The Primer provides a rapid guide to the most interesting comment and analysis on the English health and care sector that has not (usually) appeared in HSJ.

Ex-CEO’s insurance call

The national press’s somewhat late awakening to the high salaries on offer for integrated care system chiefs last week (first reported by HSJ three weeks ago) prompted the usual howls of outrage from sections of the right-wing press, particularly in light of the government’s new tax for health and social care.

One of the many voices wading into the debate about NHS funding and black holes was Stephen Smith, the former CEO of Imperial College Healthcare Trust (2007-2011).

Professor Smith, a medic who more recently served as chair of the troubled East Kent University Hospitals Foundation Trust (2018-2020), put his above the parapet to argue for “radical surgery of the entire system” in this piece for the Daily Mail.

He concludes the NHS is not “fit for purpose” and calls for a new “Beveridge Review” in the form of either a Royal Commission or a judge-led inquiry.

Simply “throwing more money” at the NHS is not the solution, according to Professor Smith – who instead favours the introduction of a social insurance system such as those found in several Germanic nations.

Us Brits, in our adoration for the NHS, have set the bar too low for what we expect from the NHS, he argues. In Sweden, consultants hold clinics in GP surgeries while we gratefully see our GP several weeks after booking an appointment.

Whether you agree with the social insurance model, it’s notable that a prominent figure from NHS leadership of recent times is joining supporters of such normally fringe ideas.

Strange logic

On the subject of payment for healthcare, prominent Conservative MP Jacob Rees-Mogg made the point that it is strange that we – in today’s society – have a system that pays for your cancer care but not your Alzheimer’s care.

Speaking on a podcast recorded by ConservativeHome, Mr Mogg backed a call by Policy Exchange to make social care more free-at-the-point-of-use than it is today. Rees-Mogg, despite generally firm right-wing credentials, has a history of backing health spending.

He questioned why the NHS provides free statins, for which prescriptions would only cost a few pounds, while Alzheimer’s patients’ social care is charged for.

“PE is arguing that is a strange order of priorities where you provide for free what people could afford and charge them for what they could not afford, whereas we look on the state for being there to help us when we can’t do things for ourselves,” he said.

“There should be more logic to what the state provides to people and I do feel that it is right for the state to do for the people what the overwhelming majority of people can’t do for themselves.”

New Bill’s journey continues

For health policy enthusiasts, the resumption of Parliament signals more must-watch action in Westminster as the new Health and Care Bill reaches Committee stage.

This is the stage at which amendments can be tabled to refine and – hopefully – improve the bill, but who is likely to do this and what will they be focusing on?

MHP has helpfully provided some analysis on this which you can read here. Their research of the bill committee’s members’ backgrounds and interests sets out each MP’s likely priorities, which could give clues to where amendments will come.