Nhs

How to cure what ails the NHS

Wrong cure Sir: In referring to the UK as the highest-spending European nation in healthcare proportionate to GDP (‘Hospital pass’, 4 December), Kate Andrews paints an exaggerated picture which is based upon additional expenditure in the NHS during the Covid pandemic, partly accounted for by £38 billion spent on test and trace. The figures are further inflated by the UK suffering a relatively greater fall in GDP. In reality, the NHS has been woefully under-resourced compared to its European counterparts over the past decade, leaving it with approximately 50,000 fewer doctors compared to OECD averages, the second-lowest numbers of hospital beds per capita, and the lowest numbers of MRI scanners.

Punishing the unvaccinated threatens everyone’s liberty

How should we treat the unvaccinated? Should we stop them from participating in normal life? Castigate them in the media? Mandate they get vaccinated or block them from accessing NHS services? It’s a creeping question across developed countries — asked on Good Morning Britain’s Twitter page yesterday, and then subsequently deleted. Germany has barred the unvaccinated from most aspects of public life, including shops and restaurants. Greece is charging the over-60s Є100 for every month they remain unvaccinated, with money going to top up the health services. In Singapore, the unvaccinated will no longer have their Covid care paid for by the state. A letter in the Times this week suggested

Boris’s social care plans are hollow

Boris Johnson promised to ‘fix social care once and for all’ as he became Prime Minister on the steps of No. 10. On the basis of today’s social care white paper, he doesn’t think it’s particularly badly broken. Care minister Gillian Keegan launched the document in the Commons this afternoon, telling MPs that while this set out a 10-year ‘vision’, ‘today’s white paper is an important step on our journey to giving more people the dignified care that we want for our loved ones’. Those words — ‘important step’ — suggest that ministers don’t think this is the sum total of their proposals to fix social care, which is just

Why is the Treasury blocking a helpful health reform?

The Health and Care Bill is having a predictably stormy passage through parliament, popping up in the Lords next week for its second reading. If you’d paid only cursory attention to its closing stages in the Commons then you might be forgiven for thinking the legislation is largely about reform to social care and privatisation of the NHS. In reality, the social care policy was inserted at the last minute, and it’s only an amendment covering the cap on care costs, while privatisation has become something left-wing politicians like to warn is about to happen regardless of what’s in the bill before them (more on that here). It is not

Chris Whitty on the Omicron variant

This is an edited transcript of Professor Chris Whitty’s remarks at today’s Downing Street press conference The existing situation is almost entirely Delta.  In terms of numbers of cases, it is broadly flat. In younger children, there is quite significant transmission at this point in time, and rates are increasing in many parts of the country. At the other end of the spectrum, as a result of the booster programme almost certainly, rates are beginning to drift downwards in people over 60 and particularly people above 70. So we’re seeing an improvement in the group who are most vulnerable.  The numbers going to hospital are gradually decreasing. This is not a

Frustration grows with Boris, but the social care cap passes

MPs have approved the government’s social care cap in the Commons. But the vote doing so was narrow, and there seem to have been a lot of Conservative MPs either abstaining (which would be a rebellion against a three-line whip) or absent. Some will have been unwell, and ‘slipped’, as it is known, for other reasons. But some may have agreed with the whips that their car was due to break down or a tooth due to need emergency dental work, thus preventing them from voting against this controversial amendment. Others, like Matt Hancock, gave such rousing speeches in its favour that casual observers might have been forgiven for thinking

It’s time to fix the NHS’s looming winter crisis

My patient has sepsis. The window for treatment is short; in less than an hour, he could die. In urgent care, the direct line to ambulance control bypasses 999: it lets the call handler know a doctor requires urgent attention for a sick patient. Ten minutes: no response. I’m on a second phone to central dispatch: what is going on? A critical incident has been called; the service is overwhelmed. Finally, after 15 minutes, the phone answers and help is on its way.  Worryingly, this is far from an isolated incident. Last week, it was reported that an ambulance service sent a taxi to a GP practice in Bristol to collect a

James Kirkup

The vaccine cheer is gone

I am 45, which means I’ve now had my third Covid vaccine. The experience of getting that injection crystallises a thought: Britain is starting to take the miracle of vaccination for granted, and that spells trouble for Boris Johnson. I don’t use that word ‘miracle’ lightly. The development and distribution of working vaccines with such speed and scale is surely a historical event, and one that should give both big-state left-wingers and the free-market right pause for thought, since it relied on the partnership between public and private. The politics of the vaccine have always been slightly under-appreciated in the Westminster village. The Hartlepool by-election, for instance, was undoubtedly another moment

Central planning won’t solve the problem of GP shortages

Under plans being considered by ministers, GPs in affluent parts of England could be barred from taking jobs in wealthy areas to force them to work in deprived areas, in a bid to address health inequalities. The solution to doctor shortages, apparently, is to make the job less attractive. This would be the healthcare equivalent of the government taking charge of the hospitality industry and informing the owners of the Ivy that all new restaurants should be located in towns north of the Watford Gap, to ensure the pleasures of fine dining are evenly enjoyed across the country. And yet the Social Market Foundation (SMF) who put forward this proposal

Sleaze isn’t the biggest danger to Boris Johnson

This week’s events have undoubtedly done the government damage. But I suspect that ultimately its fate will be determined by whether its gamble of raising taxes to put more money into the NHS results in much lower waiting lists — or just grumpy taxpayers. Reducing the backlog will require more capacity. So, it is worrying that the Department of Health doesn’t know how many extra doctors and nurses it will need to clear the backlog. The government is currently miles off even its pre-pandemic target of 6,000 extra doctors by 2024. Optimistic numbers suggest there might be 300 more than in 2019, but others think things have gone backwards. If these

Do you really need to see the GP in person?

Only later, perhaps even a decade later, as the pandemic of 2020-22 shrinks in our rear-view mirror, may we be able to assess its enduring consequences. So I am only speculating when I suggest that one of these may be the beginning of the slow death of general practice in the United Kingdom. And, no, this will not be a column attacking Britain’s GPs, whom I think to be mostly dedicated and hard-working men and women whose careers are demanding, whose work is difficult, and who are not paid excessively for the hours and expertise they bring to their vocation. Rather as with the class for which we use the

James Forsyth

Three little words that could cost Boris

Boris Johnson knows the value of three-word slogans. ‘Take back control’ and ‘get Brexit done’ helped propel him to his two greatest electoral triumphs. But another three words that no one would ever put on a campaign poster might determine the success of his premiership: public service reform. Johnson has taken an unusual decision for a Tory prime minister. He has chosen to raise personal and business taxes to put more money into public services. This gamble may pay off if people feel that services have improved. If they do not, he risks an angry electorate who are paying more tax yet not getting anything extra in return. No. 10

Boris has no answer to the backlog crisis

Jeremy Hunt asked an entirely reasonable question of the Prime Minister today in the Commons — and got an entirely unreasonable answer. Hunt raised an amendment he is tabling which would require Health Education England to produce regular forecasts for the numbers of doctors and nurses that the UK needs to train. This is quite a small thing to ask for, but Johnson’s response was first to dodge his way around the question, and then to turn the issue into a party political attack on Labour. He said: My right hon. friend is absolutely right that we have to ensure that our NHS has the staff that it needs. That

No. 10 moves to kickstart the booster campaign

In a move that as important as any in the recent Cabinet reshuffle, Emily Lawson is returning to run the Covid vaccination programme. Lawson headed up NHS England’s vaccination team during the rollout, and after its success, she was moved to take charge of the new Number 10 delivery unit. The hope was that she would bring the rollout mindset to public services more broadly. The delivery unit, modelled on its Blair era predecessor, is meant to ensure that the government actually does what it says it is going to do. Such is its importance that Lawson addressed the first meeting of the newly reshuffled Cabinet. The fact that she is

Javid says no to restrictions – for now

Is the government considering activating its ‘plan B’ Covid plans? Not yet.  After the Business Secretary played down talk of new restrictions this morning, Sajid Javid used today’s press conference to confirm that he would not be implementing the back-up plan ‘at this point’. However, the Health Secretary suggested that further measures – namely vaccine passports, work-from-home orders and mask mandates – could not be ruled out if the data substantially worsens. The main message from the press conference: get vaccinated There was a marked change in tone from Javid since the days soon after his appointment as Health Secretary when he declared that there was ‘no going back’. He said that

Sajid Javid is right to make the NHS more accountable

The health secretary has announced more money for the National Health Service. It’s a story we’ve heard time and time again – but this time the details are different. Sajid Javid has committed an additional £250 million for GP health practices to assist them in expanding their hours and upping the number of face-to-face appointments they offer. In-person appointments plummeted during lockdown and have never recovered: they are now hovering around 60 per cent, compared to 80 per cent pre-pandemic. So what’s new? In short, the money comes with more accountability. A league table is being created to rank surgeries on how many in-person appointments they offer. Patients will also

‘I’m entitled not to listen to Sage’: an interview with Sajid Javid

In six years Sajid Javid has had six cabinet jobs. He has been culture secretary, business secretary, communities secretary, home secretary and chancellor — and, just over 100 days ago, he was made Secretary of State for Health. When we meet on stage for an interview at Tory party conference, I ask him about his credentials for the job. He has none. ‘But that’s not unusual for a health secretary,’ he chirps. And experience? He has visited a few hospitals. He then offers the story of his early run-in with the NHS. As a child, he had his appendix removed in hospital. ‘Next thing I remember is being back at

The SNP’s NHS meltdown

When he’s not falling off his scooter like he’s auditioning for the role of Inspector Clouseau in the Pink Panther franchise, the gaffe-prone Scottish health minister, Humza Yousaf, is mired in a multitude of Scottish NHS crises. This month saw Britain’s armed forces parachuted in to prop up the Scottish Ambulance Service. Nicola Sturgeon was forced to call on the military after distressed patients had to wait hours, and sometimes even days, for an ambulance – one of the most harrowing cases involved a frail Glasgow pensioner who died after waiting 40 hours for an ambulance to arrive. Dig into the government statistics and the scale of the crisis facing the

PMQs: Boris blustered his way out of trouble

What were they? Model broomsticks? Mini cricket bats? The chewed ends of lolly-sticks? At PMQs today many MPs arrived with odd sprigs of material attached to their clothing. The badges turned out to be ‘wheat-pins’ which are part of ‘Back British Farming Day’. Sir Keir Starmer had attached his device firmly to his jacket. Very sensible. Boris had lazily shoved the thing into his breast pocket. It slowly descended into the depths of the lining and disappeared. The session began sombrely as members expressed their sympathy with Boris over his recent bereavement. Sir Keir Starmer took just three seconds to turn it into a story about himself. ‘I offer my

Why the NHS needs more bureaucrats

If the NHS’s cheerleaders and detractors can agree on one thing, it’s this: we need fewer backroom staff. If the health service’s doctors, nurses and cleaners are heroes, the pen-pushers, middle-men and legions of drab men in drab suits are sucking the vital lifeblood out of the NHS, while droning on about synergies in management. All this while claiming a salary that could have paid for another two nurses. This debate has re-emerged after it was reported that almost half of all NHS staff are managers, administrators or unqualified assistants. Helen Whately, the care minister, spoke for many when she said she feels ‘strongly that the money we put into the NHS needs to