Tag Archives: Jeremy

Jeremy Hunt’s rhetoric over breast cancer screening looks overheated

Jeremy Hunt has described the failure of the breast screening programme to invite some older women for a mammogram in apocalyptic terms, warning of a possible 270 deaths and causing huge alarm among women and their families. He is blaming the body that has “oversight” of the NHS screening programme – now Public Health England – for what is described as a disastrous computer error that meant 450,000 women did not get vital letters calling them in.

But the numbers do not stack up, say some experts with inside knowledge. Both the mortality figures and the number of those affected are now in dispute, and the health secretary’s rhetoric is beginning to look overheated in the light of an issue officials have been wrangling over and trying to understand since January.

There isn’t a scandal, those experts say. There is confusion.

Hunt said the issue goes back to 2009 but was detected in January, thanks to a new IT system introduced by Public Health England that picked up that some women over 68 had not been sent a letter inviting them for a last mammogram before their 71st birthday.

It would not have been noticed if it had not been for a trial, called AgeX, that was enrolling women to see whether screening should actually be extended from the current 50-70 years bracket to include women who were both younger and older than that.

AgeX, based at Oxford University, is the first trial of breast screening in the UK. The evidence that exists for breast screening’s effectiveness in picking up cancers and reducing deaths comes from Scandinavia. Nobody in the world has run trials in women in either their late 60s or 70s until now.

Women of 71 to 73 enrolled on AgeX are randomly assigned either to being screened or to not being screened. The new IT system spotted that women in the control arm (no screening) had been flagged in the NHS screening system not to receive any more routine mammograms. Some of them had their last one before they turned 68.

According to Sir Richard Peto, professor of medical statistics at Oxford University and the statistician on AgeX, there were 80,000 women recruited in the pilot phase between 2009 and 2015, and 80,000 more in the year 2016 to 2017. That means 80,000 women at most in the trial – the 50% randomly assigned to no more screening – could have lost out on a last invitation to have a mammogram. Some of those would have been 68 at their last screening, but some would have been 69 or 70.

The numbers got bigger when Public Health England looked back to 2009 using the new computer system, which was able to see the detailed screening history of individual women for the first time. It found there were thousands of women who had not been invited after they turned 68.

Peto says that was just the way the screening programme had been set up to work. The invitations for screening were sent out every three years from every general practice. The final invitation, up to the age of 70 when routine screening stopped, would go to all the women who would turn 68 to 70 in that year who had been invited three years previously. That therefore includes some who are 67.

But even if you include all of those women invited to a last mammogram before they were 68 – who were not missed by computer error but by the normal workings of the screening programme – the numbers do not reach 450,000, says Peto.

Two million women are called for screening in England each year. About one-sixth of those called for final screening are 67 and turning 68 that year. “My guess is that about 300,000 is the real number,” he said.

Interestingly that is about the number – 309,000 – that Hunt said were still alive out of the 450,000 he said were affected and who would be contacted with an offer of another mammogram.

Public Health England is unable to give details of how it got to what it says is 450,000 missed invites. “It is based on modelling data,” said a spokesperson. “It is an estimation. That’s all we know at the present.” Requests to speak to anybody who might have more knowledge were turned away.

The possible 270 deaths – or as Hunt said, “shortened” lives – is also in dispute. “To be talking about deaths in this way was quite surprising,” said Sara Hiom of Cancer Research UK. “It was quite surprising that a health minister would be making such a statement quite that strongly.”

The women will have missed an extra opportunity to have a breast cancer detected by x-ray before they could be aware of it, but it may still have been picked up even at an early stage because it manifests as a lump in the breast. “Breast cancer does tend to have quite clear symptoms and there are excellent treatments even for late-stage breast cancers,” she said.

David Spiegelhalter, statistician and chair of the Winton Centre for Risk and Evidence Communication at Cambridge University, took issue with Hunt’s statement that there could be “135 and 270 women who had their lives shortened”. He gave several reasons “why this claim is misleading”.

“There is only weak evidence that screening helps prolong life, particularly for older women,” he said in a blog. And “contrary to popular belief, screening also does harm … for every 200 women attending screening between 50 and 70, we would expect one to have her early death from breast cancer prevented, but three to be unnecessarily treated for a harmless cancer that would not have troubled them.”

That treatment involves biopsies, and possibly surgery and drugs and a great deal of trauma for the women. The growing knowledge of the downsides as well as the upsides of screening may be why only two-thirds of those invited for it actually go.

Anybody over 70 can request regular screening. But the questions are especially relevant to those in that age group. Screening may detect cancer but it may also pick up suspect cells in the breast that are either benign growths or are so slow-growing that they will not cause harm in the woman’s lifetime.

That was the point of setting up AgeX – to find out whether it was better to screen or not to screen. That question was never asked before screening was rolled out beyond the original cutoff of 64.

“There isn’t a scandal,” said Peto. “At what age should screening stop? We don’t know.”

Jeremy Hunt’s rhetoric over breast cancer screening looks overheated

Jeremy Hunt has described the failure of the breast screening programme to invite some older women for a mammogram in apocalyptic terms, warning of a possible 270 deaths and causing huge alarm among women and their families. He is blaming the body that has “oversight” of the NHS screening programme – now Public Health England – for what is described as a disastrous computer error that meant 450,000 women did not get vital letters calling them in.

But the numbers do not stack up, say some experts with inside knowledge. Both the mortality figures and the number of those affected are now in dispute, and the health secretary’s rhetoric is beginning to look overheated in the light of an issue officials have been wrangling over and trying to understand since January.

There isn’t a scandal, those experts say. There is confusion.

Hunt said the issue goes back to 2009 but was detected in January, thanks to a new IT system introduced by Public Health England that picked up that some women over 68 had not been sent a letter inviting them for a last mammogram before their 71st birthday.

It would not have been noticed if it had not been for a trial, called AgeX, that was enrolling women to see whether screening should actually be extended from the current 50-70 years bracket to include women who were both younger and older than that.

AgeX, based at Oxford University, is the first trial of breast screening in the UK. The evidence that exists for breast screening’s effectiveness in picking up cancers and reducing deaths comes from Scandinavia. Nobody in the world has run trials in women in either their late 60s or 70s until now.

Women of 71 to 73 enrolled on AgeX are randomly assigned either to being screened or to not being screened. The new IT system spotted that women in the control arm (no screening) had been flagged in the NHS screening system not to receive any more routine mammograms. Some of them had their last one before they turned 68.

According to Sir Richard Peto, professor of medical statistics at Oxford University and the statistician on AgeX, there were 80,000 women recruited in the pilot phase between 2009 and 2015, and 80,000 more in the year 2016 to 2017. That means 80,000 women at most in the trial – the 50% randomly assigned to no more screening – could have lost out on a last invitation to have a mammogram. Some of those would have been 68 at their last screening, but some would have been 69 or 70.

The numbers got bigger when Public Health England looked back to 2009 using the new computer system, which was able to see the detailed screening history of individual women for the first time. It found there were thousands of women who had not been invited after they turned 68.

Peto says that was just the way the screening programme had been set up to work. The invitations for screening were sent out every three years from every general practice. The final invitation, up to the age of 70 when routine screening stopped, would go to all the women who would turn 68 to 70 in that year who had been invited three years previously. That therefore includes some who are 67.

But even if you include all of those women invited to a last mammogram before they were 68 – who were not missed by computer error but by the normal workings of the screening programme – the numbers do not reach 450,000, says Peto.

Two million women are called for screening in England each year. About one-sixth of those called for final screening are 67 and turning 68 that year. “My guess is that about 300,000 is the real number,” he said.

Interestingly that is about the number – 309,000 – that Hunt said were still alive out of the 450,000 he said were affected and who would be contacted with an offer of another mammogram.

Public Health England is unable to give details of how it got to what it says is 450,000 missed invites. “It is based on modelling data,” said a spokesperson. “It is an estimation. That’s all we know at the present.” Requests to speak to anybody who might have more knowledge were turned away.

The possible 270 deaths – or as Hunt said, “shortened” lives – is also in dispute. “To be talking about deaths in this way was quite surprising,” said Sara Hiom of Cancer Research UK. “It was quite surprising that a health minister would be making such a statement quite that strongly.”

The women will have missed an extra opportunity to have a breast cancer detected by x-ray before they could be aware of it, but it may still have been picked up even at an early stage because it manifests as a lump in the breast. “Breast cancer does tend to have quite clear symptoms and there are excellent treatments even for late-stage breast cancers,” she said.

David Spiegelhalter, statistician and chair of the Winton Centre for Risk and Evidence Communication at Cambridge University, took issue with Hunt’s statement that there could be “135 and 270 women who had their lives shortened”. He gave several reasons “why this claim is misleading”.

“There is only weak evidence that screening helps prolong life, particularly for older women,” he said in a blog. And “contrary to popular belief, screening also does harm … for every 200 women attending screening between 50 and 70, we would expect one to have her early death from breast cancer prevented, but three to be unnecessarily treated for a harmless cancer that would not have troubled them.”

That treatment involves biopsies, and possibly surgery and drugs and a great deal of trauma for the women. The growing knowledge of the downsides as well as the upsides of screening may be why only two-thirds of those invited for it actually go.

Anybody over 70 can request regular screening. But the questions are especially relevant to those in that age group. Screening may detect cancer but it may also pick up suspect cells in the breast that are either benign growths or are so slow-growing that they will not cause harm in the woman’s lifetime.

That was the point of setting up AgeX – to find out whether it was better to screen or not to screen. That question was never asked before screening was rolled out beyond the original cutoff of 64.

“There isn’t a scandal,” said Peto. “At what age should screening stop? We don’t know.”

Jeremy Hunt’s rhetoric over breast cancer screening looks overheated

Jeremy Hunt has described the failure of the breast screening programme to invite some older women for a mammogram in apocalyptic terms, warning of a possible 270 deaths and causing huge alarm among women and their families. He is blaming the body that has “oversight” of the NHS screening programme – now Public Health England – for what is described as a disastrous computer error that meant 450,000 women did not get vital letters calling them in.

But the numbers do not stack up, say some experts with inside knowledge. Both the mortality figures and the number of those affected are now in dispute, and the health secretary’s rhetoric is beginning to look overheated in the light of an issue officials have been wrangling over and trying to understand since January.

There isn’t a scandal, those experts say. There is confusion.

Hunt said the issue goes back to 2009 but was detected in January, thanks to a new IT system introduced by Public Health England that picked up that some women over 68 had not been sent a letter inviting them for a last mammogram before their 71st birthday.

It would not have been noticed if it had not been for a trial, called AgeX, that was enrolling women to see whether screening should actually be extended from the current 50-70 years bracket to include women who were both younger and older than that.

AgeX, based at Oxford University, is the first trial of breast screening in the UK. The evidence that exists for breast screening’s effectiveness in picking up cancers and reducing deaths comes from Scandinavia. Nobody in the world has run trials in women in either their late 60s or 70s until now.

Women of 71 to 73 enrolled on AgeX are randomly assigned either to being screened or to not being screened. The new IT system spotted that women in the control arm (no screening) had been flagged in the NHS screening system not to receive any more routine mammograms. Some of them had their last one before they turned 68.

According to Sir Richard Peto, professor of medical statistics at Oxford University and the statistician on AgeX, there were 80,000 women recruited in the pilot phase between 2009 and 2015, and 80,000 more in the year 2016 to 2017. That means 80,000 women at most in the trial – the 50% randomly assigned to no more screening – could have lost out on a last invitation to have a mammogram. Some of those would have been 68 at their last screening, but some would have been 69 or 70.

The numbers got bigger when Public Health England looked back to 2009 using the new computer system, which was able to see the detailed screening history of individual women for the first time. It found there were thousands of women who had not been invited after they turned 68.

Peto says that was just the way the screening programme had been set up to work. The invitations for screening were sent out every three years from every general practice. The final invitation, up to the age of 70 when routine screening stopped, would go to all the women who would turn 68 to 70 in that year who had been invited three years previously. That therefore includes some who are 67.

But even if you include all of those women invited to a last mammogram before they were 68 – who were not missed by computer error but by the normal workings of the screening programme – the numbers do not reach 450,000, says Peto.

Two million women are called for screening in England each year. About one-sixth of those called for final screening are 67 and turning 68 that year. “My guess is that about 300,000 is the real number,” he said.

Interestingly that is about the number – 309,000 – that Hunt said were still alive out of the 450,000 he said were affected and who would be contacted with an offer of another mammogram.

Public Health England is unable to give details of how it got to what it says is 450,000 missed invites. “It is based on modelling data,” said a spokesperson. “It is an estimation. That’s all we know at the present.” Requests to speak to anybody who might have more knowledge were turned away.

The possible 270 deaths – or as Hunt said, “shortened” lives – is also in dispute. “To be talking about deaths in this way was quite surprising,” said Sara Hiom of Cancer Research UK. “It was quite surprising that a health minister would be making such a statement quite that strongly.”

The women will have missed an extra opportunity to have a breast cancer detected by x-ray before they could be aware of it, but it may still have been picked up even at an early stage because it manifests as a lump in the breast. “Breast cancer does tend to have quite clear symptoms and there are excellent treatments even for late-stage breast cancers,” she said.

David Spiegelhalter, statistician and chair of the Winton Centre for Risk and Evidence Communication at Cambridge University, took issue with Hunt’s statement that there could be “135 and 270 women who had their lives shortened”. He gave several reasons “why this claim is misleading”.

“There is only weak evidence that screening helps prolong life, particularly for older women,” he said in a blog. And “contrary to popular belief, screening also does harm … for every 200 women attending screening between 50 and 70, we would expect one to have her early death from breast cancer prevented, but three to be unnecessarily treated for a harmless cancer that would not have troubled them.”

That treatment involves biopsies, and possibly surgery and drugs and a great deal of trauma for the women. The growing knowledge of the downsides as well as the upsides of screening may be why only two-thirds of those invited for it actually go.

Anybody over 70 can request regular screening. But the questions are especially relevant to those in that age group. Screening may detect cancer but it may also pick up suspect cells in the breast that are either benign growths or are so slow-growing that they will not cause harm in the woman’s lifetime.

That was the point of setting up AgeX – to find out whether it was better to screen or not to screen. That question was never asked before screening was rolled out beyond the original cutoff of 64.

“There isn’t a scandal,” said Peto. “At what age should screening stop? We don’t know.”

Jeremy Hunt’s rhetoric over breast cancer screening looks overheated

Jeremy Hunt has described the failure of the breast screening programme to invite some older women for a mammogram in apocalyptic terms, warning of a possible 270 deaths and causing huge alarm among women and their families. He is blaming the body with “oversight” of the NHS screening programme – now Public Health England – for what is described as a disastrous computer error that meant 450,000 women did not get vital letters calling them in.

But the numbers do not stack up, say some experts with inside knowledge. Both the mortality figures and the number of those affected are now in dispute, and the health secretary’s rhetoric is beginning to look overheated in the light of an issue officials have been wrangling over and trying to understand since January.

There isn’t a scandal, those experts say. There is confusion.

Hunt said the issue goes back to 2009 but was detected in January, thanks to a new IT system introduced by Public Health England that picked up that some women over 68 had not been sent a letter inviting them for a last mammogram before their 71st birthday.

It would not have been noticed if it had not been for a trial, called AgeX, that was enrolling women to see whether screening should actually be extended from the current 50-70 years to include women who were both younger and older than that.

AgeX, based at Oxford University, is the first trial of breast screening in the UK. The evidence that exists for breast screening’s effectiveness in picking up cancers and reducing deaths comes from Scandinavia. Nobody in the world has run trials in women in either their late 60s or 70s until now.

Women of 71 to 73 enrolled on AgeX are randomly assigned either to being screened or to not being screened. The new IT system spotted that women in the control arm (no screening) had been flagged in the NHS screening system not to receive any more routine mammograms. Some of them had their last one before they turned 68.

According to Sir Richard Peto, professor of medical statistics at Oxford University and the statistician on AgeX, there were 80,000 women recruited in the pilot phase between 2009 and 2015, and 80,000 more in the year 2016 to 2017. That means 80,000 women at most in the trial – the 50% randomly assigned to no more screening – could have lost out on a last invitation to have a mammogram. Some of those would have been 68 at their last screening, but some would have been 69 or 70.

The numbers got bigger when Public Health England looked back to 2009 using the new computer system, which was able to see the detailed screening history of individual women for the first time. It found there were thousands of women who had not been invited after they turned 68.

Peto says that was just the way the screening programme had been set up to work. The invitations for screening were sent out every three years from every general practice. The final invitation, up to the age of 70 when routine screening stopped, would go to all the women who would turn 68 to 70 in that year who had been invited three years previously. That therefore includes some who are 67.

But even if you include all of those women invited to a last mammogram before they were 68 – who were not missed by computer error but by the normal workings of the screening programme – the numbers do not reach 450,000, says Peto.

Two million women are called for screening in England each year. About one-sixth of those called for final screening are 67 and turning 68 that year. “My guess is that about 300,000 is the real number,” he said.

Interestingly that is about the number – 309,000 – that Hunt said were still alive out of the 450,000 he said were affected and who would be contacted with an offer of another mammogram.

Public Health England is unable to give details of how it got to what it says is 450,000 missed invites. “It is based on modelling data,” said a spokesperson. “It is an estimation. That’s all we know at the present.” Requests to speak to anybody who might have more knowledge were turned away.

The possible 270 deaths – or as Hunt said, “shortened” lives – is also in dispute. “To be talking about deaths in this way was quite surprising,” said Sara Hiom of Cancer Research UK. “It was quite surprising that a health minister would be making such a statement quite that strongly.”

The women will have missed an extra opportunity to have a breast cancer detected by x-ray before they could be aware of it, but it may still have been picked up even at an early stage because it manifests as a lump in the breast. “Breast cancer does tend to have quite clear symptoms and there are excellent treatments even for late-stage breast cancers,” she said.

David Spiegelhalter, statistician and chair of the Winton Centre for Risk and Evidence Communication at Cambridge University, took issue with Hunt’s statement that there could be “135 and 270 women who had their lives shortened”. He gave several reasons “why this claim is misleading”.

“There is only weak evidence that screening helps prolong life, particularly for older women,” he said in a blog. And “contrary to popular belief, screening also does harm … for every 200 women attending screening between 50 and 70, we would expect one to have her early death from breast cancer prevented, but three to be unnecessarily treated for a harmless cancer that would not have troubled them.”

That treatment involves biopsies, and possibly surgery and drugs and a great deal of trauma for the women. The growing knowledge of the downsides as well as the upsides of screening may be why only two-thirds of those invited for it actually go.

Anybody over 70 can request regular screening. But the questions are especially relevant to those in that age group. Screening may detect cancer but it may also pick up suspect cells in the breast that are either benign growths or are so slow-growing that they will not cause harm in the woman’s lifetime.

That was the point of setting up AgeX – to find out whether it was better to screen or not to screen. That question was never asked before screening was rolled out beyond the original cutoff of 64.

“There isn’t a scandal,” said Peto. “At what age should screening stop? We don’t know.”

Is Jeremy Hunt positioning himself to be next prime minister? | Katy Balls

Jeremy Hunt backs 10-year funding deals for NHS – video

At the weekend a Conservative MP took to the airwaves to break from party orthodoxy. Decrying the government’s funding model for the NHS as “crazy”, this Tory rebel with a cause made clear their support for a new health tax. Only, this wasn’t an unruly backbencher fed up of Theresa May’s weak and wobbly leadership, nor was it an ambitious minister sticking their oar into the health brief. Instead, it was Jeremy Hunt – the secretary of state for health.

The fact Hunt felt able to go public with his NHS demands reveals two things. First, the Conservatives have changed the way they look at the NHS and funding since the EU referendum. Second, Hunt’s position within government has never looked more secure. When it comes to NHS funding, the Conservatives used to see it as an issue they needed to at best try to neutralise ahead of elections. However, a combination of Brexit and Jeremy Corbyn has changed that. The Vote Leave pledge of £350m a week for the NHS showed how potent it was to weaponise health funding.

Now it’s a high-stakes game – if the Conservatives fail to deliver on NHS funding, they will be associated with broken Brexit promises, regardless of the fact May never made the promise herself. What makes things more difficult for the Tories is that Corbyn’s Labour is gaining ground on the issue. A No 10 briefing before Christmas saw MPs presented with a series of route maps that revealed which party led on different values. The good news for the Conservatives is that they still lead on the economy. The bad news is that they lag on nearly everything else, and on the NHS Labour are streets ahead. Things are so bad that usually fiscally conservative MPs – such as Jacob Rees-Mogg – now agree with their anti-austerity colleagues that more money is needed.

The disagreement begins, however, when it comes to how it should be funded. Hunt’s call for a hypothecated tax is popular with MPs such as Sarah Wollaston, the chair of the health select committee, and holds some allure for No 10. However, the chancellor is sceptical and there is a wing of the Conservatives who are opposed to taking lessons from Labour. That lesson came from Gordon Brown in 2002 when he increased national insurance contributions to pay for extra NHS spending. Despite initial scepticism, it turned out to be a popular move – the NHS is so valued that it’s one thing that the public really do appear to be prepared to pay more tax for. It follows that a 1p rise in national insurance to pay for extra health spending would fit with the Tory rhetoric about a “balanced approach” – compared to a Corbynite borrowing binge.

Given that the Institute for Fiscal Studies says the tax burden is already on course to rise to its highest level in 40 years, there are those who think the money ought to be found from cuts elsewhere. But even if No 10 and No 11 don’t take heed of Hunt’s very public warning, it’s unlikely to do him much harm. In fact, although Hunt is sincere in his call, it’s not purely coincidental that he benefits from the publicity.

Over the past six months, Hunt has seen his popularity grow within the party – and cabinet – to the point that he is now seen as one of the favourites to be May’s successor. Unlike Rees-Mogg or Amber Rudd, Hunt is seen as a unity candidate who can appeal to both sides of the Brexit debate. A remainer-turned-Brexiteer, we are looking at the “Theresa May candidate” of the next Tory leadership race: a unifier whose biggest plus point is that they are not as divisive as their colleagues.

Hunt’s critics pour cold water on the idea by pointing to the fact that he failed to get enough nominations from MPs to stand in the leadership contest after the referendum. However, he could take a lesson from May’s ascendancy. She also tried and failed to get on the ballot in 2005 – in the contest that made David Cameron leader. She didn’t make the same mistake twice: the second time, she took advantage of infighting colleagues and won by pitching herself as the “sensible” option. It’s easy to see how Hunt could tread a similar path. Tory leadership contests nearly always turn into a battle to stop X. And Hunt’s colleagues are likely to spend more time trying to stop Rees-Mogg, Boris Johnson or Rudd than him.

But there’s one more snag he must overcome. According to conventional wisdom, it would be near impossible for a politician to go straight from the notoriously difficult health brief to leader. That’s why many had tipped Hunt for a promotion in the reshuffle. However, by rewriting the rulebook and speaking frankly on the issue of health funding, Hunt is showing us that anything is possible.

Katy Balls is the Spectator’s political correspondent

Jeremy Hunt admits NHS spending boost would mean tax rise

Health secretary Jeremy Hunt has conceded he believes taxes may have to rise to pay for a boost in NHS spending.

Appearing on ITV’s Peston on Sunday, Hunt said speculation in the Sunday Times about a £4bn-a-year funding boost to coincide with the NHS’s 70th birthday was premature.

But the health secretary, who resisted Theresa May’s plan to move him into another post in January, said it was time to scrap what he said had been a “feast or famine” approach to funding the NHS.

“There’s no doubt that NHS staff right now are working unbelievably hard and they need to have some hope for the future,” he said. “But I think their real concern is this rather crazy way we have been funding the NHS over the last 20 years, which has really been feast or famine.”

Asked about where the extra resources would come from, he said: “We are a taxpayer-funded system, so in the end if we are going to get more resources into the NHS and social care system, it will have to come through the tax system and also through growth in the economy.”

A growing number of Conservative MPs have been raising the issue of the underfunding of healthcare – particularly the social care system – and some have suggested a dedicated “NHS tax”.

The foreign secretary, Boris Johnson, has been among those calling for an increase in NHS funding, raising it at cabinet level in a well-briefed intervention in January.

The Vote Leave campaign in the 2016 referendum suggested that by allowing Britain to stop paying into the EU budget, Brexit could free up an extra £350m a week to spend on the NHS.

Q&A

What was wrong with the claim that the UK sends the EU £350m a week?

The claim that Britain “sends the EU £350m a week” is wrong because:

  • The rebate negotiated by Margaret Thatcher is removed before anything is paid ​​to Brussels. In 2014, this meant Britain actually “sent” £276m a week to Brussels; in 2016, the figure was £252m.
  • Slightly less than half that sum – the money that Britain does send to the EU – either comes back to the UK to be spent mainly on agriculture, regional aid, research and community projects, or gets counted towards ​the country’s international aid target.

Regardless of how much the UK “saves” by leaving the EU, the claim that a future government would be able to spend it on the NHS is highly misleading because:

  • It assumes the government would choose to spend on the NHS the money it currently gets back from the EU (£115m a week in 2014), thus cutting f​unding for​ agriculture, regional development and research by that amount.
  • It assumes​ the UK economy will not be adversely affected by Brexit, which many economists doubt.

Calculations by the independent Office for Budget Responsibility (OBR) published alongside the spring statement this month suggested it was impossible as yet to estimate the size of any such Brexit dividend.

In the short term, much of the money saved by not contributing to the EU budget has already been pledged elsewhere – for example on maintaining current levels of subsidies to farmers.

“The government has not yet fully articulated its intentions in this area and, even if it had, the precise post-Brexit outcome remains subject to negotiation,” the OBR said.

Hunt reiterated his support for longer-term funding settlements for the NHS, saying a 10-year plan could allow the government to negotiate cheaper prices with drugs companies by striking longer-term deals, and also to pay for new IT systems.

“There’s lot of things that you could do that could fundamentally improve the efficiency of the system. What the public want to know is, yes, I understand the case that the NHS needs more money, I’d like to see that money going in – but I want to know that every pound of that money is being spent wisely.”

The chancellor, Philip Hammond, has made the funding available for the NHS pay deal struck last week with nurses, midwives and other staff – paid for partly from Treasury reserves. But in his spring statement, he stressed he had already injected more cash into social care.

A comprehensive spending review, setting out plans across all departments three years ahead is due next summer, with the overall spending total likely to be announced in Hammond’s autumn budget.

Jeremy Hunt admits NHS spending boost would mean tax rise

Health secretary Jeremy Hunt has conceded he believes taxes may have to rise to pay for a boost in NHS spending.

Appearing on ITV’s Peston on Sunday, Hunt said speculation in the Sunday Times about a £4bn-a-year funding boost to coincide with the NHS’s 70th birthday was premature.

But the health secretary, who resisted Theresa May’s plan to move him into another post in January, said it was time to scrap what he said had been a “feast or famine” approach to funding the NHS.

“There’s no doubt that NHS staff right now are working unbelievably hard and they need to have some hope for the future,” he said. “But I think their real concern is this rather crazy way we have been funding the NHS over the last 20 years, which has really been feast or famine.”

Asked about where the extra resources would come from, he said: “We are a taxpayer-funded system, so in the end if we are going to get more resources into the NHS and social care system, it will have to come through the tax system and also through growth in the economy.”

A growing number of Conservative MPs have been raising the issue of the underfunding of healthcare – particularly the social care system – and some have suggested a dedicated “NHS tax”.

The foreign secretary, Boris Johnson, has been among those calling for an increase in NHS funding, raising it at cabinet level in a well-briefed intervention in January.

The Vote Leave campaign in the 2016 referendum suggested that by allowing Britain to stop paying into the EU budget, Brexit could free up an extra £350m a week to spend on the NHS.

Q&A

What was wrong with the claim that the UK sends the EU £350m a week?

The claim that Britain “sends the EU £350m a week” is wrong because:

  • The rebate negotiated by Margaret Thatcher is removed before anything is paid ​​to Brussels. In 2014, this meant Britain actually “sent” £276m a week to Brussels; in 2016, the figure was £252m.
  • Slightly less than half that sum – the money that Britain does send to the EU – either comes back to the UK to be spent mainly on agriculture, regional aid, research and community projects, or gets counted towards ​the country’s international aid target.

Regardless of how much the UK “saves” by leaving the EU, the claim that a future government would be able to spend it on the NHS is highly misleading because:

  • It assumes the government would choose to spend on the NHS the money it currently gets back from the EU (£115m a week in 2014), thus cutting f​unding for​ agriculture, regional development and research by that amount.
  • It assumes​ the UK economy will not be adversely affected by Brexit, which many economists doubt.

Calculations by the independent Office for Budget Responsibility (OBR) published alongside the spring statement this month suggested it was impossible as yet to estimate the size of any such Brexit dividend.

In the short term, much of the money saved by not contributing to the EU budget has already been pledged elsewhere – for example on maintaining current levels of subsidies to farmers.

“The government has not yet fully articulated its intentions in this area and, even if it had, the precise post-Brexit outcome remains subject to negotiation,” the OBR said.

Hunt reiterated his support for longer-term funding settlements for the NHS, saying a 10-year plan could allow the government to negotiate cheaper prices with drugs companies by striking longer-term deals, and also to pay for new IT systems.

“There’s lot of things that you could do that could fundamentally improve the efficiency of the system. What the public want to know is, yes, I understand the case that the NHS needs more money, I’d like to see that money going in – but I want to know that every pound of that money is being spent wisely.”

The chancellor, Philip Hammond, has made the funding available for the NHS pay deal struck last week with nurses, midwives and other staff – paid for partly from Treasury reserves. But in his spring statement, he stressed he had already injected more cash into social care.

A comprehensive spending review, setting out plans across all departments three years ahead is due next summer, with the overall spending total likely to be announced in Hammond’s autumn budget.

Jeremy Hunt admits NHS spending boost would mean tax rise

Health secretary Jeremy Hunt has conceded he believes taxes may have to rise to pay for a boost in NHS spending.

Appearing on ITV’s Peston on Sunday, Hunt said speculation in the Sunday Times about a £4bn-a-year funding boost to coincide with the NHS’s 70th birthday was premature.

But the health secretary, who resisted Theresa May’s plan to move him into another post in January, said it was time to scrap what he said had been a “feast or famine” approach to funding the NHS.

“There’s no doubt that NHS staff right now are working unbelievably hard and they need to have some hope for the future,” he said. “But I think their real concern is this rather crazy way we have been funding the NHS over the last 20 years, which has really been feast or famine.”

Asked about where the extra resources would come from, he said: “We are a taxpayer-funded system, so in the end if we are going to get more resources into the NHS and social care system, it will have to come through the tax system and also through growth in the economy.”

A growing number of Conservative MPs have been raising the issue of the underfunding of healthcare – particularly the social care system – and some have suggested a dedicated “NHS tax”.

The foreign secretary, Boris Johnson, has been among those calling for an increase in NHS funding, raising it at cabinet level in a well-briefed intervention in January.

The Vote Leave campaign in the 2016 referendum suggested that by allowing Britain to stop paying into the EU budget, Brexit could free up an extra £350m a week to spend on the NHS.

Q&A

What was wrong with the claim that the UK sends the EU £350m a week?

The claim that Britain “sends the EU £350m a week” is wrong because:

  • The rebate negotiated by Margaret Thatcher is removed before anything is paid ​​to Brussels. In 2014, this meant Britain actually “sent” £276m a week to Brussels; in 2016, the figure was £252m.
  • Slightly less than half that sum – the money that Britain does send to the EU – either comes back to the UK to be spent mainly on agriculture, regional aid, research and community projects, or gets counted towards ​the country’s international aid target.

Regardless of how much the UK “saves” by leaving the EU, the claim that a future government would be able to spend it on the NHS is highly misleading because:

  • It assumes the government would choose to spend on the NHS the money it currently gets back from the EU (£115m a week in 2014), thus cutting f​unding for​ agriculture, regional development and research by that amount.
  • It assumes​ the UK economy will not be adversely affected by Brexit, which many economists doubt.

Calculations by the independent Office for Budget Responsibility (OBR) published alongside the spring statement this month suggested it was impossible as yet to estimate the size of any such Brexit dividend.

In the short term, much of the money saved by not contributing to the EU budget has already been pledged elsewhere – for example on maintaining current levels of subsidies to farmers.

“The government has not yet fully articulated its intentions in this area and, even if it had, the precise post-Brexit outcome remains subject to negotiation,” the OBR said.

Hunt reiterated his support for longer-term funding settlements for the NHS, saying a 10-year plan could allow the government to negotiate cheaper prices with drugs companies by striking longer-term deals, and also to pay for new IT systems.

“There’s lot of things that you could do that could fundamentally improve the efficiency of the system. What the public want to know is, yes, I understand the case that the NHS needs more money, I’d like to see that money going in – but I want to know that every pound of that money is being spent wisely.”

The chancellor, Philip Hammond, has made the funding available for the NHS pay deal struck last week with nurses, midwives and other staff – paid for partly from Treasury reserves. But in his spring statement, he stressed he had already injected more cash into social care.

A comprehensive spending review, setting out plans across all departments three years ahead is due next summer, with the overall spending total likely to be announced in Hammond’s autumn budget.

Integrating health and social care is vital to deliver Jeremy Hunt’s plan | Julia Scott

Jeremy Hunt’s speech outlining the seven principles for reforming social care was most welcome after another winter of discontent in the NHS. The speech recognised that much of the pressure on the health service is brought about by problems in transitioning patients back into their homes and communities, an issue the Royal College of Occupational Therapists (RCOT) has been talking about for a number of years. The crux of the challenge lies in how to better align health and social care and how to change perceptions of social care so it receives parity with health.

Serious, sustainable investment in IT

First, let’s focus on the patient, as per Hunt’s second principle. It seems obvious but it’s where the NHS is getting lost.

One of the greatest barriers to patient-centred care is the vast array of IT systems carrying relevant information across the two sectors. Anecdotally, we hear numerous stories about how patients have to repeat their medical and treatment histories as they are referred across services.

Where does this leave patients who are confused, anxious or with a history of self-harm? Vulnerable and more confused; unsure of who they are speaking to and uncertain that they have been heard. Staff are also in the dark; the patient in front of them is a blank canvas about whom they have no prior knowledge. They have to spend time trying to trace records and understand previous treatments. Empathy and trust between patient and professional must be built repeatedly from scratch.

Imagine that health or social care professional had their patient’s history. They would know something about the person and immediately understand why the patient was referred to them. They could quickly establish a rapport, assess the patient and, most importantly, swiftly deliver the interventions needed. Trust is maintained between patient and professional.

When we consider this issue in the context of the millions of people in the NHS system, we can begin to understand the volume of time wasted in health and social care. We need serious, sustainable investment in an IT system that serves both sectors and that patients can access. This is not a “nice to have”, it is a must for the future of our health and social care system.

Care is not just about doctors and nurses

Second, we need to remember that people don’t live in hospital, they live at home. At present, the medical approach to care undermines the patient-centred focus the NHS seeks. In recognising and assessing the person, as opposed to their condition or illness, health and social care can combine for a holistic approach that supports an individual’s return home as quickly as possible.

The traditional approach focuses too much on acute and primary care issues in the NHS: waiting times, lack of funding, shortages of doctors and nurses. The broader – and, crucially, potential – scope of the rest of the health and social care service is overlooked.

Not all health and social care professionals are doctors and nurses. In addition to 106,430 doctors and 285,000 nurses and health visitors, there were 158,000 allied health professionals (AHPs) in the NHS in March 2017.

The RCOT has evidence of occupational therapists working with paramedics reducing admission rates to hospital from 999 calls as a result of a fall by up to 76% in East Lancashire. This represents a real-time saving of approximately £200,000 a year. If all 207 clinical commissioning groups in England made a similar saving responding to falls, £41m would be saved.

Sadly, such achievements often go unrecognised, and recognition and national roll-out of great initiatives led by AHPs become hard to achieve. This is just one example. How many others are there of AHPs contributing to excellent patient-centred care that demonstrates real value for money? I would guess hundreds, if not thousands. I’m not saying we don’t need nurses and doctors. Of course we do. But the answer to better care lies in better use of AHPs, not just in more doctors and nurses.

Harness the enthusiasm of staff

Third, we spend too much time bemoaning our greatest national asset instead of celebrating it. The spirit to fix the NHS and deliver a health and social care system that works for the future is there in abundance. What we now need is for Hunt and his policy team to better support us to deliver it.

Join the Social Care Network for comment, analysis and job opportunities, direct to your inbox. Follow us on Twitter (@GdnSocialCare) and like us on Facebook. If you have an idea for a blog, read our guidelines and email your pitch to us at socialcare@theguardian.com

If you’re looking for a social care job or need to recruit staff, visit Guardian Jobs

Integrating health and social care is vital to deliver Jeremy Hunt’s plan | Julia Scott

Jeremy Hunt’s speech outlining the seven principles for reforming social care was most welcome after another winter of discontent in the NHS. The speech recognised that much of the pressure on the health service is brought about by problems in transitioning patients back into their homes and communities, an issue the Royal College of Occupational Therapists (RCOT) has been talking about for a number of years. The crux of the challenge lies in how to better align health and social care and how to change perceptions of social care so it receives parity with health.

Serious, sustainable investment in IT

First, let’s focus on the patient, as per Hunt’s second principle. It seems obvious but it’s where the NHS is getting lost.

One of the greatest barriers to patient-centred care is the vast array of IT systems carrying relevant information across the two sectors. Anecdotally, we hear numerous stories about how patients have to repeat their medical and treatment histories as they are referred across services.

Where does this leave patients who are confused, anxious or with a history of self-harm? Vulnerable and more confused; unsure of who they are speaking to and uncertain that they have been heard. Staff are also in the dark; the patient in front of them is a blank canvas about whom they have no prior knowledge. They have to spend time trying to trace records and understand previous treatments. Empathy and trust between patient and professional must be built repeatedly from scratch.

Imagine that health or social care professional had their patient’s history. They would know something about the person and immediately understand why the patient was referred to them. They could quickly establish a rapport, assess the patient and, most importantly, swiftly deliver the interventions needed. Trust is maintained between patient and professional.

When we consider this issue in the context of the millions of people in the NHS system, we can begin to understand the volume of time wasted in health and social care. We need serious, sustainable investment in an IT system that serves both sectors and that patients can access. This is not a “nice to have”, it is a must for the future of our health and social care system.

Care is not just about doctors and nurses

Second, we need to remember that people don’t live in hospital, they live at home. At present, the medical approach to care undermines the patient-centred focus the NHS seeks. In recognising and assessing the person, as opposed to their condition or illness, health and social care can combine for a holistic approach that supports an individual’s return home as quickly as possible.

The traditional approach focuses too much on acute and primary care issues in the NHS: waiting times, lack of funding, shortages of doctors and nurses. The broader – and, crucially, potential – scope of the rest of the health and social care service is overlooked.

Not all health and social care professionals are doctors and nurses. In addition to 106,430 doctors and 285,000 nurses and health visitors, there were 158,000 allied health professionals (AHPs) in the NHS in March 2017.

The RCOT has evidence of occupational therapists working with paramedics reducing admission rates to hospital from 999 calls as a result of a fall by up to 76% in East Lancashire. This represents a real-time saving of approximately £200,000 a year. If all 207 clinical commissioning groups in England made a similar saving responding to falls, £41m would be saved.

Sadly, such achievements often go unrecognised, and recognition and national roll-out of great initiatives led by AHPs become hard to achieve. This is just one example. How many others are there of AHPs contributing to excellent patient-centred care that demonstrates real value for money? I would guess hundreds, if not thousands. I’m not saying we don’t need nurses and doctors. Of course we do. But the answer to better care lies in better use of AHPs, not just in more doctors and nurses.

Harness the enthusiasm of staff

Third, we spend too much time bemoaning our greatest national asset instead of celebrating it. The spirit to fix the NHS and deliver a health and social care system that works for the future is there in abundance. What we now need is for Hunt and his policy team to better support us to deliver it.

Join the Social Care Network for comment, analysis and job opportunities, direct to your inbox. Follow us on Twitter (@GdnSocialCare) and like us on Facebook. If you have an idea for a blog, read our guidelines and email your pitch to us at socialcare@theguardian.com

If you’re looking for a social care job or need to recruit staff, visit Guardian Jobs