Six issues facing Sajid Javid in ‘baptism of fire’ as Health Secretary

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Sajid Javid has said he recognises the “huge responsibility” of his new role as Health Secretary.

Former chancellor and home secretary Mr Javid will be used to taking on all-encompassing briefs, but the coronavirus pandemic has catapulted health to the top of the Government’s agenda.

British Medical Association (BMA) council chairman Dr Chaand Nagpaul warned Mr Javid faces a “baptism of fire”.

Here are some of the issues he will be dealing with.

– Coronavirus pandemic

Mr Javid said on Sunday that Covid will be his “most immediate priority”.

An update on the extension of lockdown measures is expected on Monday and Professor Sir Peter Horby, chairman of the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag), said: “We always have to be driven by the data, not the dates.”

Dr Nagpaul warned: “He is going to logistically need to deliver on the vaccination programme because we are still in the midst of a pandemic, we have spiralling numbers of cases now, over 18,000 yesterday, new cases.

“We are actually seeing increases in hospitalisation, not at the level as before but it is impacting on hospitals at the moment and he is going to have to get up to speed and make sure that the adult population – tens of millions of which have not yet been vaccinated – get vaccinated in the coming weeks. It’s a huge challenge.”

Coronavirus – Sat Jan 23, 2021
Nurse Eleanor Pinkerton administers a coronavirus vaccine (Jane Barlow/PA)

Opposition parties and health leaders have warned of a “perfect storm” to hit the NHS this winter, as a backlog of cases reached more than five million.

Dr Nagpaul told Trevor Phillips On Sunday on Sky News: “We are facing… a record five-plus million patients on waiting lists and that includes about 400,000 who have been waiting more than 12 months and that doesn’t include about 20 million patients who were not seen in outpatient clinics last year.

“So, we really do have an issue of a backlog crisis of care because many of those patients will become more ill as time goes on, many of them have health conditions which if they’re not treated promptly will become more serious and what he will need to do is manage that crisis in a way that delivers prioritisation but also be honest with the public about the length of time it is going to take.

“As a Health Secretary and a former chancellor, he is going to need to negotiate the resources that the NHS needs.”

Coronavirus – Tue Jan 26, 2021
Dr Chaand Nagpaul, chairman of the British Medical Association Council (BMA)

Mr Javid will also have to deal with an exhausted NHS workforce following 15 months of the pandemic.

A survey released by NHS Providers – which represents NHS trusts – earlier this week showed almost half (48%) of leaders said they have seen evidence of staff leaving their organisation due to early retirement, Covid-19 burnout or other effects from working in the pandemic.

Dr Nagpaul said: “Many have worked flat-out without breaks, they’ve worked during the lockdowns and the stay-at-home periods, busier than ever, about four in 10 say their mental health is worse than before the pandemic significantly and you have one in three saying they are going to be retiring in the next year and about one in five saying they will leave the NHS or reduce their hours.

“Remember, this is on the back of about 8,500 unfilled doctor vacancies, about 80,000 vacancies in the NHS that have been unfilled.”

Former health secretary Jeremy Hunt told the Andrew Marr Show: “We have staff shortages in nearly every specialty and we really need to overhaul the way we do our long-term planning for staff.”

– Social care

Six former health and social care ministers have backed proposals to reform the social care workforce in the absence of long-awaited Government plans.

And Mr Javid will face questions over the plan, which the Prime Minister said was ready on the steps of Downing Street after the election in December 2019.

Asked on The Andrew Marr Show whether Mr Javid would fail to deliver on the promises, Northern Ireland Secretary Brandon Lewis said: “No, I think the team – as I say I think the team under Matt as well were very focused on delivering on this. The Prime Minister’s focused on it, I think Sajid will be able to press forward.”

Mr Hunt added that “if we don’t do something about (social care) that will continue to export its most vulnerable people into our hospitals, and the NHS will never get back on its feet unless we fix that”.

Asked how long Mr Javid had, he said: “Six months, because the Government have said they will do it by the end of this year, and I know Sajid will want to honour that promise.”

– NHS pay

Healthcare workers will continue to push for a pay rise amid continuing anger over the Government recommending a 1% increase.

Unite national officer for health Jackie Williams said: “NHS staff are exhausted after 16 months of tireless caring for patients during the pandemic – and many are now prepared to leave the health service after a decade of pay austerity which has seen pay packets for many shrink by 19% in real terms.

“Unless the insulting 1% recommendation from the Government is greatly increased, this could be the last straw for many dedicated staff.”

– Reforms

Mr Hancock had been poised to launch the new Health and Social Care Bill in coming days, expected to be the biggest shake-up in health legislation since the Andrew Lansley reforms, and which would hand more power to the Secretary of State.

Mr Javid will also be faced with a decision over who will replace Sir Simon Stevens, who steps down as NHS England chief executive at the end of July.

Coronavirus – Fri Nov 13, 2020
Baroness Dido Harding (Kirsty O’Connor/PA)

And while NHS England’s board chooses Sir Simon’s replacement, the Government – via the Health Secretary – has a right of veto.

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