Category: Health

  • Sajid Javid – 2022 Statement on Reducing the Need for Anti-Biotics

    Sajid Javid – 2022 Statement on Reducing the Need for Anti-Biotics

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 20 June 2022.

    The ability of bacteria—and other types of pathogen—to develop and propagate resistance to the available therapeutic drugs and medicines, such as antibiotics, used to treat them is a significant and growing threat. Alongside extensive efforts to tackle this threat, as set out in the Government’s five-year National Action Plan, we have sought to reduce the need for antibiotics. This is being achieved through both effective infection prevention and control, and through careful stewardship of the antibiotics that we have at our disposal, by reducing inappropriate prescribing. It is also essential that we incentivise the development—by pharmaceutical companies—of new antimicrobials, which has historically been challenging. To address this challenge, we committed to develop and test a new purchasing model for antimicrobials that de-links payments for antibiotics from the volumes used.

    As a result, NHS England and Improvement (NHSEI), the National Institute for Health and Care Excellence (NICE) and the Department of Health and Social Care (DHSC) launched a joint project in July 2019 to test a “subscription-style” payment for two antibiotics, basing the annual payment on a NICE-led assessment of the value of the medicines, rather than on the volumes of drugs used. On 12 April 2022, NICE published guidance estimating the value of the two antibiotics to the NHS. This guidance informed negotiations between NHSEI and the two companies to agree payment levels in the “subscription-style” contracts.

    I would like to inform the House that the contracts between NHSEI and the two pharmaceutical companies have now been signed. Payments to the companies for their antibiotics, Cefiderocol—manufactured by Shionogi —and Ceftazidime with Avibactum—manufactured by Pfizer—will start on 1 July 2022.

    This world-leading project represents an important development in our approach to incentivising innovation in antimicrobial drugs and in our efforts to tackle antimicrobial resistance (AMR). We will continue to build on this work to develop routine arrangements for the evaluation and purchase of new antimicrobials as they are developed. I will be writing to my counterparts in Scotland, Wales and Northern Ireland to formally invite them to participate in these next steps, to ensure that the project can be adapted and scaled across the UK.

    Maintaining momentum on our international advocacy and action on market incentives is crucial. We hope other countries will offer similar incentives in their own domestic markets, so that collectively we can achieve a meaningful incentive for global investment in antimicrobials. This project is representative of our leading role in this area, aligning with the Government’s vision for a Global Britain.

  • Sajid Javid – 2022 Speech at the NHS ConfedExpo

    Sajid Javid – 2022 Speech at the NHS ConfedExpo

    The speech made by Sajid Javid, the Secretary of State for Health and Social Care, in Liverpool on 15 June 2022.

    Thank you, Victor [Adebowale]. It’s great to be with you all in person – and to be part of the new format. The NHS Confederation has always had an awesome ability to bring people together and this Expo is an incredible example of just that.

    The last time I saw a crowd this size was at the Platinum Jubilee. We came together that week to celebrate an institution we’ve all grown up with. And I think these kinds of moments matter because they make us look forward, as well as back. Few can match the Her Majesty the Queen’s record of sacrifice and service – but the NHS can make a very fair claim. Like the monarchy, its success stems from continually reinventing itself for the times we live in.

    In nearly 74 years, the NHS has reigned over the greatest uplift in health in British history. And 50 of those years were spent safely in Conservative hands. I’m so proud to be the latest custodian of our health and social care system, working in partnership with Amanda, who – I think you’ll agree – has been a real force for good.

    Later this month, I’ll mark my first year in the job. It’s just the blink of an eye when you consider our history. But it’s been a remarkable year. Our Roadmap to Recovery. Omicron, and our fightback against it. And our Covid-19 Elective Recovery Plan. There have been so many unprecedented achievements of which you should be fiercely proud.

    In just a short time, I’ve experienced more highs and lows than in any other job – and I’ve had a few! Highs – like how we rose to meet the challenge of Omicron. Highs – like the way so many of you moved mountains to run a remarkable booster campaign. Highs – like how the social care workforce helped to safely open care homes so family members could visit again.

    But the lows have been profound too. Like receiving Donna Ockenden’s report on maternity failings in Shrewsbury and Telford. Like meeting heartbroken families, bereaved by painfully similar tragedies in Nottingham. Or learning of the allegations about the North East Ambulance Service.

    My experiences of health and care are so many people across the country. We’ve all borne witness to phenomenal bravery and dedication, all while knowing, things still need to get much much better.

    It is possible to love the NHS and still demand change. There’s no contradiction there.

    Like most of us, I watched that recent video from the A&E at Princess Alexandra Hospital in Harlow with a mixture of emotions. Horror – at the thought: how would I feel if it was me in that room? Or one of my children? But also respect. Respect for the colleague who had to deliver that difficult message and her poise in the face of unimaginable pressure.

    We all know that people working in health and care have one of the most difficult jobs in Britain today. So to her, and to everyone else working in health and care: I want to thank you for everything you’re doing in such difficult circumstances.

    And I’m under no illusion about the challenges we face.

    Our Covid-19 Recovery Plan is ramping up to deliver a huge increase in activity, embedding new ways of working. Our new Community Diagnostics Centres are bringing life-saving tests, checks and scans closer to people’s home. It’s a vast effort, of which we should all be enormously proud.

    Yet the scale of the challenge is equally vast. We know that some 11 to 13 million people stayed away from the NHS because of the pandemic. Many of those people are now righty coming forward – and many of them to A&E.

    Omicron was also set-back, with an additional 16,000 Covid positive people in hospitals. And we know the number of people on waiting lists is continuing to rise.

    Not only that, but the Covid-19 backlog sits atop a broader set of generational challenges.

    Improved life-expectancy is one of the great triumphs of the modern age, and in so many ways, an NHS triumph. But it also comes with its own challenges.

    The Resolution Foundation has projected that this decade is likely to see the fastest pace of ageing in any decade from the 1960s to the 2040s. As our population gets older, more and more people are living with increasingly complex long-term conditions. Treating an 80-year-old is around four times more expensive than treating a 50-year-old.

    At the start of this century, in 2000, health spending represented around 27 percent of day-to-day public service spending. By 2024, that figure it is set to rise to 44 percent.

    This government will always make sure our health and care system has what it needs to face the future with confidence. We’ve put in record levels of funding in recent years, including raising billions more through the new Health and Social Care Levy.

    But funding will only ever be part of the answer. Growing health spending at double the rate of economic growth over the next decade, as I’ve heard some propose, is neither sustainable, desirable, nor necessary.

    I don’t want anyone’s children to grow up in a country where more than half of our national budget is taken up by healthcare, at the expense of everything from housing to education. That’s not a fair deal for the British people – particularly young people.

    Obviously, we face many structural challenges, from an ageing population and multiple long-term conditions. But demanding spending growth of this kind suggests that we will fail to reduce demand through prevention, early diagnosis and more effective care – as well as a fail to increase health and care productivity with improved use of capital, skills, management, data and innovative models of care. I refuse to countenance such failures.

    I know that – when it comes to improving productivity and quality over the next decade – there’s no one more ambitious than you. Indeed, it’s one of the four key objectives which Matthew set out for this conference, which I very much welcome.

    When reports came out of Cabinet last week that I’d described the NHS as like “Blockbuster in the age of Netflix”, it caused a bit of a stir. But it’s because I believe in the NHS and its founding principles that I want to focus minds on why some organisations keep pace, while others get left behind.

    Before entering Parliament, I had the privilege to live and work around the world. I can tell you: the NHS is unique. It’s not there to make a profit – and it never will be.

    But it’s also not immune to the same basic choices that face organisations right across the world. We need to be smarter with our capital, digitise and transform our use of data. We need to grow the workforce, improve leadership and management and prevent problems from escalating in the first place. We need to accelerate the development of new, innovative models of care and build a more personalised service in a way that people now come to expect.

    Can you imagine any multinational without access to levers like workforce planning? Or any big supermarket chain without a consistent leadership and management programme? Or any FTSE 100 company with its digital functions outside of its own organisation? I believe there are a great many things still to do before we even think about turning to taxpayers again. And it was great to hear what Amanda said just now about making the best use of taxpayers’ money.

    What we’ve done

    Together with all of you here today, a lot of this work is already under way. Let’s just take a quick look at some of the things we’ve worked on in the last year alone.

    We’ve built new institutions, like UKHSA and OHID to redefine how we do public health in this country.

    We’ve strengthened existing institutions, like NHSE by bringing workforce and digital transformation into the heart of the NHS.

    We’ve announced how we’ll improve the provision of social care, something successive governments have ducked for far too long.

    We’ve set out ambitious public targets to slash long waits in the coming years through the Covid-19 Elective Recovery Plan, and we’re projected to meet the first of these targets by next month.

    We’ve published our Integration White Paper, a blueprint for how we provide better care for patients and better value for taxpayers.

    In March, in a speech at the RCP, I laid out the building blocks for our future around Prevention, Personalisation, Performance and People. I did note Amanda’s ‘4 Rs’ earlier, which I also very much agree with.

    On Monday, I announced our new data strategy, called ‘Data Saves Lives’, to bridge the digital divides between health and social care and ensure we use people’s data safely and responsibly so we can take the public with us on this exciting journey.

    And next month, the bulk of the new Health and Care Act comes into force, including our statutory ICSs. It’s certainly not been a quiet first year in the job!

    But I’ve been determined we keep moving forward, because this moment in time we dare not lose. It’s a moment when we can combine valuable lessons from the pandemic, with incredible new technology and innovative ways of working which when taken together, help us face the challenges of the future.

    It’s a small window of time where we can make a big difference.

    Leadership Review

    For me, an important recent moment was when General Sir Gordon Messenger and Dame Linda Pollard published their landmark review into health and social care leadership.

    I remember Gordon saying: “For a report like this to really have an impact… it has to be supportive and honest”. I think we can all agree, that’s what we got. And I’m pleased it has been welcomed by the NHS Confederation, NHS Providers and many more.

    I’m so grateful to Gordon and Linda for their work, and I’m pleased to accept their recommendations in full. They found countless examples of great leadership, not just at the top but at all levels. More than that, they found great leadership under considerable stress.

    They found that where there’s better leaders, there’s better teams. And where there’s better teams, there’s better outcomes. I’ve seen this for myself, in countless visits around the country including this morning, on my visit to the Royal Liverpool University Hospital.

    But this kind of exceptional leadership isn’t embedded everywhere. The review had some really important insights.

    First, on collaboration. We know that, for years, people have worked tirelessly to do the right things for patients – doing their best to work across the walls that have kept us apart. The walls between health and care. The walls between neighbouring trusts. The walls between one organisation and another.

    We’ve chipped away at these walls for a while now. And through the pandemic, we sent whole sections crumbling down, for instance, the incredible way that we rolled out the vaccine – the incredible job the NHS did. No one wants the walls to go back up, so now we’re bringing more and more walls down. From the changes to NHSE to the new ICBs, colleagues can collaborate as never before.

    Implementing the recommendations of the review will support more collaborative leadership: one where we’re working across the divides where the walls once stood, and embracing a ‘connection culture’.

    I was also moved by the insights on culture in the workplace. They found “too many reports to ignore” of poor behaviour – and that we’ve reached a point where – in some parts of the system bullying and discrimination are – and I quote – “almost normalised”. All of us know, from our own careers, just how toxic that can be. Because when even just a tiny minority behave that way it can be contagious for behaviour and morale.

    We will have zero-tolerance on discrimination, bullying and blame cultures. And that of course includes racism – which was highlighted by the BMA’s report yesterday.

    We know that, if we tolerate it, it doesn’t just make health and care a worse place to work, it makes this country a worse place to live. The examples of Shrewsbury and Telford and Mid Staffs shows the extremes where this behaviour can take us. Standards not met. Complaints ignored. Lives, needlessly lost.

    Let me be clear: the actions of the few should take nothing away from the values of the many. In fact, it’s because of the incredible professionalism of the overwhelming majority of colleagues in health and care that we should be even more determined to get it right.

    And the good news is this: just as Gordon and Linda found that bad behaviour was contagious, they found that great leadership was contagious too. It works best when everyone – even those without the word ‘leader’ in their job title – feels like a leader.

    Other recommendations around training, standards and management will support this effort, helping the workforce at all levels, by creating the conditions for everyone to thrive.

    And when I say everyone, I mean everyone everywhere. Not just those in leafy pockets of England, but where people need it most.

    We know that in some regions, poor leadership is a constant challenge. That’s an injustice we’re just not prepared to tolerate. We need the best people doing the hardest jobs – and getting the right leaders in the right places takes the right incentives.

    One of the first things I did in this job was to read Sir Chris Whitty’s report on the serious health and social challenges in coastal communities. And I’ve seen them first-hand. I did my first speech in Blackpool, on health disparities. And I was recently in Clacton as part of my Road to Recovery tour, where they have the second highest mental health need of anywhere in the country. So I’ll make no apologies for encouraging top talent to areas facing the biggest problems, especially some of our most deprived communities.

    I’m committed to making these changes: To supporting the leadership our colleagues in the NHS and social care deserve – and the leadership everyone everywhere deserves.

    What’s to come

    The year ahead promises to be no less busy. We’ll shortly be publishing: our Digital Health and Care Plan; our Health Disparities White Paper; our 10-year plans on cancer, dementia, and mental health; our update of the NHS long-term plan after Covid; the HEE workforce framework, which, later in the year, will be followed by the NHS’s first-ever 15-year workforce strategy.

    I also recognise that Primary Care is going to be a crucial part of the puzzle. It’s the front door to health and care – and I’m grateful to all the primary care staff who make a difference every single day.

    But I don’t think our current model of primary care is working. That won’t be a surprise to you. I know. You know. Patients know. And everyone working in primary care knows: we need a plan for change.

    We are starting with pharmacy – and I will be setting out my plans shortly.

    I’m grateful to Dr Claire Fuller for her recent review on how we can improve patient access to primary care. I’m confident her recommendations will improve access, including for those with the most complex needs, and, ultimately, help us tackle the Covid backlog and help people live healthier lives for longer.

    I’m determined that when we look back on these years – on this window of change we have right now – that we can say we did all we could to secure the future of health and care for the generations that come after as.

    Reform Partnerships

    So today, I want to focus on one more thing our new Health and Care Act can help us achieve.

    The pressure of the pandemic produced some powerful partnerships. With the ingenuity of people on the front line, including so many of you, walls that had seemed so rigid came crumbling down. As we face the challenges of recovery, those ways of working can work again.

    Back at the RCP in March, I talked about the potential power of ‘partnerships for reform’. Now, we have a legislative framework that encourages it. For ICSs to fulfil their full potential – and make the changes truly worthwhile – I want to see the creation of many more of these reform partnerships.

    This is already happening. We’ve already taken forward the Provider Collaborative model where are group of providers of acute or mental health services agree to work together to improve the care pathway of their local population.

    For example, there are currently 47 NHS-led Provider Collaboratives for mental health, learning disabilities and autism. We’ve seen the success of this approach in London, where the South London Health and Community Partnership has been able to bring out of area patients down by a third, and readmissions down by two-thirds.

    There are also some 50 acute trust collaboratives and mixed collaboratives, bringing together acute, specialist, mental health and community providers. It’s about listening to the innovators already doing incredible things within the system – then giving them a platform to do it.

    They’ve already shown that when we partner like this, challenges that appear intractable in one place can be resolved in another. These partnerships work. They deliver for patients. And they’re helping us to tackle the Covid backlog.

    So for me, the logical next step is to think about how we can use these kinds of partnerships to support underperforming trusts.

    Earlier, I talked about using incentives to get the right leaders in the right places – places that have been let down for too long.

    Reform Partnerships will be a central way we can spread good leadership to those places. So as part of the work on Reform Partnerships, I want to explore whether we make being part of a Reform Partnership a requirement for underperforming trusts.

    I believe this could be powerful way to ensure that the leadership we need doesn’t stay in the walled gardens of England’s best performing trusts, but is there to help turn trusts round and with it, the health and happiness of those who live there.

    So I’m looking forward to working with all of you on these plans.

    I know you’ve faced – and continue to face – the most unimaginable kinds of pressures. And you continue to do so with passion and innovation.

    You have, not just my admiration, but my full support.

    I’m proud to work with you and call you my colleagues.

    Because if there’s a theme that unites all of this work, it’s this: that the ideas and the ways working we need are already here – with so many of you in the room today.

    I believe we can continue to reinvent ourselves for the times we live in; for this institution we’ve all grown up with to be the one we grow old with – with dignity and with good health.

    And the moment to do it is now. We have no time to lose. We have a small window of time to make a very big difference.

    Let’s keep breaking down the walls between us. To meet the challenges before us. So that, together, we can deliver better health and care for everyone everywhere.

    Thank you all very much.

  • Sajid Javid – 2022 Statement on Health and Social Care

    Sajid Javid – 2022 Statement on Health and Social Care

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 13 June 2022.

    I would like to inform the House that the final version of “Data saves lives: reshaping health and social care with data” has been published today. It builds on the groundbreaking use of data during the pandemic and sets out ambitious plans to harness the potential of data in health and care, while maintaining the highest standards of privacy and ethics.

    When facing this country’s greatest public health emergency for generations, one of the most effective tools at our disposal has been the power of data. Now, as we look to live with covid, we must apply those same tools as we tackle the most pressing challenges facing the country including elective recovery and integration of health and social care.

    Earlier this year, I made a speech setting out my four priorities for reform in health; prevention, personalisation, performance and people. We cannot deliver the change we need to see, and our 10 year plans for cancer, dementia and mental health, unless we embrace the opportunities from data-driven technologies. Last week, Sir Gordon Messenger and Dame Linda Pollard published their review into leadership of health and social care, and I accepted their recommendations in full. Today’s data strategy is the next step in our plans to modernise the NHS.

    This strategy shows how we will use data to bring benefits to all parts of health and social care; from patients and care users, to staff on the front line, to the pioneers driving the most cutting-edge research.

    It is backed by a series of concrete commitments, including investing in secure data environments to power research into new treatments, using technology to allow staff to spend more quality time with patients, and giving people better access to their own data through shared care records and the NHS app. The strategy will support NHS providers to tackle the covid backlog, providing them with the means to monitor and optimise capacity through improved data sharing and the development of advanced analytics. This is all on top of the huge investment that we have already made; for instance investing £200 million in our data for research and development programme.

    It is vital that, as we deliver these benefits, we work in a way that maintains the high level of public trust in how the NHS uses health and care data. That means maintaining the highest standards of privacy and ethics, investing in secure data environments and cyber security, involving the public in decisions about how data is used in the future, listening and responding to their views and concerns.

    We published a draft of this strategy in June 2021, and I would like to thank the hundreds of people and organisations who provided feedback which was invaluable in shaping this final version of our strategy for the future.

    I would also like to thank Dr Ben Goldacre for his work on the Goldacre Report, which was published in April, and made a compelling case for how data can drive innovation and improve healthcare. I fully support his recommendations and this strategy shows how we will take them forward.

    I will deposit a copy of the draft strategy in both Libraries.

  • Sajid Javid – 2022 Statement on a Smokefree 2030

    Sajid Javid – 2022 Statement on a Smokefree 2030

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 9 June 2022.

    In 2019, this Government set the bold ambition for England to be smokefree by 2030—reducing smoking rates to 5% or less.

    Today, Dr Javed Khan OBE published his independent review on Smokefree 2030, providing this Government with a wide range of recommendations for how we can achieve this ambition.

    Tragically, smoking remains the single biggest cause of preventable illness and death across the country. There are still almost 6 million smokers in England—and two out of three will die from smoking unless they quit.

    Although smoking rates have fallen, we know that they are currently not falling fast enough.

    The Government are committed to levelling up society and extending the same chances in life to all people and all parts of our country. However, smoking is one of the largest drivers of health disparities and rates vary substantially across different parts of the country. As stated by Dr Khan in his independent review, at its most extreme, smoking prevalence is 4.5 times higher in Burnley than in Exeter.

    Smoking is a significant drain on the household finances of our most disadvantaged families. In Halton in Cheshire, smokers spend an estimated £3,551 a year on tobacco, nearly 15% of their income. Reducing smoking presents a huge economic opportunity in higher disposable income and higher labour productivity.

    Smoking is particularly high amongst certain populations, and one third of all cigarettes smoked in England are smoked by people with a mental health condition. Nearly 10% of mothers smoke at the time of giving birth, increasing the risk of sudden infant death syndrome by over three times compared to mothers who do not smoke. Further, the risk of stillbirth is increased by at least 60% if the father smokes. Smoking is also known to increase the risk of miscarriage.

    Behind all of these statistics are individuals, families and communities who are suffering from the harms of tobacco. This Government are committed to doing more to help smokers to quit and stop people from taking up this deadly addiction. We also know that most smokers want to quit.

    For these reasons, we asked Dr Khan to undertake this independent review to help the Government reduce the devastation that smoking causes in our communities. There are a number of recommendations in Dr Khan’s independent review. The Government will now consider their response.

    There is a call for greater investment—from local authority-led stop smoking services, through to improved data and evidence. The Government are already investing funding through the public health grant, but we will examine where we can go further.

    There is a call to offer vaping as a substitute for smoking. Vaping is far less harmful than smoking and is an effective quitting device. It is recognised that there is much more Government can do to tackle the myths and misconceptions that surround vaping. We have worked with the MHRA to provide guidance to support bringing e-cigarettes to market as licensed therapies and this Government will take forward a range of work on vaping as a substitute for smoking in due course.

    Dr Khan also calls for the NHS to prioritise further action to stop people from smoking. Smoking costs the NHS £2.5 billion every year. The benefits of focusing on preventing smoking-related illnesses, rather than treating them, are clear for patients and the NHS themselves.

    This Government are determined to address the challenges raised in the independent review and to meet the Smokefree 2030 target. We know that more action needs to be taken to protect our people from this dangerous addiction.

    The Department will now carefully consider the recommendations set out in this independent review. The independent review will help to inform our upcoming White Paper on health disparities, which we plan to publish this summer. To complement this, the Department will also be publishing a new tobacco control plan in due course.

    We would like to thank Dr Khan for his far-reaching work on the independent review, and for his clear and challenging recommendations.

    A copy of the independent Khan review will be deposited in the Libraries of both Houses.

  • Sajid Javid – 2022 Statement on Monkeypox

    Sajid Javid – 2022 Statement on Monkeypox

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 8 June 2022.

    Following the increased prevalence of cases of monkeypox in England, and transmission within the community for the first time, I would like to inform the House that as of Wednesday 8 June 2022, the following amendments have been laid and come into force:

    The Health Protection (Notification) Regulations 2010 have been amended to include monkeypox as a notifiable disease in Schedule 1 and monkeypox virus as a notifiable causative agent in Schedule 2.

    The National Health Service (Charges to Overseas Visitors) Regulations 2015 have been amended to include monkeypox in Schedule 1.

    The public health assessment remains that the threat to the public is low. These amendments will support the UK Health Security Agency, or UKHSA, and our health partners to swiftly identify, treat and control the disease, and reduce potential financial barriers to overseas visitors in England who require NHS-funded secondary care services in relation to monkeypox.

    Health Protection (Notification) Regulations 2010

    From today, 8 June 2022, monkeypox is a notifiable disease and there is now an explicit legal duty on doctors to notify the “proper officer” of the relevant local authority if they see a patient they suspect of having the monkeypox virus in England. While we believe cases have been reliably notified to date, this amendment puts beyond doubt the legal obligation of doctors to report cases of suspected monkeypox. Placing a legal duty on doctors to report suspected monkeypox cases, and provide the relevant patient information, will strengthen our understanding of the virus and its transmission within the UK and, if required, support the implementation of timely prevention and control measures.

    We have also placed a legal duty on laboratories to notify the UKHSA if they identify monkeypox virus when they test a sample in England, by listing the virus as a notifiable causative agent. Positive laboratory samples will be an important core dataset, strengthening surveillance and helping to inform our understanding of outbreak progression and trends to underpin action. Laboratory notification will also help to identify the links between cases and act as an important contingency if case notification by doctors has not occurred.

    National Health Service (Charges to Overseas Visitors) Regulations 2015 (“the charging regulations”)

    The charging regulations require providers of NHS-funded secondary care to make charges to people not ordinarily resident in the UK (“overseas visitors”) except where an exemption category applies.

    We have taken swift action to ensure that, should an overseas visitor in England need NHS- funded secondary care services in respect of monkeypox, they will not face any charge for them. Providing such services without charge removes a potential financial barrier to overseas visitors presenting for NHS-funded secondary care, therefore ensuring that the risk to the public’s health from infected visitors is minimised. This brings monkeypox into line with most other infectious diseases, such as tuberculosis and covid-19.

    The inclusion today of monkeypox in Schedule 1 of the charging regulations will mean that overseas visitors will not be charged for the diagnosis and treatment of monkeypox. The charging regulations have also been amended so that if any charges have already been incurred during this outbreak, they must be cancelled, or, if paid, they must be refunded.

  • Wes Streeting – 2022 Speech on the Health and Social Care Leadership Review

    Wes Streeting – 2022 Speech on the Health and Social Care Leadership Review

    The speech made by Wes Streeting, the Labour MP for Ilford North, in the House of Commons on 8 June 2022.

    The Secretary of State has picked quite the week to talk about standards in leadership.

    I give a huge thanks to NHS staff and leaders for the work they are doing against the most extraordinarily difficult backdrop. I also thank General Sir Gordon Messenger and Dame Linda Pollard for carrying out the review. Its seven recommendations are sensible, and I am pleased the Secretary of State has already committed to implementing them.

    As this is a rare example of decisiveness from the Health Secretary, can he tell us when he intends to publish his implementation plan? All too often, the senior leadership of the NHS still does not represent the diversity of the population it serves. Instead of throwing red meat to his Back Benchers, for reasons that will probably be obvious to everyone, I would like to hear how, in particular, he intends to ensure that equality, diversity and inclusion will be improved, so that the best leaders are incentivised into the most challenging roles and are able to provide inclusive healthcare for the breadth of diversity in our great country. Can he explain why the review has not covered leadership in primary care or social care in any detail? Surely this is a missed opportunity. Let us face it: although he is trying to dress this up as the biggest shake-up in history, I am not sure that giving staff an induction on joining the NHS is a revolutionary development, and it hardly meets the scale of the challenge.

    The NHS faces the biggest crisis in its history. NHS staff are in a system under pressure like never before, and there are simply not enough of them. There are currently 106,000 vacancies across the NHS, and staff are leaving in droves. In some specialties, such as midwifery, they are leaving faster than we can recruit them. I do not know how the Health Secretary expects NHS managers to demonstrate good leadership and deliver the best outcomes for patients when there are no staff to lead. For an organisation the size of the NHS, one of the biggest employers in the world, not to have a plan for its workforce is unbelievably negligent. What is the NHS meant to do until he eventually delivers his long-term workforce strategy, which he has been promising for some time? How are managers meant to lead effectively when instead of thinking about patient care as their primary driver, they have become buildings and facilities managers, because the ceilings are falling in? The only place where more than 40 new hospitals really exist is in the Prime Minister’s imagination.

    The Health Secretary said that we should accept only the highest standards in NHS management, so let me ask him not about the generalities, but about the specifics. Last month, it was reported that North East Ambulance Service bosses oversaw cover-ups of negligence, leaving about 90 families not knowing how their loved ones died. He said yesterday that he is still considering whether to launch a review. Is he seriously considering protecting managers who cover up bad practice, instead of standing up for grieving families? Staff in that service were reportedly paid to sign gagging clauses, and I understand that attempts to get them to sign such clauses are still under way. In a written question, I asked how many non-disclosure agreements had been signed in the NHS since the Government said that they would be banned in 2014. He does not know and he is refusing to investigate the use of gaging clauses in the NHS. So how can he claim to be shaking up NHS culture and dealing with bullying when he has no interest in what is going on under his nose?

    Of course the NHS needs good leaders, but when it comes to examples of poor leadership in the NHS, the Health Secretary did not need the Messenger review; he just needed to look in the mirror. This is the man who described the NHS as Blockbuster Video

    “in the age of Netflix”,

    as if it was the greatest revelation since Moses received the 10 commandments. Who has been in government for the past 12 years? On his watch, on this Government’s watch, we have the highest waiting times in the NHS’s history; the lowest patient satisfaction since 1997; longer waiting times for cancer in every year since 2010; heart attack and stroke victims left waiting for about an hour, on average, for ambulances; and patients at risk of serious injury because the hospital is crumbling around them. He kicked off his own Health Week expecting applause for the fact that, despite his best efforts, there are still 9,000 people waiting for more than two years for treatment. He knows, I know, NHS staff know and the public know that with this Government, NHS staff are lions led by donkeys, wanting and inadequate.

  • Sajid Javid – 2022 Statement on the Health and Social Care Leadership Review

    Sajid Javid – 2022 Statement on the Health and Social Care Leadership Review

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 8 June 2022.

    With permission, Mr Speaker, I will make a statement on the independent leadership review of health and social care.

    This is an important report that comes at a critical time. This Government are embarking on a huge programme of reform to tackle the covid backlogs, to improve people’s experience of the NHS and social care, and to place this system on a sustainable footing for the future. But we cannot seize this opportunity and deliver the change that is so urgently needed without the best possible health and care leadership in place, because great leaders create successful teams, and successful teams get better results. So a focus on strong and consistent leadership at all levels, not just on those who have the word “leader” in their job title, will help us in our mission to transform health and care and to level up disparities and patient experiences.

    This review, which I have deposited in the Libraries of both Houses, was tasked with proposing how to deliver a radical improvement in health and social care leadership across England. It sets out a once in a generation shake-up of management, leadership and training, as well as how we can make sure that health and care is a welcoming environment for people from all backgrounds, free from bullying, harassment and discrimination.

    The review was led by General Sir Gordon Messenger, former Vice-Chief of the Defence Staff, and Dame Linda Pollard, the chair of Leeds Teaching Hospitals NHS Trust. I thank them both for taking on this role and providing their varied experience of leadership, along with everyone in their review team who has contributed to this important review.

    Before I turn to the recommendations of the review, I shall update the House on its findings. The review found that, although there are many examples of inspirational leadership within health and social care, from ward to board, these qualities are not universal. The report states that

    “there has developed over time an institutional inadequacy in the way that leadership and management is trained, developed and valued.”

    As a result, careers in management are not viewed with the same respect and prestige as clinical careers. The review also found

    “too many reports to ignore”

    of poor behaviour, and that the acceptance of bad behaviours like discrimination, bullying and responsibility avoidance has become “almost normalised” in certain parts of the system.

    We must only accept the highest standards in health and care, where failures in culture and leadership can make the difference between life and death. So we must do everything in our power to share and promote brilliant, innovative management and to act firmly where standards fall short. This means culture change from the top of the system to the frontline. The review identifies a number of areas where improvement is needed, and it makes seven transformative recommendations. I will quickly update the House on each of them in turn.

    First, the review recommends new measures to promote collaborative leadership and to set a unified set of values across health and care. This includes a new national entry-level induction for new joiners to health and care, and a new national mid-career programme for managers.

    Secondly, the review recommends that we should agree and set uniform standards for equal opportunities and fairness, with more training to ensure that the very best leadership approaches become ingrained. The Care Quality Commission must support this work by measuring progress through regular assessments. This does not mean more people working in diversity but fewer. In my view, there are already too many of these roles and, at a time when our constituents are facing real pressures on the cost of living, we must spend every penny with care. Instead of farming out this important work to a specific group of managers, it must be seen as everyone’s responsibility, with everyone being accountable for extending fairness and equal opportunities at work.

    Thirdly, the review recommends a single set of unified leadership and management standards for NHS managers. These standards will apply to everyone, including those who work part time and flexibly, with a curriculum of training and development to help people meet them. This modernisation is well overdue, and completing the training should be a prerequisite for advancing to more senior roles.

    Fourthly, the review recommends a more simplified, standardised appraisal system for the NHS, moving away from variation in how performance and career aspirations are managed towards a more consistent system that takes into account how people have behaved, not just what they have achieved.

    Fifthly, the review identifies a lack of structure around careers in NHS management. It proposes a new career and talent management function for managers at a regional level, to oversee and support careers in NHS management and to provide clear routes to promotion, along with training and development.

    Sixthly, the review recommends that the recruitment and development of non-executive directors needs to be given greater priority due to their vital role in providing scrutiny and assurance. It proposes an expanded specialist appointments team in the NHS, tasked with encouraging a diverse pipeline of talent.

    Finally, there is currently little or no incentive for leaders and managers to move into the most challenging roles, as the barriers are often seen as simply too high. I want leaders in the NHS to seek out those roles, not shy away from them. It is essential that we address that and get great leaders into areas that feel left behind. The review proposes an improved offer, with stronger support and incentives to recruit top talent into those positions.

    We will be accepting these comprehensive, common-sense recommendations in full. The recommendations have been welcomed by groups representing people who work throughout the NHS, including by the NHS Confederation and NHS Providers. By taking the review forward, we can finally bring how we do health and care leadership into the 21st century, so that we have the kind of leadership that patients and staff deserve, right across the country, and so that we make sure that some of our country’s most cherished institutions can thrive in the years ahead.

    I commend this statement to the House.

  • Sajid Javid – 2022 Comments on the Innovative Medicines Fund

    Sajid Javid – 2022 Comments on the Innovative Medicines Fund

    The comments made by Sajid Javid, the Secretary of State for Health and Social Care, on 7 June 2022.

    I want NHS patients to be the first in the world to access the most promising and revolutionary treatments that could extend or save their lives.

    The launch of the Innovative Medicines Fund delivers another manifesto pledge and will fast-track cutting-edge medicines to adults and children to give people renewed hope for a better future.

  • Sajid Javid – 2022 Statement on Monkeypox

    Sajid Javid – 2022 Statement on Monkeypox

    The statement made by Sajid Javid, the Secretary of State for Health and Social Care, in the House of Commons on 23 May 2022.

    Following announcements made by the UK Health Security Agency on 7,14,18 and 20 May, I am writing to inform the House that—as of 12 pm on Monday 23 May 2022—a total of 56 monkeypox cases, in three unlinked incidents, have now been confirmed in the UK. Further cases have been identified worldwide, outside the endemic regions of west and central Africa.

    Monkeypox virus in the UK is extremely rare and the detection of monkeypox in unlinked cases indicates community transmission. Prior to May 2022, there were three previous domestically acquired cases—two household transmissions related to an imported case and one healthcare worker related to a separate imported case.

    In the coming days, I expect that further cases will be detected by the UK Health Security Agency’s expert diagnostic capabilities, working with NHS services to ensure heightened vigilance among healthcare professionals.

    The UK was the first country in the world to identify and report this recent emergence of non-endemic cases to the World Health Organisation, which continues to receive reports of further cases in other countries across the globe.

    The infection can be passed on through direct contact with monkeypox skin lesions or scabs; contact with clothing or linens—such as bedding or towels—used by an infected person; and potentially by close respiratory contact via coughing/sneezing by an individual with a monkeypox rash. Monkeypox has not previously been described as a sexually transmitted infection, though it can be passed on by direct contact during sex. A notable proportion of cases have been among gay, bisexual and other men who have sex with men.

    The virus does not usually spread easily between people without close contact and the risk to the UK population remains low.

    World-leading experts at the UK Health Security Agency, working in partnership with health protection agencies in Scotland, Wales, and Northern Ireland, are providing the latest scientific, clinical and public health advice. They are also providing testing capability at the Rare and Imported Pathogens Laboratory at UKHSA Porton Down and have stood up additional capacity at UKHSA Colindale. They continue to contact trace, rapidly investigate the source of these infections, and raise awareness among healthcare professionals. Any close contacts of the cases are being identified and provided with health information and advice.

    UKHSA, and its partner public health agencies in the devolved Administrations, will continue to keep the scientific and clinical evidence under review to ensure that decisions are made on the best available evidence despite the fast-moving situation.

    Individuals, especially gay, bisexual and other men who have sex with men, who develop an unusual rash or lesions—such as scabs—on any part of their body, but particularly their genitalia, should contact NHS 111 or a sexual health service. Individuals should notify clinics ahead of attendance and avoid close contact with others until they have been seen by a clinician. They can be assured that discussion will be treated sensitively and confidentially.

    UKHSA has set up a dedicated helpline to support clinicians dealing with monkeypox cases.

    Vaccination and treatment

    The smallpox vaccine, Imvanex (MVA-Bavarian Nordic), although not specifically licensed for the prevention of monkeypox in Europe, has been used in the UK in response to previous incidents. This vaccine has a good safety record; it is made from a smallpox-related virus that cannot replicate and has been demonstrated to be highly effective at preventing infection—when given within four days of exposure—and reducing severe illness, if given between four and 14 days of exposure.

    The vaccination of named close contacts of cases is under way, with vaccine eligibility being kept under close review. As of 10 am on 23 May 2022, over 1,000 doses of Imvanex have been issued or are in the process of being issued, to NHS trusts. There remain over 3,500 doses of Imvanex in the UK.

    We are also exploring procurement options in case any specific antiviral treatment is shown to be effective against this virus; further details will be provided in due course.

    I can confirm to the House that it will be kept abreast of updates as the situation evolves.

  • Maria Caulfield – 2022 Statement on the Introduction of Additional Blood Donor Testing

    Maria Caulfield – 2022 Statement on the Introduction of Additional Blood Donor Testing

    The statement made by Maria Caulfield, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 23 May 2022.

    I would like to inform the House that the Government have accepted the advice of the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) and will be introducing additional testing to detect hepatitis B in donated blood from 31 May 2022. The Scottish Government, Welsh Government and Northern Ireland Executive have also accepted the advice of SaBTO.

    The safety of people donating and people receiving blood and blood products is the Government’s priority. We have robust safeguards in place that protect both donors and those receiving this potentially lifesaving intervention, which includes testing all donations for possible infections prior to use in transfusion.

    In 2019, SaBTO established the occult hepatitis B infection (OBI) working group to consider options for further improving pre-donation testing for hepatitis B. The group considered different testing options to identify those donors who have undetectable levels of the surface antibody to hepatitis B, but do have hepatitis B DNA and a core antibody to hepatitis B. These donors are known as occult donors and have been shown to be able to transmit hepatitis B to blood donor recipients. The OBI working group recommended the introduction of core antibody testing, alongside the current testing, for all current donors once, and then all new and returning donors. SaBTO reviewed the findings of the working group and agreed with the recommendations.

    The Government have reviewed the evidence compiled by the OBI working group together with SaBTO’s advice and has accepted the recommendation. The introduction of this new form of testing further improves the rigorous processes we have in place to ensure the health and wellbeing of donors and the safe and consistent supply of blood for patients.

    The Department of Health and Social Care is working with NHS Blood and Transplant to implement this change and the overall impact of the changes will be reviewed in 12 months by SaBTO and the Government.