Nhs

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

Time to ditch the pension triple-lock for good

Perhaps it’s finally dawned on the government that they have an intergenerational inequality problem on their hands. The decision to suspend the pension triple-lock for one year to avoid an 8 per cent increase to the state pension would suggest so. Asset wealth is already excessively concentrated in the over-55s. To even this spendthrift government, a massive bump in pensions while the rest of the economy languishes is a step too far. But that’s exactly what happens every year anyway under the triple-lock. The policy means that even when the rest of the economy stagnates, pensioners receive a boost. It is a feature of the system, not a bug, which came into place

Isabel Hardman

Tories brace for more tax rises to fund NHS

Any Tory rebellion on social care is unlikely to be very big this evening when the Commons votes on a resolution introducing it. There are a number of reasons for this, not least that voting against a money resolution, particularly one on an issue that is as big as a budget, is a much bigger deal than rebelling on normal legislation. Then there’s the prospect of a reshuffle, with everyone in Westminster busily trying to read runes about whether Boris Johnson will move around his front bench tomorrow. If it doesn’t happen, disappointed MPs are hardly going to complain in public that they’d supported the policy in the hope of career

James Kirkup

Boris should keep copying Blair

Having written here at least once before that Boris Johnson is the heir to Blair, my first thought on the Prime Minister’s tax-to-spend announcement on the NHS and social care is a petty one: I told you so. The striking thing about making the Boris-Blair comparison is how resistant some people are to it. Among Bozza fans on the Leave-voting right, there is often fury at the suggestion that their man, the hero of Brexit, is anything like the Europhile they used to call ‘Bliar’. On the left, there is an almost pathological determination to believe that a Tory PM must, by definition, be a small-state free-marketeer intent on starving and

The red herring at the heart of Boris’s tax hike

One of the most dubious and meaningless parts of today’s health and social care plan is the pledge that the new tax will be a ‘legally hypothecated levy’ – ring-fenced so that the money raised can only go to health and social care services.  It’s dubious in the same way that the Tory manifesto pledge not to raise taxes turned out not to be worth the paper it was printed on. And it’s meaningless because a government that wants to unlink the tax could just pass a law doing that – and no legal ring-fence can stop it. It’s also worth remembering that the ring-fence around health and social care is

Katy Balls

Boris dodges a tax hike Tory rebellion – for now

After emerging relatively unscathed from his appearance in front of MPs, Boris Johnson addressed the public in a bid to sell his plan to raise taxes as part of a a new health and social care levy. Given that polling suggests broad support for the proposals, the press conference was – at least on paper – the easier outing of the two. Appearing alongside Health Secretary Sajid Javid and Chancellor Rishi Sunak, the Prime Minister tried to justify his decision to break a manifesto pledge and raise national insurance in order to clear the NHS backlog and fund social care.  Johnson said he was fully aware it meant reneging on an election promise – but

Isabel Hardman

Javid’s cash boost can’t fix a battered NHS

The new £5.4 billion cash boost for NHS England is the easy bit of a very tricky situation for the health service and the politicians trying to work out how to deal with it. As Health Secretary Sajid Javid made clear on Monday, while the money will help deal with the backlog in treatment caused by the pandemic, it won’t do so immediately. He said that waiting lists would go up before they started to go down because people are still coming forward for treatment. Javid has been pitch-rolling for a dreadful winter ever since he took on the job, warning almost immediately that waiting lists could reach 13 million.

It’s time for NHS GPs to stop hiding behind their telephones

Nye Bevan famously said that he was only able to persuade family doctors to support the creation of the NHS because he ‘stuffed their mouths with gold’. But at least he obtained good service from them — including home visits. Until Tony Blair awarded GPs hefty pay rises while allowing them simultaneously to opt out of night-time and weekend work, they were responsible for their patients’ care 24 hours a day, seven days a week — with practices often pooling resources to provide continuous cover. But the role of GPs has become increasingly unclear: do patients have a right to be seen in person? It was revealed this week that

The NHS blood tube shortage should concern us

One of the great lessons from the early stages of the pandemic was the need to shorten supply chains and make them more robust. This was especially true for medical supplies. Just-in-time supply chains have been developed over the years to increase efficiency, but had never been tested in a global crisis when demand for certain medical products is high and supply is weak. The government ended up paying huge sums for PPE which, in some cases, was not even suitable for use. The shortage raises eyebrows because a plastic tube is, after all, a plastic tube It seems the lesson has not entirely been learned. There is now a shortage of

Will Alta Fixsler be allowed to die at home?

If your severely disabled two-year-old daughter is dying, should you be allowed to take her home for her final hours? It sounds like the answer should be a simple ‘yes’. But in the law surrounding parents, children and healthcare, nothing is that simple. Alta Fixsler’s parents have been repeatedly thwarted in their efforts – as they see it – to do their best for their daughter. First, Manchester University NHS Foundation Trust sought to withdraw life-saving treatment for Alta. A judge subsequently agreed that it was in Alta’s ‘best interests for the treatment that is currently sustaining her precious life…to be withdrawn’. This was in spite of her parents seeking to

Why shouldn’t we worship the NHS?

For obvious reasons, stocks in ex-editors of The Spectator are experiencing an all-time low. But my own complaint is with Nigel Lawson. Lawson may say it’s hardly his fault that his remark ‘The NHS is the closest thing the English people have to a religion’ has been appropriated ever since by anyone who thinks it’s a clinching argument for privatisation. Actually, it’s the opposite — a clinching argument for the present arrangements. I’ve had to make a lot of visits to hospitals in the past year, far more often than I’ve been to the theatre or the cinema. By force, I’ve seen a great deal of the NHS at first