Tag Archives: Former

The NHS is underfunded. Even a former Tory health secretary sees it | Gaby Hinsliff

The former Conservative health secretary was diagnosed with bowel cancer after his wife nagged him into seeing his GP about his back pain. While his prospects would have been better if it had been caught earlier, things could be worse. He is still fairly optimistic about recovering, and he isn’t asking for your sympathy – although it was classy of the shadow health secretary, Jon Ashworth, to offer Labour’s anyway.

What he does seem to want, however, is for his own party to acknowledge that lucky isn’t good enough, either for him or for the millions of over-55s in England and Wales supposed to benefit from a national screening programme to detect and treat bowel cancer early. This was something Lansley himself piloted in office, before finding out the hard way that it hasn’t been delivered as planned.

About half the population did get access to testing, which can pick up and treat the disease in its earliest, highly survivable stage, and Scotland has introduced routine screening for the over-50s. But for the other half, things aren’t so rosy. Crucially, Lansley blames that not just on IT failings and a shortage of endoscopists but, at least in part, on Treasury cuts (since reversed) to a body overseeing NHS workforce development.

When a former Conservative health secretary is diagnosing the NHS’s problems in these terms, it’s no longer possible for his own party to ignore the perennial elephant in the room: money.

There is an emerging consensus across politics now that the health service can’t patch things together for much longer – that neither a bafflingly technocratic reorganisation (Lansley’s own rather dubious contribution to the health service), nor shielding its budget from the austerity cuts imposed on other departments, was enough to solve its problems. Put bluntly, it needs more cash – which is why Jeremy Hunt, Lansley’s successor at the Department of Health, has recently reopened the debate over the funding of long-term care.

But the time for tiptoeing tactfully around the fringes of this argument is over. Everyone needs to stop pretending that Britons can have all the healthcare they want at no extra cost, and to start making the case for tax rises before the service falls even further behind public expectations.

For Lansley’s story also hints at a wider debate about preventive medicine more generally, and what it’s reasonable for all of us to expect. As the healthcare thinktank the King’s Fund has tirelessly pointed out, the biggest pressure on health spending in recent times hasn’t actually been an ageing population but technological leaps and bounds: things becoming possible that a decade or two ago couldn’t even have been imagined, but which it now seems unethical to withhold.

Screening isn’t always the panacea people think. There are careful judgments to be made about the benefits of catching something early versus the risks of over-treatment – pushing people into radical surgery when it’s not yet clear how aggressive their particular case will turn out to be, for example – or of false positive results clogging up NHS clinics with people who aren’t actually ill. There are ethical considerations with some diseases, too, about telling people they’re in the early stages of something incurable.

But once a test exists people, not unreasonably, want to have it; and once they’re promised it – as people were in the case of bowel cancer – they rightly expect politicians to deliver on those promises. Screening and treating early, before cancer gets a chance to spread, has the capacity to save not just thousands of lives but millions of pounds, which could in turn be used to save more lives. But it’s downright dishonest to pretend all of that can be done for little or no upfront cost in a service that’s already struggling to cope with acute cases landing on its doorstep, never mind people who don’t actually realise yet that they are sick. History may not make much of his achievements in the job, but Lansley has done the NHS and those who use it a belated favour by being honest about what now ails it. Let’s hope that diagnosis hasn’t come too late.

Gaby Hinsliff is a Guardian columnist

The NHS is underfunded. Even a former Tory health secretary sees it | Gaby Hinsliff

The former Conservative health secretary was diagnosed with bowel cancer after his wife nagged him into seeing his GP about his back pain. While his prospects would have been better if it had been caught earlier, things could be worse. He is still fairly optimistic about recovering, and he isn’t asking for your sympathy – although it was classy of the shadow health secretary, Jon Ashworth, to offer Labour’s anyway.

What he does seem to want, however, is for his own party to acknowledge that lucky isn’t good enough, either for him or for the millions of over-55s in England and Wales supposed to benefit from a national screening programme to detect and treat bowel cancer early. This was something Lansley himself piloted in office, before finding out the hard way that it hasn’t been delivered as planned.

About half the population did get access to testing, which can pick up and treat the disease in its earliest, highly survivable stage, and Scotland has introduced routine screening for the over-50s. But for the other half, things aren’t so rosy. Crucially, Lansley blames that not just on IT failings and a shortage of endoscopists but, at least in part, on Treasury cuts (since reversed) to a body overseeing NHS workforce development.

When a former Conservative health secretary is diagnosing the NHS’s problems in these terms, it’s no longer possible for his own party to ignore the perennial elephant in the room: money.

There is an emerging consensus across politics now that the health service can’t patch things together for much longer – that neither a bafflingly technocratic reorganisation (Lansley’s own rather dubious contribution to the health service), nor shielding its budget from the austerity cuts imposed on other departments, was enough to solve its problems. Put bluntly, it needs more cash – which is why Jeremy Hunt, Lansley’s successor at the Department of Health, has recently reopened the debate over the funding of long-term care.

But the time for tiptoeing tactfully around the fringes of this argument is over. Everyone needs to stop pretending that Britons can have all the healthcare they want at no extra cost, and to start making the case for tax rises before the service falls even further behind public expectations.

For Lansley’s story also hints at a wider debate about preventive medicine more generally, and what it’s reasonable for all of us to expect. As the healthcare thinktank the King’s Fund has tirelessly pointed out, the biggest pressure on health spending in recent times hasn’t actually been an ageing population but technological leaps and bounds: things becoming possible that a decade or two ago couldn’t even have been imagined, but which it now seems unethical to withhold.

Screening isn’t always the panacea people think. There are careful judgments to be made about the benefits of catching something early versus the risks of over-treatment – pushing people into radical surgery when it’s not yet clear how aggressive their particular case will turn out to be, for example – or of false positive results clogging up NHS clinics with people who aren’t actually ill. There are ethical considerations with some diseases, too, about telling people they’re in the early stages of something incurable.

But once a test exists people, not unreasonably, want to have it; and once they’re promised it – as people were in the case of bowel cancer – they rightly expect politicians to deliver on those promises. Screening and treating early, before cancer gets a chance to spread, has the capacity to save not just thousands of lives but millions of pounds, which could in turn be used to save more lives. But it’s downright dishonest to pretend all of that can be done for little or no upfront cost in a service that’s already struggling to cope with acute cases landing on its doorstep, never mind people who don’t actually realise yet that they are sick. History may not make much of his achievements in the job, but Lansley has done the NHS and those who use it a belated favour by being honest about what now ails it. Let’s hope that diagnosis hasn’t come too late.

Gaby Hinsliff is a Guardian columnist

The NHS is underfunded. Even a former Tory health secretary sees it | Gaby Hinsliff

The former Conservative health secretary was diagnosed with bowel cancer after his wife nagged him into seeing his GP about his back pain. While his prospects would have been better if it had been caught earlier, things could be worse. He is still fairly optimistic about recovering, and he isn’t asking for your sympathy – although it was classy of the shadow health secretary, Jon Ashworth, to offer Labour’s anyway.

What he does seem to want, however, is for his own party to acknowledge that lucky isn’t good enough, either for him or for the millions of over-55s in England and Wales supposed to benefit from a national screening programme to detect and treat bowel cancer early. This was something Lansley himself piloted in office, before finding out the hard way that it hasn’t been delivered as planned.

About half the population did get access to testing, which can pick up and treat the disease in its earliest, highly survivable stage, and Scotland has introduced routine screening for the over-50s. But for the other half, things aren’t so rosy. Crucially, Lansley blames that not just on IT failings and a shortage of endoscopists but, at least in part, on Treasury cuts (since reversed) to a body overseeing NHS workforce development.

When a former Conservative health secretary is diagnosing the NHS’s problems in these terms, it’s no longer possible for his own party to ignore the perennial elephant in the room: money.

There is an emerging consensus across politics now that the health service can’t patch things together for much longer – that neither a bafflingly technocratic reorganisation (Lansley’s own rather dubious contribution to the health service), nor shielding its budget from the austerity cuts imposed on other departments, was enough to solve its problems. Put bluntly, it needs more cash – which is why Jeremy Hunt, Lansley’s successor at the Department of Health, has recently reopened the debate over the funding of long-term care.

But the time for tiptoeing tactfully around the fringes of this argument is over. Everyone needs to stop pretending that Britons can have all the healthcare they want at no extra cost, and to start making the case for tax rises before the service falls even further behind public expectations.

For Lansley’s story also hints at a wider debate about preventive medicine more generally, and what it’s reasonable for all of us to expect. As the healthcare thinktank the King’s Fund has tirelessly pointed out, the biggest pressure on health spending in recent times hasn’t actually been an ageing population but technological leaps and bounds: things becoming possible that a decade or two ago couldn’t even have been imagined, but which it now seems unethical to withhold.

Screening isn’t always the panacea people think. There are careful judgments to be made about the benefits of catching something early versus the risks of over-treatment – pushing people into radical surgery when it’s not yet clear how aggressive their particular case will turn out to be, for example – or of false positive results clogging up NHS clinics with people who aren’t actually ill. There are ethical considerations with some diseases, too, about telling people they’re in the early stages of something incurable.

But once a test exists people, not unreasonably, want to have it; and once they’re promised it – as people were in the case of bowel cancer – they rightly expect politicians to deliver on those promises. Screening and treating early, before cancer gets a chance to spread, has the capacity to save not just thousands of lives but millions of pounds, which could in turn be used to save more lives. But it’s downright dishonest to pretend all of that can be done for little or no upfront cost in a service that’s already struggling to cope with acute cases landing on its doorstep, never mind people who don’t actually realise yet that they are sick. History may not make much of his achievements in the job, but Lansley has done the NHS and those who use it a belated favour by being honest about what now ails it. Let’s hope that diagnosis hasn’t come too late.

Gaby Hinsliff is a Guardian columnist

The NHS is underfunded. Even a former Tory health secretary sees it | Gaby Hinsliff

The former Conservative health secretary was diagnosed with bowel cancer after his wife nagged him into seeing his GP about his back pain. While his prospects would have been better if it had been caught earlier, things could be worse. He is still fairly optimistic about recovering, and he isn’t asking for your sympathy – although it was classy of the shadow health secretary, Jon Ashworth, to offer Labour’s anyway.

What he does seem to want, however, is for his own party to acknowledge that lucky isn’t good enough, either for him or for the millions of over-55s in England and Wales supposed to benefit from a national screening programme to detect and treat bowel cancer early. This was something Lansley himself piloted in office, before finding out the hard way that it hasn’t been delivered as planned.

About half the population did get access to testing, which can pick up and treat the disease in its earliest, highly survivable stage, and Scotland has introduced routine screening for the over-50s. But for the other half, things aren’t so rosy. Crucially, Lansley blames that not just on IT failings and a shortage of endoscopists but, at least in part, on Treasury cuts (since reversed) to a body overseeing NHS workforce development.

When a former Conservative health secretary is diagnosing the NHS’s problems in these terms, it’s no longer possible for his own party to ignore the perennial elephant in the room: money.

There is an emerging consensus across politics now that the health service can’t patch things together for much longer – that neither a bafflingly technocratic reorganisation (Lansley’s own rather dubious contribution to the health service), nor shielding its budget from the austerity cuts imposed on other departments, was enough to solve its problems. Put bluntly, it needs more cash – which is why Jeremy Hunt, Lansley’s successor at the Department of Health, has recently reopened the debate over the funding of long-term care.

But the time for tiptoeing tactfully around the fringes of this argument is over. Everyone needs to stop pretending that Britons can have all the healthcare they want at no extra cost, and to start making the case for tax rises before the service falls even further behind public expectations.

For Lansley’s story also hints at a wider debate about preventive medicine more generally, and what it’s reasonable for all of us to expect. As the healthcare thinktank the King’s Fund has tirelessly pointed out, the biggest pressure on health spending in recent times hasn’t actually been an ageing population but technological leaps and bounds: things becoming possible that a decade or two ago couldn’t even have been imagined, but which it now seems unethical to withhold.

Screening isn’t always the panacea people think. There are careful judgments to be made about the benefits of catching something early versus the risks of over-treatment – pushing people into radical surgery when it’s not yet clear how aggressive their particular case will turn out to be, for example – or of false positive results clogging up NHS clinics with people who aren’t actually ill. There are ethical considerations with some diseases, too, about telling people they’re in the early stages of something incurable.

But once a test exists people, not unreasonably, want to have it; and once they’re promised it – as people were in the case of bowel cancer – they rightly expect politicians to deliver on those promises. Screening and treating early, before cancer gets a chance to spread, has the capacity to save not just thousands of lives but millions of pounds, which could in turn be used to save more lives. But it’s downright dishonest to pretend all of that can be done for little or no upfront cost in a service that’s already struggling to cope with acute cases landing on its doorstep, never mind people who don’t actually realise yet that they are sick. History may not make much of his achievements in the job, but Lansley has done the NHS and those who use it a belated favour by being honest about what now ails it. Let’s hope that diagnosis hasn’t come too late.

Gaby Hinsliff is a Guardian columnist

Trump picks former anti-abortion leader for health and human services post

Donald Trump has appointed the former president of a leading anti-abortion group to the top communications role at the Department of Health and Human Services (DHSS).

Charmaine Yoest, who for several years was head of Americans United for Life (AUL), will be HHS assistant secretary for public affairs. AUL played an instrumental role in the recent wave of anti-abortion laws by feeding model legislation to state lawmakers.

Under Yoest, the group pushed model bills that outlawed abortion after 20 weeks, required abortion providers to gain admitting privileges at local hospitals, and mandated counseling and waiting periods for women seeking abortions. AUL is also opposed to the use of the morning-after pill and IUDs.

Between 2010 and 2016, states have enacted 288 restrictions on abortion. The AUL directly credits its own work for several dozen of those laws. Its model legislation may have inspired countless more. Abortion rights advocates have managed to block many such measures in court.

As AUL president, Yoest played a key role in framing abortion restrictions as necessary to protect women’s health, although the medical evidence for such claims was often dubious. AUL’s ultimate goal is to end abortion.

Since leaving AUL, in 2016, Yoest has been a senior fellow at American Values, an anti-abortion, anti-same-sex marriage nonprofit. In her new role, she will set communications strategy for the entire health department.

The agency is headed by another staunch opponent of reproductive rights, former Georgia congressman Tom Price, who as chair of the House budget committee oversaw passage of a measure that defunded Planned Parenthood.

Price has also voiced hostility toward the requirement, put in place by the Obama administration, that health insurance plans cover contraception with no co-pay, once challenging a reporter to “bring me one woman” who struggled to afford contraception on her own.

Treating former child soldiers and refugees is tough yet fascinating

My first client of the day is Ahmed. He witnessed around 30 people, including family members, drowning when the boat in which they were crossing to Europe, sank in a storm. He feels guilty for surviving. He was one of the youngest on the boat, so was wearing one of the few life jackets.

This morning I’ll try to help Ahmed with the flashbacks he has every time it rains, with the nightmares that wake him every night about drowning, people calling his name in the darkness, bombs falling, bodies on the street. He is claiming asylum in the UK. He knows that some people don’t want him here, but he’s frightened of going home. His home town is being bombed, and he doesn’t feel wanted there either.


For all the stories of human suffering, these are also narratives of survival

After Ahmed, I’ll see Erica, who was beaten so badly by her husband that she has a metal plate in her skull; Louise, who regained consciousness in the middle of an operation, able to feel everything but unable to move or raise the alarm; and Alex, who dreams every night about the colleague he could not save when their vehicle was hit by an IED in Afghanistan.

As a trauma therapist, this is a normal day for me. Some people associate post-traumatic stress disorder (PTSD) only with military veterans, but my clients come from a huge range of backgrounds. Almost any life-threatening experience can cause PTSD, as can sexual assaults, witnessing terrible things happen to someone else, or hearing about them repeatedly as part of your job.

There is still a stigma associated with many mental health problems, and PTSD is no exception. Some people feel it is a sign of weakness, and they should just be able to get over what has happened. Others are unaware that help is available, or that treatments are effective.

There is no shortage of referrals, and managing the waiting list is a constant struggle. Trauma therapists spend their days listening to some of the most heartbreaking and horrifying stories imaginable. Confidentiality prevents us talking about what we have heard outside of the therapy room, but we support each other with time, care, biscuits and humour.

NHS trauma services exist in various cities across the UK, but service provision is patchy and postcode-dependent. Cuts over the years have put further pressure on mental health services which are already spread thin, leaving many therapists feeling burnt out by unachievable targets and endless waiting lists. Insidious measures to cut costs, such as limited session numbers, freezes on recruitment and service restructures (another word for cuts) continue to whittle away services, and lead to patients waiting longer for less treatment.

Why would I choose to work in this field? It is fascinating. I’ve heard firsthand accounts of what it is like to be recruited as a child soldier, to survive the Rwandan genocide, to travel Basra’s road of death. Perhaps not experiences everyone would want to hear but, for all the stories of human suffering, these are also narratives of survival. My clients have escaped, endured and overcome events which can, and have, killed many others. I bear witness to their fortitude, and help them mend the mental scars.

Thankfully, many of my clients recover. Trauma memories are not forgotten, but they can fade. Through treatment, clients achieve goals which many of us take for granted, like sleeping through the night without nightmares, or meeting new people without fearing they will be attacked. Things which were previously out of reach because of their symptoms, like working and having relationships, become achievable.

There is no magic pill or quick fix to treat PTSD. The most effective treatments are trauma-focused. Rather than avoiding the horrific memories, therapy involves talking about them, processing what happened, and making sense of what can feel senseless. We spend some sessions out of the office, helping clients to overcome situations and places which they have been avoiding, teaching them to discriminate the past from the present.

As a therapist, seeing someone who has been so mentally, emotionally, and often physically, damaged, begin to heal is incredibly rewarding. On a gloomy day, I read the cards and letters that clients have written to me after treatment. They tell stories of recovery and hope.

Knowing the potential for recovery will help me in my session with Ahmed today. At the moment he feels that he lost everything worth living for in that storm over the Mediterranean. Today, we’ll start picking up the pieces. We’ll talk about what happened, and grieve for the losses. We’ll try to put the bad memories in the past, so that he can look towards a future. When that happens, it will remind me again why I do my job.

Some details have been changed

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Former Tory health minister defends Simon Stevens over NHS winter crisis

A former Conservative health secretary has said it was unfair for Downing Street to hint that the NHS England boss, Simon Stevens, was to blame for the winter crisis gripping the health service.

Stephen Dorrell, now chair of the NHS Confederation, issued the rebuke after Stevens told MPs on Wednesday that Theresa May was “stretching it” by saying the health service had got more money than it had requested.

Sources close to May had suggested to the Times that Downing Street thought Stevens was “not enthusiastic” and was annoyed by his political interventions, particularly on social care funding. The prime minister’s spokeswoman later denied relations were frosty, saying May had full confidence in Stevens.

Dorrell said he believed that any allegations of political interference, and the insistence that the NHS had received the funding it had requested, were not fair to Stevens.

He told BBC Radio 4’s Today programme: “I do think it is unfair on him, because he’s made it clear from the beginning … He set out, he is the author of, the five-year forward view; he is the author of the government’s policy of the health service as part of a broad range of public services.

Theresa May and Jeremy Corbyn clash over NHS at first PMQs of 2017

“He’s been the strong advocate of the need to integrate, to change the way we deliver health and care in our communities in order to deliver more joined-up services with proper emphasis on care as well as on the essential elements of acute medicine.”

Dorrell said the government “should be addressing the evidence about what is happening on the ground rather than engaging in a rather high-profile discussion about, frankly, what sound to the public like telephone numbers of public expenditure”.

Speaking to the Commons public accounts committee on Wednesday, Stevens said “there are clearly very substantial pressures, and I don’t think it helps anybody to try and pretend that there aren’t”. He pointed that out the extra £10bn the government had referred to was being granted over six years, meaning the health service had less than it had asked for in its five-year-plan.

Stevens even appeared to take aim at May’s experience as home secretary, saying that dealing with challenges posed by an ageing population was “quite different to the criminal justice system”.

The row came as it was reported that at least 23 NHS trusts in England had declared a black alert in the past week, while freezing temperatures are expected to exacerbate the strain on the UK’s overstretched hospitals and heath services.

On Wednesday, May said claims by the Red Cross that the health service was suffering a humanitarian crisis were “irresponsible and overblown” in a series of clashes with the Labour leader, Jeremy Corbyn, over the issue. “Our NHS, Mr Speaker, is in crisis, but the prime minister is in denial,” Corbyn said.

The shadow health secretary, Jon Ashworth, published a letter he sent to May about Stevens’ performance, asking if she agreed with his assessment of funding levels and the effects of cuts to social care.

“Failure to take Simon Stevens’ warnings seriously would risk deepening a crisis that has already pushed the NHS to breaking point,” he wrote.

Former NHS director sues Jeremy Hunt for religious discrimination

A former director of an NHS trust is suing Jeremy Hunt for religious discrimination after he was effectively barred from applying for positions following his public opposition to gay adoption.

Richard Page has lodged a claim at the employment tribunal, saying his televised comments in 2015 that it was in the best interests of a child to have a mother and father stemmed from his Christian faith.

His remarks led to him being sacked as a magistrate in March for serious misconduct, after 15 years on the bench. Two years earlier, the lord chancellor and lord chief justice reprimanded Page after finding his religious beliefs, rather than evidence, had influenced his decisions during a family court hearing.

Page, 70, was also a non-executive director at the Kent and Medway NHS and social care partnership trust. In March, following a complaint by the trust’s LGBT staff network, Page was suspended for the final three months of his four-year term in office.

In August, the NHS Termination of Appointments Panel told Page “it was not in the interests of the health service for you to serve as a non-executive director in the NHS”, in effect barring him from applying for directorships in the future.

Page, a former NHS manager from Headcorn, Kent, is bringing a claim against the health secretary and NHS Improvement, which has the power to appoint non-executive directors. He is pursuing a similar case against the lord chancellor over his sacking as a magistrate.

In a TV debate on Christians in public life in March 2015, Page said: “My responsibility as a magistrate, as I saw it, was to do what I considered best for the child, and my feeling was therefore that it would be better if it was a man and woman who were the adopted parents.”

In a video on the website of Christian Concern, which is backing his case, Page denied he was homophobic and claimed that more than 6,500 emails had been sent to the Kent NHS trust in his support against one complaint “from the LGBT people”.

He said: “This is the second public sector organisation that has got rid of me. This, I feel, is completely wrong because it’s discriminatory against my opinions and the fact I was doing what I considered to be right.

“The political correctness makes people be frightened, or makes them think they’re the only ones that believe this way, and yet they obviously are the majority … There are people standing up against the so-called politically correct views.”

Andrea Minichiello Williams, of Christian Concern, said freedoms in the UK were being “catastrophically eroded by political correctness and fear”.

“The comment that a child needs a mother and a father is a belief held by Christians, and many others around the world. Everything that Richard Page does, his whole belief system is rooted in his Christian faith. Beliefs arising from the Christian faith continue to be lawful beliefs in our country.”

She said government assurances that equality legislation would not lead to the removal of people who expressed Christian views while holding public positions had turned out to be baseless.

“If it is possible to suffer the detriment of losing your position at work for expressing lawful Christian views, the situation is crucial. There is, in effect, a religious bar to office for Christians solely; those politically correct institutions would not do the same to other faiths.”

A spokesperson for NHS Improvement said: “We are unable to comment on ongoing court cases.”

Former minister calls for new tax to save NHS and social care

A dramatic call for a new health and care tax has been made by a former Tory health minister, amid demands by MPs of all parties for Theresa May to act to save the NHS and the social care system from collapse.

Dr Dan Poulter, who stepped down from the Department of Health last year and now works both as an MP and as a part-time NHS doctor, said his experience inside hospitals had convinced him that radical, long-term funding solutions for the health and care sectors are “urgently required”.

He told the Observer: “On the hospital wards I often see people who are medically fit to go home, but who are forced to stay in hospital because of difficulties arranging their social care package or because of a lack of appropriate housing. Good healthcare cannot be delivered without properly funded social care.

“A long-term plan to ensure a properly funded and sustainable health and social care system is urgently required, and I believe a health and care tax – perhaps introduced through raising national insurance – offers one of the simplest ways forward.”

Poulter spoke out amid growing frustration about a lack of clarity in the government’s approach to social care and how to fund it, as the number of elderly people soars and pressures on hospital services mount. In the Tory manifesto last year, former prime minister David Cameron promised to introduce a cap of £72,000 on the care costs for each individual, after which the state would pay. But soon after polling day, he delayed the scheme’s introduction until 2020, because money was not available.

Poulter, who was responsible for steering the plan for a cap through parliament, said that with public finances unlikely to improve, the much-vaunted policy had little chance of being implemented: “Given that the introduction of a cap was considered unaffordable a year ago, and that the costs of social care continue to increase, there is now little prospect of the cap being introduced at all.” What the NHS and care systems need, he said, is a special tax that will guarantee an income stream, rather than policies like the cap which are entirely dependent on the economic climate of the moment.

“Linking tax income with health and care spending would give people the opportunity to see how their money is being spent, and allow a legitimate debate about what is an appropriate level of taxation required to ensure a sustainable funding settlement for our NHS and social care system in the years ahead,” Poulter said.

Echoing his call for a new approach from government that would offer long-term security of funding, Richard Murray, director of policy at health thinktank the King’s Fund, said: “Tackling the growing crisis in social care will be a key test of the prime minister’s promise of a country that works for everyone, and must move much higher up the government’s agenda.

Dr Dan Poulter


Dr Dan Poulter stepped down from the Department of Health last year. Photograph: Felix Clay for the Guardian

“England remains one of the few major advanced countries that has not reformed the way it funds long-term care in response to the needs of an ageing population. A frank and open debate is needed on how to fund health and social care on a sustainable basis into the future, recognising that a long-term strategy will exceed the lifetime of a single parliament. With many people facing real problems in paying for social care right now, this is not something that can be put off any longer.’’

The calls for action came as May prepared to chair her first cabinet meeting since the summer break at Chequers on Wednesday. Downing Street officials said that while the challenges of how to make a success of Brexit would top the agenda, social policies including the challenges for the NHS would also be discussed.

Last week the Guardian revealed that NHS bosses were drawing up plans for hospital closures, cutbacks and radical changes to the way healthcare is delivered in an attempt to meet spiralling demand and plug the hole in its finances. Without the cuts the NHS at local level would face a financial shortfall of about £20bn by 2020-21.

Lib Dem MP Norman Lamb, who was also a health minister in the coalition government, said it was a disgrace that ministers had postponed the care cap on the grounds of cost, yet maintained it would still be introduced in four years’ time. The Department of Health maintained it was still committed to the care cap, despite a widespread belief in the sector that the plan is dead.

“This government is committed to ensuring that those in old age can access care that is both affordable and dignified. The position on the care cost cap hasn’t changed,” a spokesperson said.

Vicky McDermott, chair of the Care and Support Alliance, which represents 80 of Britain’s leading charities campaigning for a properly funded care system, said the crises hitting the NHS and social care were inextricably linked and needed a long-term solution.

“The government needs to get to grips with the scale of the social care crisis. The reality is that at least a million people aren’t getting the basic care they need. One million hospital days were lost to delayed discharge in 2015, costing the NHS £2.4bn, and it’s estimated that the money spent by the NHS on excess bed days due to people awaiting homecare could fund 5.2 million hours of homecare. The latest figures show that at least £1bn is needed for social care this year – just to keep things as they are,” she said

Last year’s Conservative manifesto pledged an extra £8bn a year for the NHS by the end of this parliament, as demanded by the NHS chief executive, Simon Stevens, in his 2014 “five-year forward view”. But Stevens made clear that was the minimum money required, and radical reforms to the way healthcare is delivered would also be necessary to make the NHS hit its budgets.

Former ministers attack ‘massive damp squib’ of childhood obesity plan

Two former health ministers have heavily criticised the government’s action plan to tackle childhood obesity, while Jamie Oliver has called it “underwhelming” because “so much is missing”.

Dr Dan Poulter and Norman Lamb, who both served in the last coalition government, have spoken out amid a growing row over what doctors and health charities claim is a major letdown that does not respond effectively to the growing crisis of children becoming dangerously overweight.

“I’m in shock,” said Oliver, the celebrity chef whose Jamie’s School Dinners TV series in 2005 led to big improvements in school food. “The long-awaited childhood obesity strategy from Theresa May’s new government is far from robust, and I don’t know why it was shared during recess. It contains a few nice ideas, but so much is missing.

Related: Childhood obesity: UK’s ‘inexcusable’ strategy is wasted opportunity, say experts

“Where are the actions on the irresponsible advertising targeted at our children, and the restrictions on junk food promotions? With this disappointing and, frankly, underwhelming strategy, the health of our future generations remains at stake,” Oliver added.

Jamie Oliver said the strategy was ‘far from robust’.


Jamie Oliver said the strategy was ‘far from robust’. Photograph: Amer Ghazzal/REX/Shutterstock

The Conservative Poulter and Lamb, the Lib Dems’ health spokesman, told the Guardian that the 10-page document had failed to live up to a promise by the health secretary, Jeremy Hunt, that the government’s strategy would be necessarily “draconian” and interventionist in order to respond properly to what he last year called the “national disgrace” of childhood obesity. Hunt pledged as recently as February to deliver “a gamechanging moment, a robust strategy”.

Poulter, an NHS psychiatrist, said: “This is certainly not the ‘gamechanging’ plan for reducing childhood obesity that it had been built up to be. This policy has over-promised, but I fear that the reality will be under-delivery.”

The sugar tax should be extended to all heavily sugared foods, not just soft drinks, he said. “A sugar tax should be broadly welcomed, but it remains unclear how this will be implemented, why it will be limited just to soft drinks and not include sugary foods, and how it will avoid becoming a tax that unintentionally penalises fruit juice, and as a result farmers and food producers,” said Poulter.

He said measures to boost school sport “sound good, particularly during the Olympics. But there is a worrying lack of practical measures about how we can turn warm words into reality. There is also an urgent need for more joined-up government thinking to ensure that regular physical activity as well as personal and social education, which includes important public health messages, becomes mandatory in all schools.”

Lamb, like Poulter a health minister alongside Hunt until May 2015, described the action plan as “a massive damp squib”. He said: “Given Jeremy Hunt’s rhetoric we were entitled to expect something a bit more dramatic and effective than what we got. Is this really the best response to a ‘growing public health catastrophe’, or ‘national emergency’? Can it really be described as a ‘game-changing moment’?”

Related: Is a sugar tax enough to tackle childhood obesity? – live debate

Poulter sharply criticised the plan’s continued reliance on voluntary action by the food industry to tackle children’s expanding waistlines. Food and soft drink producers could not be trusted to take action to boost health, he said. Health charities believe that the “responsibility deal” begun by then health secretary, Andrew Lansley, in 2010, under which manufacturers and sellers pledged to improve their practices to reduce obesity and alcohol misuse, has failed.

“Looking more closely at some of these plans, I have concerns, because when we draw on learned experience of corporate behaviour, we know that the continuation of a policy of hoping that sugary drinks and junk food manufacturers will want to start working with government to drastically reduce unhealthy sugar content is unlikely to be successful,” Poulter said.

“The responsibility deal has failed to deliver and has revealed a woeful lack of corporate responsibility. Junk food and sugary drink manufacturers have shown that they can be no more trusted to help help tackle childhood obesity than drinks companies can be to play their part in reducing irresponsible drinking habits.”

Poulter said ministers should recognise that evidence showed increasing the price of products that can harm health decreased both demand and consumption. “So we need strong legislation, for example through increases in VAT, that will increase the price of junk food,” he said.

Meanwhile, the leader of Britain’s paediatricians has accused ministers of letting children down and risking the public’s health by discarding plans that would have made the UK a world leader in tackling obesity.

“What is deeply saddening, because they can’t exercise personal responsibility, is the failure of the state to protect infants and children,” said Prof Neena Modi, president of the Royal College of Paediatrics and Child Health. She was extremely disappointed that the government’s “weak” plan had eschewed necessarily “tough policies”, such as taxing unhealthy foods, limiting the number of fast food outlets near schools and banning the advertising of foods high in fat, salt or sugar.

“Had measures such as these been put forward, the UK would have a strategy of which to be proud. Instead, infants and children have been let down, and because the overwhelming majority of obese children will become obese adults, government is placing the health of the entire nation in grave jeopardy,” Modi said.

Prof John Middleton, president of the Faculty of Public Health (FPH), the leading professional body for public health specialists in the UK, said the plan “let down a generation of children by not going far enough to tackle childhood obesity”.

He said: “FPH remains fully supportive of a duty on sugary drinks a part of a wider strategy to tackle childhood obesity, and is very disappointed that the necessary, evidence-based measures to make the duty a success are not included in this report. These include tougher regulations of junk food marketing to children, particularly online, where there are far fewer restrictions.

Anna Taylor, executive director of the Food Foundation, said: “This represents a gear change, but is nowhere near the “game-change” promised by Jeremy Hunt. It’s good to see better commitments on reformulation but there is so much missing!

“Children and their parents are being systematically targeted with adverts, promotions and brand awareness of unhealthy foods – they can’t escape. Any parent waking up this morning in the hope that the government would help them protect their child from obesity will be bitterly disappointed.”

A Coca-Cola Great Britain spokesperson said: “We agree with the government that obesity rates are too high, but we do not believe a tax on only some soft drinks with sugar will reduce them. What it will do is hit consumers in the pocket and damage a range of businesses up and down the country.

“By reformulating 28 of our drinks since 2005, giving consumers even clearer nutritional information on our packs and investing more in marketing our no-sugar options, we have contributed to a significant reduction in sugar consumption from soft drinks over the last decade – and a 16% reduction in the last four years alone.

“During this time there has been no corresponding decline in obesity rates. A policy focused on a single nutrient in narrow range of products – that provide an average of just 5% of the total calories in a British teenager’s diet – is not the right response.”