The must read stories and talking points in health from Wednesday

Stevens on the attack

Simon Stevens was under fire on Wednesday morning, with the front page of The Times reporting claims that Number 10 was unhappy with the NHS England chief for his lack of enthusiasm for the NHS recovery plan and responsiveness to mounting pressure.

Unfortunately for Downing Street he had the perfect platform in the afternoon to hit back with full force and style, drawing heavily on both his sharp intellect and top level political experience.

Mr Stevens appeared before the Commons public accounts committee. He stuck by his guns in asserting that the government had not met the NHS’s full request for funding. He also:

  • Indicated that a comparison of UK health spending with the OECD – by Department of Health permanent secretary Chris Wormald, who was sitting next to him – was misleading, and instead held up a story from the Daily Mail in November which said the UK spent less on its health service and had less doctors and other resources than other EU countries.
  • Joked that “I’ve been running a campaign against” cuts to social care by the government, continuing “enthusiastically I might add” – in what must be a reference to the Downing Street briefing in The Times that it was unhappy as he was too “unenthusiastic”. 
  • Unprompted, raised his proposal for a social care funding settlement paid for by revising other publicly funded entitlements for older people – something which has also apparently irritated Theresa May and friends, because he is foraying into political territory.

Mr Stevens seems to be raising the stakes in the relationship with Number 10.

Laura Kuenssberg, BBC political editor, tweeted: “NHS boss Stevens’ evidence very strong – this makes it personal…”; while HSJ editor Alastair McLellan commented: “That smell of burning is the bridge between NHS England and Number 10 going up in smoke.”

The question is where the government chooses to go next. A number of commentators see Mr Stevens as unsackable for a government seeking to avoid blame, but Mike Birtwistle, health policy adviser, noted: “No one is unsackable. Number 10 and Number 11 don’t see Simon Stevens as the ‘star signing’ – just a manager. Can only push it so far without walking.” 

Mr Stevens had also been roundly defended earlier by Commons health committee chair Sarah Wollaston, Labour peer Lord Hunt, and former Tory health secretary (now NHS Confederation chair) Stephen Dorrell, who called the criticism “unfair”.

Mr Dorrell said: “Simon Stevens set out when the Five Year Forward View was published the NHS can only do its job in the context of properly funded public services, and in particular properly funded social care was the basis on which the forward view was built it’s the basis on which it is being carried forward…. It’s his policy and he is seeking to carry it out he has made it clear that the policy requires proper funding for social care. That’s the most serious issue that the health and care system currently faces… The policy that he is carrying out is the policy that he developed and is endorsed by the government.”

May on the defensive

Theresa May was inevitably asked about the NHS during prime minister’s questions earlier in the day, with the opposition trying to put her on the back foot over increasing pressure in emergency departments.

The PM rejected the use of the term “humanitarian crisis”, used by the British Red Cross and repeated by Jeremy Corbyn, to describe the state of A&Es. But added: “I accept there have been a small number of incidents where unacceptable incidents have taken place.”

Former coalition health minister Norman Lamb highlighted concerns of staff across the NHS and repeated his call for an NHS and care commission to come up with a “long term” settlement for the NHS. Ms May said she was happy to meet with him to discuss the idea.

What Ms May didn’t mention was that she has already launched a review into care and integration policy. Fortunately, HSJ had revealed this project earlier in the day.

The review will look at social care funding, delivery and integration with health, amid huge concern about failure in the sector. It was initiated by Ms May before Christmas and work is now under way.