The must-read stories and debate in health policy and leadership.

It’s not about money, it’s about people – underperforming leaders, specifically.

That was the health and social care secretary’s explanation for why some NHS trusts are in “trouble all the time”, while their peers facing similar situations perform well.

Speaking at the Centre for Social Justice event during the Conservative Party conference, he said: “I have seen examples already of areas where demographically the health challenges are quite similar, but the outcomes of two comparable NHS trusts are just completely different. And one has very high outcomes, the other one [is in] challenges and trouble all the time.

“And I think that has to come down to leadership. Because generally the funding per head is similar — it may be we have to look at that — but if that is quite similar as well [then leadership is the main factor].”

Asked by HSJ about the issue, Mr Javid acknowledged that for some parts of the country and organisations, demographics made it more difficult for NHS services to deliver quality care.

He said: “When it comes to assessing the performance of hospitals or different parts of the NHS system, then absolutely you should take account of the local challenges, the facts on the ground. So in Blackpool there are enormous health challenges there, that clearly should be part of the assessment: how successful is the NHS in trying to turn around the situation, to help, given the context?”

Mr Javid’s broadside consolidated his actions of last week, when he commissioned a former senior army general to carry out a rapid review of health and social care leadership.

Poor leaders weren’t the only ones in Mr Javid’s sights. His criticism turned from the general to the specific when he hit out at the manufacturers of medical devices. They should check that their products work well for people of all ethnic backgrounds, he said, citing problems that those with dark skin have experienced when using pulse oximeters.

Several studies have found oximeters are not as good at identifying hypoxia in people with darker skin. The devices have been widely used during the covid pandemic to monitor people at risk of deteriorating at home. 

The health and social care secretary has identified health inequalities as one of his priorities. He gave the issue as an example of racial bias in healthcare when speaking at the party conference on Tuesday evening.

He said: “It turned out that pulse oximeters, all of them that exist in the world, were giving often the wrong reading for people with dark skin, because they were designed by companies where basically all they were thinking about were white people. Why is that? Because the companies, their market was white countries with a majority of white people.”

A predictably busy conference for Mr Javid, but surely not so busy that he will be unaware of his place in HSJ’s list of the 50 most influential Black, Asian and minority ethnic people in health, published yesterday.