Nhs

Letters: Why we need libraries

NHS origins Sir: Your leading article ‘Wes or bust’ (5 July) credited Labour with founding the NHS. In fact, the NHS was founded during the second world war by the Labour, Liberal and Conservative coalition. The speech with the famous line ‘free at the point of use’ was in fact made by Winston Churchill. He made it because he was PM and it was his job. For Labour to claim to be the initiator is somewhat disingenuous. Edward Hirst Aston, Sheffield All aboard Sir: Michael Gove is quite right (‘Tracks of my tears’, 5 July): the retirement of the royal train is sad news for those of us who like

Portrait of the week: Rachel Reeves cries, Rishi Sunak joins Goldman Sachs and a six-month bin strike

Home Rachel Reeves, the Chancellor of the Exchequer, had given a theme to the week by sitting weeping behind Sir Keir Starmer during Prime Minister’s Questions. She later said: ‘It was a personal issue.’ Sir Keir said: ‘She will be Chancellor for a very long time to come.’ No. 10 said she and the Prime Minister were ‘in lockstep’. The government found itself short of the £5 billion it had meant to save in the welfare bill, thwarted by its own MPs. The Office for Budget Responsibility said that, with rising debt, ‘The UK’s fiscal position is increasingly vulnerable’. Asked whether she would rule out tax rises in the autumn, the

So much is still unanswered about NHS reform

Given we have known for a good while that Labour thinks the way to save the health service is to move care out of hospitals and into the community, you might have expected today’s NHS ten-year plan to explain how the government is going to do that. The preventive agenda is not a new idea that needs explaining, it’s been around for the entire 77-year history of the health service. The problem, therefore, is not the lack of an idea, it’s that reform never actually happens. The important and urgent priorities of waiting lists and emergency units always end up dominating, and the neighbourhood health centres, walk-in clinics, polyclinics or the ‘health

NHS reforms: Labour puts on a brave face

14 min listen

Today Wes Streeting – with the help of Keir Starmer and Rachel Reeves – announced his 10 year plan for curing the NHS. It’s all about creating a ‘Neighbourhood Health Service’, but what does actually mean in practice?  Much of the plan was leaked in advance: first, focusing on preventing disease before it becomes too late; second, improving community healthcare services to help reduce pressure on hospitals; and third, embracing the tech revolution to bring the NHS into the ‘digital age’. One of the glaring omissions is a chapter on how this will all be delivered. Perhaps the most notable part of today’s launch was the decision to include Rachel

For the NHS, it’s Wes or bust

Labour swept to power on a pledge to ‘save the NHS’. As shadow health secretary, Wes Streeting said he would go ‘further than New Labour ever did’ to clear the health service’s backlog and, to achieve this, he claimed old taboos would be torn up, including the use of the private sector to improve services. Failure to clear the backlog now will be hugely politically consequential for this government. Partly because of how important the NHS is to the voting public, but more so because of the emotional resonance the service and its ‘free-at-the-point-of-use’ model has for Labour, both its MPs and its supporters. If the party that founded the

Does Starmer still want to be PM?

13 min listen

There have been a number of navel-gazing interviews with the Prime Minister over the weekend. Across thousands and thousands of words, he seems to be saying – if you read between the lines – that he doesn’t particularly enjoy being PM. In better news, Labour seems to have quelled the welfare rebellion. Liz Kendall is making a statement in the Commons this afternoon, in which she will outline the concessions that Labour has made on its controversial welfare bill. All in, the cost has spiralled by £3 billion per calendar year – which an already put-upon Chancellor will have to find. Whilst it remains the largest rebellion of this government,

Why must B&B guests give us advice?

‘You could mow all this lawn here and it would look a treat,’ said the arborist, returning from a stroll around the grounds, which were looking resplendent in the sunshine. ‘Yes, yes, mow the grass. Good idea,’ I said, for the builder boyfriend has told me I have to agree with the customers. No matter what they say, no matter how obvious their suggestions, just smile and say ‘Good idea.’ Old houses are like horses. Passing strangers feel ownership of them. Once they encounter them, they proclaim how they would care for them, because they decide from their soulful look that the owners must be neglecting them – when the

Must my fish and chips come with a side of geopolitics?

‘Our boys went to Lebanon and trained Hezbollah!’ shouted the drunk Irish lad in the fish and chip shop as an Indian man behind the counter silently fried chips. ‘Chucky ar la!’ the lad shouted, or Tiocfaidh ar la, to correctly spell in Irish the slogan of the IRA, meaning ‘Our day will come.’ And he went on shouting this, over and over, as the Indian fellow stared down into the fryer, and the Friday night customers formed a queue in this small fast-food joint in a West Cork harbour town. The Irish lad was not getting the message that the Hindu chap frying chips was probably not a massive

It’s time to get rid of the Rich List

Here’s a takeover tale that captures the zeitgeist. It involves two FTSE 250 companies and some deep-pocketed US investors – and I’ll explain it as simply as I can. In essence, how would you feel if your GP surgery fell into the hands of American investors associated with the book title Barbarians at the Gate? The first of the two London-listed companies is Assura, which owns 600 NHS surgeries and diagnostic facilities and has accepted a cash offer of £1.6 billion from a pair of New York investment giants. They are Stone-peak, which holds a huge global portfolio of infrastructure assets, and Kohlberg Kravis Roberts, whose initials KKR may be

Mary Wakefield

I’ve reached zero tolerance on zero tolerance

I know an astonishing 89-year-old who climbs mountains, uses a chainsaw and has the muscular, vice-like grip of a gym-built thirtysomething. He refuses pills and painkillers and considers it vital to embrace life’s most horrifying experiences. Last week the astonishing 89-year-old tore his Achilles tendon (leaping into a moving car), was driven to A&E and referred for an ultrasound. On the way to the scanning room, helped along by a male nurse, he put his injured leg down by mistake and yelled: ‘FUCK!’ At this, the nurse turned on his heel and walked off, saying: ‘I don’t have to put up with this.’ This is the 89-year-old’s version of events,

Speed traps are designed to make you fail

The builder boyfriend returned from a trip to London to inform me he was being done for speeding at 32mph, for crying out loud. He was flashed by a camera crawling uphill in a 30 zone going through the almost middle-of-nowhere in the Ashdown Forest, on his way to visit his sister in Sussex for the weekend. A few weeks after I completed a speed awareness course for doing an improbably incorrect 40mph on a dual carriageway during a trip to see my parents in Coventry, we were going round the same rigmarole with him. He showed me his letter from the Sussex Police on his return to Ireland. It

The £486 driving licence con

By changing the address on my driving licence, I was somehow signed up to something that began charging my credit card £39 a month and was going to carry on charging for ever. It was Barclaycard that spotted it and warned me it was a ‘scam’ in a text alert. Had I really agreed to a recurring payment to a company called British Drive? I had no idea what British Drive was, and at first suspected it was an insurance policy, or the firm that organised my recent speeding course. Eventually, I realised it could be something to do with going on to the DVLA website – or so I

The case for replacing nurses with robots

Tending is a work of activism on behalf of the NHS. The script brings together the testimony of 70 nurses in a show spoken by three performers. It’s full of surprises and shocks. All NHS nurses are obliged to annotate their actions as they work. ‘If you haven’t documented it, you haven’t done it,’ they’re told. A nurse estimates that she spends 20 per cent of her time caring for patients and the rest of it chronicling her doings on bits of paper. There appears to be no feedback mechanism that enables the nurses to help managers find ways to improve the service. A nurse tells the story of a

Aren’t women wonderful?

The mole specialist was wearing a pink Chanel-looking suit and pink diamanté shoes. By mole specialist, I don’t mean someone turned up dressed in Chanel to deal with moles on our land. I mean I went to see a top London dermatologist about a mole I was worried about, and when I walked into her office she looked so fabulous all I wanted to do was talk to her about her Jackie O miniskirt and jacket, given a twist with the sparkly stilettos. Before I could do that, however, she complimented me on my long striped coat. ‘Villa Gallo,’ I said, sitting down in front of her desk on the

The assisted suicide bill should not survive

Until about six months ago, it would have been hard to find a more inoffensive politician than the Labour backbencher Kim Leadbeater. A well-liked, upbeat, down-to-earth Yorkshirewoman, she entered politics because of a personal tragedy, the murder of her sister, the MP Jo Cox, in 2016. When asked on a Spectator podcast what was the worst piece of advice she had ever received, Leadbeater half-joked: ‘Have you thought about being an MP?’ Visibly a normal, friendly person plunked down in SW1, she won many admirers and attracted little controversy. Then in September Leadbeater came top of the private members’ ballot and chose to take up the cause of assisted suicide.

‘We’re going to a more radical place’: Wes Streeting on his plans for the NHS

A copy of a leading article from The Spectator is stuck to the wall of Wes Streeting’s office in the Department of Health. ‘Is Wes Streeting the Hamlet of the Health Service?’ we asked in October, warning against the perils of inaction. ‘We were so riled by it we stuck it there to hold ourselves to account,’ Streeting explains. ‘We’re going further than your prescription, though. We thought it was insufficiently radical.’ The Health Secretary has certainly been busy. Over the past few months, he has unveiled a range of reforms, including abolishing NHS England. His Blairite zeal annoys some in Labour. He languishes in 21st place in LabourList’s cabinet

Why Labour are abolishing NHS England

10 min listen

It was widely briefed that the main focus of Sir Keir Starmer’s speech in Yorkshire today was his plan to do away with Whitehall red tape. What was kept under wraps was the Prime Minister’s plans for the NHS – specifically to scrap NHS England. In a bid to tackle bureaucracy in the health service, the PM this morning told reporters that the ‘arms-length NHS’ needed to go – adding that the move will ‘shift money to the front line’ and free the health service to ‘focus on patients’. What’s the point of abolishing NHS England? And are Labour ‘doing the things that the Tories only dreamed of’?  Lucy Dunn

The ‘physician associate’ will see you now…

There is a war being waged in NHS hospitals. On one side are overstretched junior doctors in understaffed wards. On the other: physician associates (PAs) or, to use the more disparaging term, ‘noctors’.   Since 2003, non-medical graduates have been able to gain entry to hospital wards and GP practices if they complete a two-year clinical course that leaves them a ‘physician associate’ or ‘anaesthesia associate’. At first, PAs were rare – ten years ago there were fewer than 150 in England. Since the pandemic, however, the numbers have exploded. There are now approximately 4,000 PAs working in England and Wales.  PAs are supposed to help doctors with the time-consuming administrative

Why Ukraine’s minerals matter, the NHS’s sterilisation problem & remembering the worst poet in history

42 min listen

This week: the carve-up of Ukraine’s natural resources From the success of Keir Starmer’s visit to Washington to the squabbling we saw in the Oval Office and the breakdown of security guarantees for Ukraine – we have seen the good, the bad and the ugly of geopolitics in the last week, say Niall Ferguson and Nicholas Kulish in this week’s cover piece. They argue that what Donald Trump is really concerned with when it comes to Ukraine is rare earth minerals – which Ukraine has in abundance under its soil. The conventional wisdom is that the US is desperately short of these crucial minerals and, as Niall and Nicholas point

Why is the NHS pushing pregnant women towards sterilisation?

It was a routine antenatal appointment. I’d done it twice before and knew the format. The obstetrician runs through the risks of an elective caesarean (ELCS). We agree a date, I sign the forms, then make a plea for adequate pain relief after the surgery, which I know will be ignored. So I was blindsided by her opening gambit. ‘Why don’t we tie your tubes when we’ve got the baby out?’ she said, or something similar – I don’t recall the exact words, but I do remember the heat in my chest, the confusion and fear. ‘What?’ ‘It’s your third child, isn’t it, so why don’t we tie your tubes