UK ‘long overdue' a conversation about NHS funding, says Javid
His comments are part of the foreword for the PolicyExchange's report The NHS – A Suitable Case For Treatment.
The centre-right thinktank suggests that 'better quality healthcare' could be delivered 'by moving from our present entirely socialised model to a hybrid model with a significant social insurance component'.
They also advocate changes such as removing free prescriptions for over-60s, but the report says that 'under no circumstances' should the UK try to replicate the US model of healthcare.
Introducing the paper, Sir Sajid described the NHS as 'one of our country's most treasured and beloved national institutions'.
'We've come to a crossroads. A serious conversation with taxpayers about how we continue funding their favourite national institution is long overdue,' he said.
He said that the UK is left with the options of putting more money into healthcare through tax rises or 'reforming' the system.
'What we cannot afford to do is to bury our heads in the sand,' he added.
'The responsible politician, the one who is concerned with the national interest, must look at every option for reform,' Sir Sajid said.
The PolicyExchange report says that 'under no circumstances should the UK consider moving towards the US model', but that other countries 'with some sort of insurance-based model do much better' such as France, Germany and Singapore.
'We believe that better quality healthcare with universal coverage and improved long-term funding sustainability could be secured by moving from our present entirely socialised model to a hybrid model with a significant social insurance component,' the report says.
Alongside a shift towards a 'social-insurance based system of financing healthcare', the thinktank made a number of recommendations for reforms that could be made within the existing NHS model.
Among the changes the PolicyExchange suggest are a £20 charge for visiting a GP, with low-income groups exempt.
They also say that people over 60 should no longer be universally eligible for free prescriptions, and the exemption should be determined by your income.
They also advocate charges for 'more luxurious hospital accommodation', which they say could raise £700million.
PolicyExchange advocate a system where universal healthcare coverage is available, and a basic model can be supplemented by other policies.
The Government would regulate insurers and healthcare providers, and they say the system should still be called the NHS, with the main change being the way it is financed.
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Leader Live
an hour ago
- Leader Live
Streeting: We are doing everything we can to minimise patient harm during strike
A five-day walkout by resident doctors in England is under way, with members of the British Medical Association (BMA) manning picket lines across the country. The Health Secretary condemned the strike as 'reckless' and said the Government would not allow the BMA to 'hold the country to ransom'. Asked about the risk of patient harm during a visit to NHS England HQ in London, he told the PA news agency on Friday: 'I'm really proud of the way that NHS leaders and frontline staff have prepared and mobilised to minimise the disruption and minimise the risk of harm to patients. 'We've seen an extraordinary response, including people cancelling their leave, turning up for work, and resident doctors themselves ignoring their union to be there for patients. I'm extremely grateful to all of them. 'What I can't do today is guarantee that there will be no disruption and that there is no risk of harm to patients. 'We are doing everything we can to minimise it, but the risk is there, and that is why the BMA's action is so irresponsible. 'They had a 28.9% pay award from this Government in our first year, there was also an offer to work with them on other things that affect resident doctors – working lives – and that's why I think this is such reckless action. 'This Government will not allow the BMA to hold the country to ransom, and we will continue to make progress on NHS improvement, as we've done in our first year.' Asked about next steps and the continued threat of doctor strikes, given the BMA has a six-month mandate to call more industrial action, Mr Streeting said: 'When the BMA asks, 'what's the difference between a Labour government and a Conservative government?', I would say a 28.9% pay rise and a willingness to work together to improve the working conditions and lives of doctors. 'That is why the public and other NHS staff cannot understand why the BMA have chosen to embark on this totally unnecessary, reckless strike action.' It comes as NHS chief executive Sir Jim Mackey told broadcasters on Friday about his different approach to managing the strike, including keeping as much pre-planned care going as possible rather than just focusing on emergency care. 'So the difference this time is the NHS has put a huge effort in to try and get back on its feet,' he said at NHS England HQ in London. 'As everybody's been aware, we've had a really tough period, and you really feel colleagues on the ground, local clinical leaders, clinical operational colleagues etc, really pulling together to try and get the NHS back on its feet. 'And we also learned from the last few rounds of industrial action that harm to patients and disruption to patients was much broader than the original definitions. So we've decided to say it needs to be a broader definition. We can't just focus on that small subset of care. 'Colleagues in the service have tried to keep as much going as humanly possible as well, and the early signs are that that's been achieved so far, but it is early doors. 'In the end, capacity will have to be constrained by the numbers of people we've actually got who do just turn up for work, and what that means in terms of safe provision, because the thing that colleagues won't compromise is safety in the actual delivery. But it does look like people have really heard that. 'They're really pulling together to maximise the range of services possible.' Asked about further strikes, he said: 'It is possible. I would hope not. I would hope after this, we'll be able to get people in a room and resolve the issue. 'But if we are in this with a six month mandate, we could be doing this once a month for the next next six months, but we've got to organise ourselves accordingly.' Asked why he was not willing to bump pay from what the BMA calculates is £18 an hour to £22 per hour, Mr Streeting told broadcasters: 'I think the public can see, and other NHS staff can see the willingness this Government showed from day one coming into office to try and deal with what had been over a decade of failure on behalf of the previous government, working with resident doctors to improve their pay and to improve the NHS. 'That's why resident doctors had a 28.9% pay award, and that's why the disruption they are inflicting on the country is so unnecessary and so irresponsible.' Mr Streeting said 'we know there'll be real challenges over the next five days'. He added that patients, particularly those who end up waiting a long time for care due to strikes, 'do come to harm, and however much the BMA try and sugarcoat it, what they are fundamentally doing today is forgetting the three words that should be at the forefront of every doctor's minds every day, which is, 'do no harm'.' On whether strikes are going to become the 'new normal', he added: 'As I've said before, the BMA have had a 28.9% pay award from this Government, and we were willing to go further to help on some of the working conditions that doctors face. 'That offer of joint working, that partnership approach, that hasn't gone away, but it does take two to tango, and I hope that the BMA will reflect very carefully on the disruption they are inflicting on patients, the pressures they're putting on their colleagues, and the circumstances in which they are doing so – a 28.9% pay rise and a government that was willing to work with them. 'Those are not grounds for strike action.' It comes after Sir Keir Starmer made a last-minute appeal to resident doctors, saying the strikes would 'cause real damage'. He added: 'Most people do not support these strikes. They know they will cause real damage… 'These strikes threaten to turn back the clock on progress we have made in rebuilding the NHS over the last year, choking off the recovery.' The BMA has argued that real-terms pay has fallen by around 20% since 2008, and is pushing for full 'pay restoration'. The union took out national newspaper adverts on Friday, saying it wanted to 'make clear that while a newly qualified doctor's assistant is taking home over £24 per hour, a newly qualified doctor with years of medical school experience is on just £18.62 per hour'. BMA council chairman Dr Tom Dolphin told BBC Radio 4's Today programme the union had been expecting more pay for doctors. He said: 'Where we were last year when we started the pay campaign, we were down a third on our pay compared to 2008. 'So you've got last year's pay offer which did indeed move us towards (pay restoration), but Wes Streeting himself said that pay restoration is a journey, not an event, implying that there would be further pay restoration to come, and we were expecting our pay to be restored in full – that's our campaign's goal. 'We got part way there, but then that came to a halt this year – we've only had an offer that brings us up, just to catch up with inflation.' Asked what it would take for doctors to go back to work, he said the BMA needed to see 'a clear, guaranteed pathway' to pay restoration. He added that 'it's very disappointing to see a Labour Government taking such a hard line against trade unions'. Elsewhere, the Nottingham City Hospital – where Dr Melissa Ryan, co-chairwoman of the BMA's resident doctors' committee works in paediatrics – reached an agreement with the BMA to exempt one doctor from the strike to work on the neonatal intensive care unit. Speaking from a London picket line, Dr Ryan told The Times: 'I do know that we've granted a derogation already. It is actually at my work, with the babies on one of the neonatal units I work on. That is because it is an intensive care unit for babies. 'We don't have enough senior staff to cover the doctors that aren't there, the residents. And actually, it is important to us that those very sick babies get a lot of care. So we have granted a resident doctor to go back.' The BMA said it had also agreed a derogation for two anaesthetists to work at University Hospital Lewisham on Saturday to ensure patient safety. Louise Stead, group chief executive of Ashford and St Peter's and Royal Surrey NHS Foundation Trusts, told BBC Radio 4's Today programme that around 500 appointments were being rescheduled 'but we are continuing to do about 96% of the work we've had planned'.
The Guardian
2 hours ago
- The Guardian
Fewer resident doctors thought to have gone on strike than in last year's stoppage
Thousands fewer resident doctors are thought to have joined picket lines on Friday during the first day of a five-day strike compared with last year's mass turnout. Although NHS England will only publish data on turnout and cancellations next week, hospital leaders are understood to have observed fewer resident doctors (previously known as junior doctors) on strike and less disruption to services than during the last round of industrial action, which ran from March 2023 until July 2024. While ministers and officials will not receive any statistics until after the five-day stoppage ends on Wednesday, there is a hope within government that the impact might be mitigated, in part by a lower strike turnout. The British Medical Association (BMA) is refusing to comment on how many of its members have joined the stoppage until it is over. The strike will continue until 7am on Wednesday. The public have been urged to keep coming forward for NHS care during this period, and NHS England has urged hospital chief executives to keep routine operations and appointments and only reschedule if there is a risk to patient safety. The NHS chief executive, Jim Mackey, told broadcasters on Friday that the NHS was taking a new approach after learning from previous strikes that 'harm to patients and disruption to patients was much broader than the original definitions'. 'Colleagues in the service have tried to keep as much going as humanly possible as well, and the early signs are that that's been achieved so far, but it is early doors,' he said. 'The thing that colleagues won't compromise is safety in the actual delivery. But it does look like people have really heard that. They're really pulling together to maximise the range of services possible.' Mackey noted that further strikes were 'possible' given the BMA has a six-month mandate. Speaking shortly after the start of the strike on Friday morning at the NHS England headquarters in London, where officials are monitoring its impact, Wes Streeting, the health secretary, praised NHS staff who, he said, were trying to limit its effects. This included, he said, 'many resident doctors who have ignored their union and are turning up for work'. Streeting warned, however, that patients would feel the impact, saying: 'We know that there have been operations, appointments and procedures already cancelled, and we know that there will be real challenges over the next five days.' Calling the BMA's decision to hold the strike a 'reckless and unnecessary action', he added: 'We won't let the BMA hold this country to ransom.' The BMA has agreed to requests for doctors to come off picket lines and work in hospitals experiencing the most pressure. One doctor was told to return to work at Nottingham City hospital's neonatal intensive care unit over the weekend, and a request from Lewisham hospital in south London for two anaesthetists to work on Saturday was also accepted. Sign up to Headlines UK Get the day's headlines and highlights emailed direct to you every morning after newsletter promotion A smaller strike turnout has been expected because the BMA achieved a lesser mandate in the strike ballot than in 2023. Of 48,000 members, 55% voted, of whom 90% supported industrial action – representing less than half of members – compared with a turnout of 71.25% in 2023's expanded electorate, of whom 43,440 (98.37%) voted to go on strike. During the last round of 12 strikes in 2023 and 2024, nearly 1.5m appointments were rescheduled. In the final industrial action from 7am on Thursday 27 June to 7am on Tuesday 2 July, 23,001 staff were absent from work at the peak of the action. The BMA is asking for a rise of 29% over the next few years in order to achieve what it considers to be full pay restoration to pre-2008 levels, after the 2023 industrial action resulted in a pay bump of 22% to cover 2023-24 and 2024-25. At present, ministers have offered a 5.4% pay rise for 2025-26. The BMA council chair, Dr Tom Dolphin, told BBC Radio 4's Today programme that a 'clear, guaranteed pathway' to pay restoration would be required for resident doctors to return to work He said: 'So you've got last year's pay offer which did indeed move us towards [pay restoration], but Wes Streeting himself said that pay restoration is a journey, not an event, implying that there would be further pay restoration to come, and we were expecting our pay to be restored in full – that's our campaign's goal. We got partway there, but then that came to a halt this year.' Keir Starmer made a last-minute appeal to resident doctors, saying the strikes would 'cause real damage'. 'Most people do not support these strikes. They know they will cause real damage … These strikes threaten to turn back the clock on progress we have made in rebuilding the NHS over the last year, choking off the recovery,' the prime minister said.
Metro
2 hours ago
- Metro
What happens to the body when it's dying of starvation amid Gaza hunger crisis
A doctor has detailed what exactly happens to a human body when it's dying from starvation, in a plea for Israel to allow aid into Gaza. Dr Amir Khan goes through step by step how the body begins to break down in the days and hours leading up to death, adding: 'It's not peaceful, it's not quick, it's a slow, lonely descent into silence.' The NHS worker told viewers: 'This is a reel I wish I didn't have to make, but it's so important to speak up and for people to know this.' It comes as the United Nation's food agency, the World Food Programme (WFP), said almost a third of people in Gaza are 'not eating for days' and describing the crisis has having reached 'new and astonishing levels of desperation'. The WFP said 470,000 people are expected to have faced 'catastrophic hunger' between May and September this year. Meanwhile, the World Health Organization (WHO) said Gaza is suffering 'man-made mass starvation' because of an Israeli blockade on aid to the enclave. Israel has denied any responsibility, with some ministers and officials even suggesting there is no hunger in Gaza – but has today allowed foreign aid to be parachuted into the territory. The UN has documented the deaths of dozens of people from malnutrition this week, and says others have collapsed in the streets while trying to reach food. In his post Dr Khan explained that when a person is starving the body first uses up glucose, 'its quickest fuel'. He added: 'That's gone in about 24 hours. You feel shaky, dizzy, cold, your stomach cramps, and worse than the hunger is the exhaustion, like your bones are filled with sand. 'Next, the body burns fat. You lose weight rapidly, your cheeks sink, your clothes hang off you, but your brain is still alert and now it's panicking. 'You can't stop thinking about food, the smell of bread, the memory of taste. It becomes torture.' He said the body then starts 'eating muscle, including the heart'. 'You feel weak, too tired to sit up, your legs tremble, every movement is an effort,' he said. 'You speak less and then you stop speaking altogether. Your brain begins to starve, confusion, hallucinations. 'You see things that aren't there, you forget who you are. It's terrifying. You feel freezing cold, even in the heat.' After this your skin breaks down, he explained, and 'your body hurts to lie on but you can't sit up'. 'In the final stages, organs shut down, breathing becomes shallow, heartbeat slows, consciousness fades,' he added. He concludes the reel by telling viewers: 'Children in Gaza are feeling this right now. This isn't happening in a [natural] famine, this is not a natural death, it's a man-made one, and it's preventable. 'Let aid in, don't look away, don't wait for history to judge, speak now.' Today, UN secretary general António Guterres criticised the international community for turning a blind eye to the suffering of starving Palestinians in the Gaza Strip, calling it a 'moral crisis that challenges the global conscience'. 'I cannot explain the level of indifference and inaction we see by too many in the international community – the lack of compassion, the lack of truth, the lack of humanity,' he said in a speech via videolink to Amnesty International's global assembly. More Trending The UK government is among those criticised by campaigners for not taking a stronger stance against Israel's actions, and for continuing to allow the supply of arms to its military. They were, however, among 28 countries to have signed a letter condemning the 'the drip feeding of aid and the inhumane killing of civilians, including children, seeking to meet their most basic needs of water and food'. The statement signed by the 28 foreign ministers added: 'The suffering of civilians in Gaza has reached new depths. The Israeli government's aid delivery model is dangerous, fuels instability and deprives Gazan's of human dignity.' The statement said Israel's war on Gaza 'must end now'. Get in touch with our news team by emailing us at webnews@ For more stories like this, check our news page. MORE: Tesco urgently recalls lunch time favourites over salmonella fears MORE: Keir Starmer says state is 'inalienable' right of Palestinian people MORE: Wild Nutrition is hosting its first ever London pop-up – here's why you don't want to miss it
