When her 9-year-old daughter was having trouble breathing, Yvette Hammonds took her to a local emergency room. It quickly became clear that girl needed to be transferred to the childrens hospital about 40 minutes away in Atlanta, so her daughter was loaded into an ambulance.
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Months later, Hammonds received a bill for nearly $1,000: the cost of the ground ambulance ride from one in-network hospital to another.
In this installment of InvestigateTV and KFF Health News Costly Care series, Caresse Jackman, InvestigateTVs national consumer investigative reporter, probes the lack of cost protections for patients who find themselves needing an ambulance ride to care.
Jackmans story features an interview with Elisabeth Rosenthal, KFF Health News senior contributing editor. When you need an ambulance, you need an ambulance, Rosenthal said. And thats the worst time in your life to be a consumer, when you have no choice.
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The UK is “really unprepared” to fight a war and has been living on a “mirage” of military strength that was shocking to discover, interviews with almost every defence secretary since the end of the Cold War have revealed.
With Sir Keir Starmer under pressure to accelerate plans to reverse the decline, two new episodes of Sky News and Tortoise’s podcast series The Wargame uncover what happened behind the scenes as Britain switched funding away from warfare and into peacetime priorities such as health and welfare after the Soviet Union collapsed.
This decades-long saga, spanning multiple Labour, Conservative and coalition governments, includes heated rows between the Ministry of Defence (MoD) and the Treasury, threats to resign, and dire warnings of weakness.
It also exposes a failure by the military and civil service to spend Britain’s still-significant defence budget effectively, further compounding the erosion of fighting power.
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4:35
The Wargame: Behind the scenes
‘Russia knew’ about UK’s weaknesses
Now, with the threat from Russia returning, there is a concern the UK has been left to bluff about its ability to respond, rather than pivot decisively back to a war footing.
“We’ve been living on a sort of mirage for so long,” says Sir Ben Wallace, a Conservative defence secretary from 2019 until 2023.
“As long as Trooping the Colour was happening, and the Red Arrows flew, and prime ministers could pose at NATO, everything was fine.
“But it wasn’t fine. And the people who knew it wasn’t fine were actually the Americans, but also the Russians.”
Not enough troops, medics, or ammo
Lord George Robertson, a Labour defence secretary from 1997 to 1999 and the lead author of a major defence review this year, says when he most recently “lifted the bonnet” to look at the state of the Army, Royal Navy and Royal Air Force, he found “we were really unprepared”.
“We don’t have enough ammunition, we don’t have enough logistics, we don’t have enough trained soldiers, the training is not right, and we don’t have enough medics to take the casualties that would be involved in a full-scale war.”
Asked if the situation was worse than he had imagined, Lord Robertson says: “Much worse.”
Image: Robertson meets the PM after last year’s election. Pic: Reuters
‘I was shocked,’ says ex-defence secretary
Sir Gavin Williamson, a former Conservative defence secretary, says he too had been “quite shocked as to how thin things were” when he was in charge at the MoD between 2017 and 2019.
“There was this sort of sense of: ‘Oh, the MoD is always good for a billion [pounds] from Treasury – you can always take a billion out of the MoD and nothing will really change.’
“And maybe that had been the case in the past, but the cupboards were really bare.
“You were just taking the cupboards.”
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0:52
Ben Wallace on role as PM in ‘The Wargame’
But Lord Philip Hammond, a Conservative defence secretary from 2011 to 2014 and chancellor from 2016 until 2019, appears less sympathetic to the cries for increased cash.
“Gavin Williamson came in [to the Ministry of Defence], the military polished up their bleeding stumps as best they could and convinced him that the UK’s defence capability was about to collapse,” he says.
“He came scuttling across the road to Downing Street to say, I need billions of pounds more money… To be honest, I didn’t think that he had sufficiently interrogated the military begging bowls that had been presented to him.”
Image: Hammond at a 2014 NATO meeting. Pic: Reuters
What to expect from The Wargame’s return
Episodes one to five of The Wargame simulate a Russian attack on the UK and imagine what might happen, with former politicians and military chiefs back in the hot seat.
The drama reveals how vulnerable the country has really become to an attack on the home front.
The two new episodes seek to find out why.
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The story of the UK’s hollowed-out defences starts in a different era when an Iron Curtain divided Europe, Ronald Reagan was president of the US, and an Iron Lady was in power in Britain.
Sir Malcolm Rifkind, who went on to serve as defence secretary between 1992 and 1995 under John Major, recalls his time as minister for state at the Foreign Office in 1984.
In December of that year, then prime minister Margaret Thatcher agreed to host a relatively unknown member of the Soviet Communist Party Politburo called Mikhail Gorbachev, who subsequently became the last leader of the Soviet Union.
Sir Malcolm remembers how Mrs Thatcher emerged from the meeting to say: “I think Mr Gorbachev is a man with whom we can do business.”
Image: Gorbachev was hosted at Chequers in 1984. Pic: Reuters
It was an opinion she shared with her close ally, the US president.
Sir Malcolm says: “Reagan would have said, ‘I’m not going to speak to some unknown communist in the Politburo’. But if the Iron Lady, who Reagan thought very highly of, says he’s worth talking to, he must be worth it. We’d better get in touch with this guy. Which they did.
“And I’m oversimplifying it, but that led to the Cold War ending without a shot being fired.”
In the years that followed, the UK and much of the rest of Europe reaped a so-called peace dividend, cutting defence budgets, shrinking militaries and reducing wider readiness for war.
Into this different era stepped Tony Blair as Labour’s first post-Cold War prime minister, with Lord Robertson as his defence secretary.
Image: Robertson and Blair in 1998. Pic: Reuters
Lord Robertson reveals the threat he and his ministerial team secretly made to protect their budget from then chancellor Gordon Brown amid a sweeping review of defence, which was meant to be shaped by foreign policy, not financial envelopes.
“I don’t think I’ve ever said this in public before, but John Reid, who was the minister for the Armed Forces, and John Speller, who was one of the junior ministers in the department, the three of us went to see Tony Blair late at night – he was wearing a tracksuit, we always remember – and we said that if the money was taken out of our budget, the budget that was based on the foreign policy baseline, then we would have to resign,” Lord Robertson says.
“We obviously didn’t resign – but we kept the money.”
The podcast hears from three other Labour defence secretaries: Geoff Hoon, Lord John Hutton and the current incumbent, John Healey.
Image: John Healey, the current defence secretary. Pic: PA
For the Conservatives, as well as Rifkind, Hammond, Williamson and Wallace, there are interviews with Liam Fox, Sir Michael Fallon, Dame Penny Mordaunt and Sir Grant Shapps.
In addition, military commanders have their say, with recollections from Field Marshal Lord David Richards, who was chief of the defence staff from 2010 until 2013, General Sir Nick Carter, who led the armed forces from 2018 until 2021, and Vice Admiral Sir Nick Hine, who was second in charge of the navy from 2019 until 2022.
‘We cut too far’
At one point, Sir Grant, who held a variety of cabinet roles, including defence secretary, is asked whether he regrets the decisions the Conservative government took when in power.
He says: “Yes, I think it did cut defence too far. I mean, I’ll just be completely black and white about it.”
Lord Robertson says Labour too shares some responsibility: “Everyone took the peace dividend right through.”
Former parliamentary researcher Christopher Cash and teacher Christopher Berry were accused of passing secrets to Beijing between 2021 and 2023. They deny the allegations.
Image: Christopher Cash (L) and Christopher Berry (R). Pics: Reuters
The charges were dropped in September as the CPS said it could not get evidence from the government referring to China as a national security threat, prompting accusations of a “cover-up” by the Conservatives.
The report by the cross-party group of MPS and peers said the case was beset by “confusion and misaligned expectations” and cautioned against dismissing the case as a “one-off” caused by outdated espionage laws – something the government blamed for the case’s collapse.
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0:58
Sky questions China on alleged spying
‘Serious systemic failures’
The committee – which launched a highly unusual investigation following the controversy – warned there are parallels in new legislation which must be handled carefully to prevent a similar issue from recurring.
But while “the sequence of some events has raised eyebrows”, it found no evidence of deliberate or co-ordinated attempts to block or collapse the prosecution – including by the prime minister’s national security adviser Jonathan Powell, who met with officials about the case two days before it was dropped.
Image: Jonathan Powell. Pic: PA
However, the committee added: “Overall it is clear that there were serious systemic failures and deficiencies in communications, co-ordination and decision-making.”
It described communications between the government and CPS as “inadequate” and lacking clarity, with an “insufficiently robust” level of senior oversight right from the start of proceedings in 2023 under the Tories.
A statement by deputy national security adviser (DNSA) Matt Collins became the focus after the case’s collapse.
Prosecutors said his refusal to describe Beijing as a “threat” to national security meant the case could not continue.
Mr Collins, the central expert prosecution witness, told the investigation he had provided evidence of a “range of threats” posed by China, but did not describe it as a “generic” threat as that was not the then Tory government’s position.
The committee acknowledged the CPS’s assertion it would have undermined the case at trial if Mr Collins refused to describe China as an active threat, but suggested his statements taken together would have been sufficient.
“We regret that common sense interpretations of the wording provided in the DNSA’s witness statements were apparently not a sufficiently strong basis for meeting the evidential requirements the Crown Prosecution Service considered necessary under the Official Secrets Act 1911,” it said.
It accepted the “root cause” of the problems lay with the Official Secrets Act, which required the term “enemy” to be used of a foreign power, but warned the new National Security Act 2023 doesn’t eliminate “diplomatic sensitivities” around labelling people members of a foreign intelligence service.
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2:18
Could a ‘super embassy’ pose a threat?
The committee recommends:
• The Cabinet Office and security services to work with the CPS to formalise principles for handling sensitive cases within the next six months
• Establishing a new rule for a formal case “conference” within 30 days of such charges to avoid a “lack of clarity” over evidence in future.
“We urge the government to avoid characterising the failure of the Cash/Berry case as a one-off peculiarity created solely by outdated legislation: there are structural parallels in the National Security Act 2023 which will require careful handling to avoid comparable issues recurring,” the committee said.
A CPS spokesperson said: “We recognise the strong interest in this case. We will review the recommendations carefully and work with partners to identify where improvements can be made.
“Our decisions are made independently and based on law and evidence, and that principle remains at the heart of our work.”
A government spokesperson said: “We welcome the committee’s report that makes clear that allegations about interference in this case were baseless and untrue.
“The decision to drop the case was taken independently by the Crown Prosecution Service. We remain disappointed that this case did not reach trial.
“Protecting national security is our first duty, and we will never waver from our efforts to keep the British people safe.”
Russian foreign policy aide Yuri Ushakov and investment envoy Kirill Dmitriev were involved in the talks, which lasted over five fours and ended after midnight.
Both sides agreed not to disclose precise details, but in a one-word social media post, Mr Dmitriev described the meeting as “productive”.
Mr Ushakov called it “rather useful, constructive” and asked whether peace was closer or further, he commented: “Not further, that’s for sure”.
However, he said a compromise hadn’t been reached on the issue of territories and that the Kremlin sees “no resolution to the crisis” without one.
Russia wants the whole of the Donbas region – even the parts it does not hold – but Ukraine has balked at the prospect.
Mr Ushakov said there was “still a lot of work to be done, both in Washington and in Moscow” and that “contacts will continue”.
Image: The two sides were joined by translators. Pic: Sputnik/AP
Image: Pic: Reuters
Image: Jared Kushner and Steve Witkoff were joined by Kirill Dmitriev (2nd right) and Yuri Ushakov (left). Pic: Reuters
The meeting took place after an initial 28-point US peace plan was leaked and alarmed European officials, who said it heavily favoured Russia.
An “updated and refined peace framework” was formulated after talks between Europe, the US, and Ukraine in Geneva last month, but Mr Putin has indicated he will not accept it.
Putin: Europe on the side of war
Earlier on Tuesday, Mr Putin said Russia was ready to fight if Europe wanted a war.
The Russian president accused European powers of changing peace proposals for Ukraine with “demands” that Russia considered “absolutely unacceptable”.
Mr Putin said the Europeans were “on the side of war”.
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2:56
Putin ‘lashes out’ at Europe
“We’re not planning to go to war with Europe, I’ve said that a hundred times,” he said following an investment forum.
“But if Europe suddenly wants to fight us and starts, we’re ready right now. There can be no doubt about that.”
“If Europe suddenly wants to start a war with us and does, then a situation could very quickly arise in which we have no one to negotiate with,” he added.
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1:28
Putin trying to frighten US away from Europe with war remarks
Zelenskyy in Dublin
Ukraine’s President Volodymyr Zelenskyywas in Dublin on Tuesday to meet Ireland’s prime minister and president.
During the trip, Mr Zelenskyy said he was ready to meet Mr Trump again, but it would depend on how successful the Moscow talks were.
He said the chances of ending the war were “better now than ever” but warned there would be “no easy decisions” and there must be “no games behind Ukraine’s back”.
Image: President Zelenskyy had a guard of honour in Dublin. Pic: Reuters
Calling it “one of the most challenging but optimistic moments” since Russia invaded in 2022, he said the US was “taking serious steps to end this war one way or another”.
He admitted “some things still need to be worked out” and said a “decent, dignified peace” was needed.
Image: President Zelenskyy, his wife Olena, and Irish President Catherine Connolly. Pic: Reuters
The Irish government announced €100m (£88m) in non-lethal aid for Ukraine, “generosity” for which Mr Zelenskyy said Ukraine was grateful.
It brings the total in non-lethal military aid provided to Ukraine this year to €200m (£176m).
The funding is part of a new Ireland-Ukraine partnership, which builds on an agreement signed last year.
It includes €25m (£22m) for the restoration and protection of energy infrastructure and a scheme to support training and other efforts as part of Ukraine’s path to EU accession, which Mr Zelenskyy said he hoped to achieve within five years.