially destroyed by shelling. Civilians were killed at the market, just a day ago. People have fled market areas but there is also shelling in residential areas. Every day, you hear of 10 or 12 civilians killed in attacks.”
His voice sounds shallow, weakened by the dire conditions, and gunshots can be heard in the background.
“The intense fighting has meant that people cannot safely search for anything to eat, but there is also nothing for their money to buy. The markets are depleted. Hundreds of thousands here are threatened by a full-blown famine,” he says.
“There has been a full blockade of any nutritional supplies arriving in al Fashir since the collapse of Zamzam camp. It closed any routes for produce or supplies to enter.”
The city’s remaining residents hide from daytime shelling
The RSF ransacked the famine-ridden Zamzam displacement camp 7.5 miles (12km) south of al Fashir town in April, after the military reclaimed Sudan’s capital Khartoum.
The United Nations believes that at least 100 people were killed in the attacks, including children and aid workers.
The majority of Zamzam’s half a million residents fled to other areas for safety. Hundreds of thousands of them are now squeezed into tents on the edges of al Fashir, completely cut off from humanitarian assistance.
The capture of the camp allowed the RSF to tighten their siege and block off the last remaining supply route. Aid convoys attempting to enter al Fashir have come under fire by the RSF since last year.
Aid convoys attempting to enter al Fashir have come under fire by the RSF since last year
“Already, between June and October 2024, we had several trucks stuck and prevented by the Rapid Support Forces from going to their destination which was al Fashir and Zamzam,” says Mathilde Simon, project coordinator at Medicins Sans Frontieres.
“They were prevented from doing so because they were taking food to those destinations.”
“There was another UN convoy that tried to reach al Fashir in the beginning of June. It could not, and five aid workers were killed.
“Since then, no convoy has been able to reach al Fashir. There have been ongoing negotiations to bring in food but they have not been successful until now.”
Mathilde Simon says malnutrition rates in al Fashir are ‘catastrophic’
Families are resorting to eating animal feed to survive.
Videos sent to Sky News by volunteers show extreme suffering and deprivation, with sickly children sitting on thin straw mats on the hard ground.
Community kitchens are their only source of survival, only able to offer small meals of sorghum porridge to hundreds of thousands of elderly men, women and children facing starvation.
The question now is whether famine has fully taken root in al Fashir after the collapse of Zamzam camp and intensified RSF siege.
‘Malnutrition rates are catastrophic’
“The lack of access has prevented us from carrying out further assessment that can help us have a better understanding of the situation, but already in December 2024 famine was confirmed by the IPC Famine Review Committee in five areas,” says Mathilde.
“It was already confirmed in August 2024 in Zamzam but had spread to other displacement camps including Abu Shouk and it was already projected in al Fashir.
“This was more than eight months ago and we know the situation has completely worsened and malnutrition rates are absolutely catastrophic.”
Fatma Yaqoub said her family have nothing to eat but animal feed
Treasurer of al Fashir’s Emergency Response Rooms, Mohamed al Doma, believes all signs point to a famine.
He had to walk for four hours to escape the city with his wife and two young children after living through a full year of the siege and offering support to residents as supplies and funding dwindled.
Read more from Sky News:
How the drug kush is ruining lives
Videos of emaciated Israeli hostage Evyatar David released
Listen to The World with Richard Engel and Yalda Hakim every Wednesday
“There is a famine of the first degree in al Fashir. All the basic necessities for life are not available,” he says.
“There is a lack of sustenance, a lack of nutrition and a lack of shelter. The fundamental conditions for human living are not living. There is nothing available in the markets – no food or work. There is no farming for subsistence. There is no aid entering al Fashir.”
“All of this points towards a full-blown famine.”
-
Sports3 years ago‘Storybook stuff’: Inside the night Bryce Harper sent the Phillies to the World Series
-
Sports1 year agoStory injured on diving stop, exits Red Sox game
-
Sports2 years agoGame 1 of WS least-watched in recorded history
-
Sports2 years agoMLB Rank 2023: Ranking baseball’s top 100 players
-
Sports4 years ago
Team Europe easily wins 4th straight Laver Cup
-
Sports2 years agoButton battles heat exhaustion in NASCAR debut
-
Environment2 years agoJapan and South Korea have a lot at stake in a free and open South China Sea
-
Environment2 years agoGame-changing Lectric XPedition launched as affordable electric cargo bike