Nhs

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 privatising public services. That latter point is why Labour people sometimes struggle to respond to Johnson.

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 blood tubes – the small plastic tubes which are used for collecting samples of blood.

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agreed that it was in Alta's 'best interests for the treatment that is currently sustaining her precious life...to be withdrawn'.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 take her to Israel for treatment.

There’s something grimly familiar about the case of little Alta Fixsler, the brain damaged toddler whose parents are contesting the decision of the Royal Manchester Children’s Hospital to withdraw her life support treatment. She hasn’t eaten or spoken since she was born, tragically prematurely, a misfortune that left her with permanent brain damage. The hospital wishes to turn off her support but her parents want her to be transferred to a hospital in the United States – her father has an American passport – or to Israel – her parents are Israeli citizens, as is she – where the leading paediatric hospital has volunteered to take her.

Many experts and modellers thought that the 19 July reopening would be a disaster. So far, that has not been the case. Daily case numbers actually started falling within days after 19 July, although that was far too soon to have been caused by anything to do with ‘freedom day’. The question now is how the pandemic will play out for the rest of this year and the next? In trying to understand this, we need to understand some important things about the biology of coronaviruses and their interaction with their hosts: us. Sars-CoV-2, the virus that causes Covid, is not going away. Like other coronaviruses, it will likely infect us all repeatedly throughout the rest of our lives, probably about once every five years.

What is the biggest single threat to the Tories being re-elected? The NHS waiting list, I say in the Times today. Already more than five million people are waiting for routine hospital treatment in England. Sajid Javid has warned that this number could rise to 13 million — which would be one in four of the population. Simon Stevens, the just-departed head of NHS England, has warned that this waiting list could take three years to clear which takes you right up to the next election. For Labour, the backlog list offers the easiest and most comfortable of attack lines: 'You can’t trust the Tories with the NHS'. If millions are stuck waiting for treatment, this line will have huge resonance.

‘Deputy succeeds boss’ might not normally feel like a ‘hold the front page’ type headline. But the announcement that Amanda Pritchard is the new head of NHS England – replacing Simon Stevens – reveals a lot about the state of the NHS and the future direction of the health service. Firstly, the process. Despite concerns that the race to succeed Stevens would be politicised, Pritchard’s appointment (which I revealed on Thursday, thanks to a spot of digital and logistical sleuthing) is understood to have been wholly free of political nudging. Some of the credit for this goes to Number 10 health advisors and some to Lord David Prior, NHS England’s chair and a former Conservative MP.

What is the point of the Covid-19 app? Ministers seem to be as in the dark about the answer to this question as the rest of us, with the government tying itself in knots over whether it means anything at all to get 'pinged' and told to self-isolate. Downing Street has contradicted Business Minister Paul Scully, who said this morning that there was no need to self-isolate if it was just the app that alerted you. He told Times Radio:  It seems that there is a genuine schism in Whitehall 'The app is there to give...to allow you to make informed decisions. And I think by backing out of mandating a lot of things, we're encouraging people to really get the data in their own hands to be able to make decisions on what's best for them, whether they're an employer or an employee.

Is the NHS about to be privatised? That’s the charge from some campaigners as the Health and Care Bill starts its journey through parliament. Certain doctors, mainly on social media, are calling on MPs to scrap the Bill because they claim it will open up the NHS to more privatisation and allow private companies to skim profits off our healthcare system. It’s a big charge, albeit a familiar one, as it tends to pop up whenever there is legislation on the health service. But the strange thing is that it’s very hard to find the evidence for these social media claims in the actual legislation. In fact, these proposals are aimed at dampening much of the emphasis on competition introduced by Andrew Lansley’s controversial Health and Social Care Act in 2012.

Effective cabinet ministers are ones who work out what they want to do in a department on arrival, and then stick to that very small set of priorities whatever the political winds and storms. Michael Gove had this approach in the Education department, setting himself three priorities and then focusing on getting them delivered. Not only did he then replicate this approach in his subsequent Whitehall briefs, but he also inspired other ministers to do the same. Jeremy Hunt, who largely modelled himself on Gove when he became health secretary, also gave himself a small list of things he wanted to do in his time overseeing that brief. Now, it seems Sajid Javid is following suit too.