Cowper’s Cut 188: Randoxxing the nation, as The Power-Posing Saj cancels NHSE meeting four times
It’s not news to anyone who follows health policy that former MP Owen Paterson was a longstanding and well-paid lobbyist for medical testing firm Randox, earning just under £50,000 a year from them.
Randox has been a prominent provider of Covid19 tests, and was given a large Government Covid19 testing contract last November after being given a first uncontested contract in March 2020, despite its testing kits having to be recalled on safety grounds in mid-2020.
When Mr Paterson was convicted of abusing his position as an MP by the Parliamentary Standards Commissioner, he claimed that the investigation into his lobbying abuse had significantly contributed to his late wife’s tragic death by suicide. It is notable that his statement following the inquest verdict in 2020 repeatedly emphasised that he did not think his wife had been depressed or suicidal.
The Government decided that it was going to use the pretext of the verdict against Mr Paterson to attack and downgrade the Parliamentary Standards Commissioner’s role and work. This plan having passed by only a narrow majority and having created huge controversy, the Government promptly U-turned.
Ooops.
Ex-MI5 boss Lord Evans, chair of the Committee On Standards In Public Life, gave a striking speech to the Institute For Government conference this week, saying of the Government’s efforts to abet and aid Paterson’s corruption, “it cannot be right to propose that the standards system in the House of Commons should be reviewed by a Select Committee chaired by a member of the ruling party, and with a majority of members from that same party. This extraordinary proposal is deeply at odds with the best traditions of British democracy. The political system in this country does not belong to one party, or even to one government. It is a common good that we have all inherited from our forebears and that we all have a responsibility to preserve and to improve.
“The Seven Principles of Public Life, that all governments have espoused for over twenty five years, require that Ministers and MPs should show leadership in upholding ethical standards in public life. I find it hard to see how yesterday’s actions in any way meet that test”.
This may well prove to be a consequential point in our politics. It could mark the moment when much more of the electorate notice the incompetence, nastiness and raw self-interest behind PM Boris Johnson’s Etonian clown façade.
The Sunday Times revealed this week that Randox was awarded one of its Covid19 testing contracts despite not having necessary equipment. The DHBSC civil servants are shown to be planning to have then-SOS Matt Hancock “send a letter to universities asking for loans of the various things we need”. The article reports that DHBSC “was later forced to pay airlines to fly used test kits from England to Northern Ireland so that Randox could analyse them at its main laboratory”.
The Saj cancels NHSE chair meetings - four times
For power-posing Health But Social Care Secretary Sajid ‘The Saj’ Javid to cancel a meeting with NHS England’s current chair, former Conservative Health Minister Lord Prior once at short notice might be considered a misfortune: for The Saj to do so four times within the past month (once at just ten minutes’ notice) seems to herald a pattern of behaviour and a revealed preference.
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This triangulates with his other reported actions (in particular, an apparently wilful refusal to understand how the feminisation of the clinical workforce has created a significant cohort of staff who do not want to work extra shifts, even if the pensions taper tax issue were sorted) to show that The Saj is sending a very clear message to system leaders. It is that he has a strong ex-Chancellor streak of Treasury mindset, and he is highly determined not to be ‘turned native’ by / on the NHS, or health overall.
Spectator political editor (and friend of his best man, Chancellor Rishi Sunak) James Forsyth reports that The Saj “thinks that another way to create more capacity in the NHS is through better organisation of its existing resources …in the short term, Javid thinks that diagnostic and surgical hubs can help to clear the backlog. The logic is that a surgical hub doing one set of operations will become particularly efficient at carrying it out”.
Oh dear. The Saj appears quite determined to ignore the fact that there are not the spare clinical staff to make such plans happen. New diagnostic and surgical hubs can only be staffed by taking staff from existing hospitals, and good luck with that. His less-than-stellar grasp of the seriousness of NHS workforce issues was evident in the following.
Tackling the backlog: “can’t put a number”
In his first appearance before the Health And Social Care Select Committee, Secretary Of State For Health But Social Care Sajid Javid was questioned on his main priorities to clear the backlog of cases caused by the pandemic.
It would be unfair to claim that we learned a great deal, but it was more than nothing.
SOS Javid told the Committee that he “can't put a number” on the number of extra doctors and nurses needed to clear the elective backlog. The Saj added a workforce plan is due to be published at the end of November that outlines vacancies in each specialty and plans to fill those gaps. There are currently 93,000 vacancies in the NHS at the moment, he claimed.
Ex-SOS and committee chair Jeremy Hunt was not too happy with this response and pushed for more information on what will be done to plug workforce gaps short-term. "There's a workforce crisis now", Hunt said: "NHS staff are desperate".
Mr Javid said that several documents are going to be published before the end of the year which set out a short-term workforce plan. (You couldn't offer NHS satirical genius Julian Patterson a better hostage to fortune, and Stockholm-Syndrome-style, he took full advantage.)
Mr Javid was asked by an on-form Barbara Keeley how the NHS can be expected to recover the elective backlog when social care is also under "immense" pressure, given that there's also "very little" in the spending review to indicate that pressure will be alleviated.
The Saj gamely replied "there's a record amount of extra funding" going into social care to deal with the challenges caused by the pandemic.
The Fifteen-Year Forward View
The NHS is, The Saj vowed, to set out elective recovery plan by the "end of November" setting out how it will use additional spending and a workforce plan. This November plan will set out elective workforce needs while a 15-year plan for whole NHS/social care workforce is due "hopefully" in Spring.
“Hopefully” does indeed seem to be the key word, given the zero clarity offered to HEE about training budgets by the Budget and CSR. It's also notable that he didn't specify 'November 2021' and 'Spring 2022'.
Despite this, the committee is told Care England has said: "There will be serious and far reaching consequences from this lack of recognition of extra funding" for social care.
Asked about planned GP league tables, The Saj claims “we never have. Didn’t come from the Department, didn’t come from the NHS”.
Mmmmmm. If not mmmmmmmmmm. I think this will come as a surprise to certain national political correspondents who were briefed about this. Or even given on-the-record interviews.
Team The Saj’s tendency to brief tough, and then brief against their briefing, is unlikely to end well. National political correspondents are not ego-less people, and they don’t like being made to look stupid.
The SOS was asked about full-time equivalent (FTE) GP numbers by Mr Hunt, who said that whether the number is up 300 or down 400 (as differing groups suggest), the Government is certainly missing the target of 6,000 more GPs.
The Saj claimed that “to June 2021 the NHS has an1 extra 1,200 more doctors”, but he was unsure if these were FTEs. Mr Hunt noted that the numbers not going up as fast as would like: The Saj proffered another target of an extra 26,000 more other clinicians.
Mr Hunt asked if DHBSC is on track for the promised additional 6,000 FTE GPs. Facing a man who clearly knew the numbers, The Saj was left in the merciless position of having to be honest. “No. We’re lifting caps in medical school; looking at international recruitment. But we’re not on track. And I’m not pretending. We’re looking at what more we can do”.
Mr Hunt had the grace to point out that the ‘6,000 more GPs’ target had come after his own of 5,000 by 2020, “which did not succeed”. This Times story highlights the actual falling GP numbers from NHS Digital. On GP workforce issues, The Times today leads with a story that The Saj is considering the reintroduction of the Medical Practice Committee to prevent new GPs working in over-doctored areas.
The session saw a good query from Laura Trott as to whether the 30% NHS capacity increase is permanent, or will be ramped down. Mr Javid claimed, “I’d like to think it would be permanent.” A non-answer if ever there were one, and there was.
Citing the community diagnostics (already announced 40), he added there “will be at least 100 with the budget boost announced last week”. But who will staff these 40-100 facilities and read the scans? We only have a short-term workforce plan on offer …
Javid also acknowledged that a significant proportion of patients were seen in A&E when they could been seen by GPs (were such GPs in existence), stressing ”that's not the fault of patients”. He says they'll be looking at boosting 111 to help with that pressure, and referred to the NHSE/I 10 point recovery action plan, 111 First.
“There is no way the NHS can meet the demands upon it without embracing the very latest technology”, said The Saj.
Answering a subsequent question about transparency, the SOS showed that there is no thought on how to meaningfully increase transparency in the NHS.
There’s still no sign of the terms of reference for the Messenger Review of NHS leadership, by the way. This new Public Accounts Committee report on the defence sector procurement is a brisk read.
Covid19 update
The lagging indicator of rising Covid19 deaths is telling us the rearview mirror picture of a few weeks back’s infection rates. Currently, new recorded infections seem to be falling, but the post-half-term data will be interesting.Hospitalisations are rising.
Ed Humpherson, Director General for Regulation of the Office for Statistics Regulation wrote to UK Health Security Agency boss Dr Jenny Harries regarding vaccine surveillance statistics, emphasising the need for change. He wrote of the “considerable room for further improvement. It remains the case that the surveillance report includes rates per 100,000 which can be used to argue that vaccines are not effective. I know that this is not the intention of the surveillance report, but the potential for misuse remains”.
The BBC’s James Gallagher has a good summary of the current state of infections, and Adam Briggs of the Health Foundation returns to public service Twitter thread duty with this analysis of the data from REACT and ONS. Dr Duncan Robertson’s analysis is also a key read.
Wellcome Trust director Jeremy Farrar’s departure from the SAGE committee was a notable moment this week.
The creaking system
The Independent has a major story from Sunday Times-bound Shaun Lintern and ex-HSJer Rebecca Thomas about the parlous state of ambulance services. Response for all types of ambulance emergency are at their highest ever recorded. Lintern and Thomas report that “deaths as a result of safety incidents in ambulance trusts are up 13 per cent compared to 2019. All 10 of England’s NHS ambulance trusts have raised their alert levels to their highest point, with some having been on what was previously called ‘black alert’ since the beginning of the summer”.
Meanwhile, Cambridge University Hospitals FT’s chief executive Roland Sinker’s concerns and feeling “scared” about current demand and performance at its main acute site, Addenbrookes, became public knowledge. Sinker has a reputation for being neither a panicker nor one given to overstatement. For him to have said, “you’d have to be asleep to not realise the profound nature of the crisis we’re in …I came here in 2015 and we were rated inadequate by the CQC. We had a £90m deficit … I’m much more anxious and scared now than I was then”.
Times Radio heard from NHS Providers boss Chris Hopson that the NHS hospital sector is already at peak winter levels for bed occupancy: it’s early November, and not yet properly cold or icy. HSJ’s editor Alastair McLellan has been hearing about the extent of trouble across the system.
The Nuffield Trust chart of the week from Mark Dayan and John Appleby reveals how the 2021 spending review may have delivered for NHS and capital budgets, but is firmly keeping other areas as ‘poor relations’.
Cronyvirus and Coronamillions update
Further to last week’s coverage of the reporting of the Immensa Health Clinic laboratory failures over PCR test accuracy, the Good Law Project issued a letter before action to the Government over the Immensa contract. The campaigning organisation is calling for the Immensa contract to be cancelled with immediate effect.
Oh, and Kit Yates queries the Government narrative that the Immensa screw-ups made no difference, with reference to the REACT1 data on infections in the south-west. One for the public inquiry.
The GLP’s legal action against the Government and Abingdon Health is also the source of this Mail story, revealing that former health minister Lord Bethell has again changed his story of why the data on his mobile phone(s) relating to Covid19 contracts is incomplete or deleted. Lord Bethell’s signed witness statement says he realises that he bought a new phone in November 2019, which he still uses. He makes various claims about why the WhatsApp data will be incomplete which will repay forensic scrutiny by IT experts. The ministry of unsound excuses just keeps on growing.
The Sunday Times also revealed this week that the then-vaccines minister Nadim Zahawi invited ex-PM David Cameron in his role as Illumaina consultant “to a briefing in Whitehall, weeks before it (Illumina) won public contracts worth up to £1.3 million”.
Getting the Bill (Health and Social Care)
Karin Smyth’s update for HSJ on the current state of play of the new Bill is a highly recommended read.
The Alan comeback
Knowing us, knowing Matt: a-ha.
The People’s Partridge’s long and winding road to a comeback continues, with the news that Tony Blair had to tell him not to read his social media, and that "the public are fantastic. They come up regularly and say things like, 'thank you for the vaccine’. They tell me their lockdown story: ‘thank you for keeping me safe’. That isn't what is reflected in the comments section of social media".
Interesting gossip
NHS England’s final shortlist of two candidates to be the new chief operating officer is, well, intriguing. One candidate has the requisite experience; the other manifestly does not.
Other important things
Would appear here.
Recommended and required reading
Will be back properly next week. We’re over length already. But Deloitte’s ‘The State Of The State 2021-22’ report is worth a look.