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Sajid Javid: patients on waiting lists need not go private as ‘NHS can manage’


Sajid Javid: patients on waiting lists need not go private as ‘NHS can manage’

Sajid Javid has urged patients stuck on lengthy waiting lists not to go private, insisting “the NHS can manage it,” as he pledged to use his position as the first minority ethnic health secretary to tackle racial disparities in health.

Speaking to the Guardian as he marks 100 days in the post, the health secretary declined to say when the NHS would be able to clear the post-pandemic backlog.

But asked if he would encourage patients to resort to using private healthcare to expedite their treatment, Javid said: “No. That’s always a choice for people that can afford it, and that’s up to them. But it’s not certainly something I would be recommending to anyone.”

He added: “I don’t want a situation where too many more people just stop [using the health service] … because I want them to use the NHS. The NHS can manage it.”

Jon Ashworth, the shadow health secretary, said last week that long waiting lists were in danger of leading to privatisation of the NHS, as patients desert it in favour of private providers.

The Institute for Public Policy Research thinktank recently suggested that eliminating the backlog in cancer care alone could take more than a decade.

The government recently announced a 1 percentage point increase in national insurance contributions, with most of the revenue initially going to the NHS, and switching to social care in later years.

As well as dealing with the legacy of the coronavirus crisis, Javid said he wanted to tackle the inequalities that mean healthy life expectancy is 20 years higher in Richmond-upon-Thames than Blackpool, where he gave a recent speech.

“With Covid, we’ve all seen that it’s had a different effect on people depending on perhaps where they live, what their income was, what their race was in some cases. Lots of people have said Covid is a great leveller but it is nothing of the sort – it is anything but that.”

He gave the example of the pulse oximeters that were used to assess patients’ oxygen levels and determine whether they should receive treatment in hospital. “They were giving the wrong readings, generally, for anyone that had dark skin – because they were designed for caucasians,” he said.

“As a result, you were less likely to end up on oxygen if you were black or brown, because the reading was just wrong.”

Asked if that could partly explain higher death rates among minority ethnic people, he said: “I think it’s a reason,” though suggested that BAME people were also more likely to be in frontline jobs such as transport or health workers.

Javid, who is the son of a Pakistani bus driver, said his background gave him a new perspective. “As the first health secretary from an ethnic minority background I think I feel able to say things about racial disparities that others couldn’t say,” he said.

He said tackling these inequalities would mean a cross-government effort and that he was examining effective ways of tackling tobacco and alcohol use, and obesity. “I want to find out the best ways to do it,” he said.

He praised the sugar tax levied on sweetened drinks in 2018, saying it had encouraged manufacturers to reformulate their products – though said he was not considering specific new tax proposals. But asked whether he would consider tax as a way of tackling health disparities, he said, “Instinctively I don’t like it.”

Javid raised the question of whether companies target advertising for unhealthy products such as junk food at less affluent areas, where health outcomes tend to be poorer.

“Just picking Blackpool as an example, I wonder whether companies – tobacco companies, certain food companies – whether they target certain areas more themselves. I mean anecdotally, when I was in Blackpool, in the driving rain, going around, it just seems there’s a lot more adverts on stuff like alcohol everywhere than I notice in Bromsgrove, for example.”

Javid said that the health and social care bill currently before parliament includes limits on junk food advertising to children, but dropped a hint that he would like to go further. “I’m almost one step ahead of that,” he said.

But Javid’s claim to be ready to tackle health disparities came as the Health Foundation thinktank and the Association of Directors of Public Health (ADPH) pointed out in a new analysis that the public health grant had been cut by 24% in real terms per capita since 2015-16 – equivalent to £43 a head in Blackpool, for example.

Jim McManus, interim director of the ADPH, said: “Investing in local public health is critical to levelling up, preparing for the future threats and building a more prevention-focused health and care system.”

Javid praised the healthcare workers who have been on the frontline during the pandemic. He said: “When it comes to GPs, they’ve done a brilliant job and continue to work incredibly hard, and if we want them to meet more people, which I do, offer more face to face appointments, then I have got to work with them in partnership and see what we can do.

“I’ve asked both GP leaders and also my department to think about what more we can do.”

Javid suggested he was considering a new “covenant” for healthcare workers, along the lines of those the government has signed with the police and members of the military, setting out the government’s responsibilities to support them.

“I am just thinking about what more we can do in law to support health and social care workers,” he said.

Asked whether there could be more serious penalties for those who attack health workers, Javid said: “You could. One thing I did for police and emergency workers was to increase the penalties. I will think about what I can do.”

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Lagos to convert General Hospital to eye centre

The Lagos State Commissioner for Health, Prof. Akin Abayomi, says the state government will designate one of its general hospitals as a centre for ophthalmic specialty to improve care for patients with eye conditions.

Abayomi said this during the 4th Annual General Meeting and Scientific Conference of the Africa Retina Society on Thursday in Lagos.

The News Agency of Nigeria (NAN) reports that the event was themed, “Upscaling Retinal Services in a Resource-Constrained Economy.”

Abayomi said the centre would provide a world-class diagnostic, medical, surgical and ophthalmic services in Lagos and Nigeria.

He stressed that the state would prioritise eye health, noting that the state was working on developing screening capacity of all its primary healthcare facilities to detect eye diseases early.

“The conditions that affect the eyes very much reflect the conditions of the community in which you live. HIV, for example, was a major problem in South Africa, and I certainly experienced the impact of HIV on our day-to-day medicine and practice.

“Here in Nigeria, we have other things. We have hypertension, diabetes, sickle cell, and lots of trauma. These are the kinds of things that we see in our clinics here in Lagos and in Nigeria.

“We need to be able to understand how these prevailing conditions really affect us,” he said.

The commissioner further said that efforts are ongoing to promote eye screening, especially in schools, starting with the training of teachers to detect students exhibiting challenges with their vision.

He added that the state would leverage the social health insurance to screen, detect and treat eye diseases as patients presents at health facilities.

The commissioner further said the state would strengthen public awareness and understanding on eye health, especially glaucoma and visual acuity.

Abayomi disclosed that the state through its Ministry of Health had forged a partnership with the Chagoury Group
to develop a specialist eye hospital in Lagos to boost access to eye services.

He acknowledged that ophthalmology was equipment-intensive, stressing that government would pay attention to that and human resources to enable practitioners make appropriate diagnosis, and treatment to reverse medical tourism.

Earlier, Prof. Linda Visser, Head, Division of Ophthalmology Stellenbosch University, South Africa, called on policy makers to formulate policies that would integrate eye screening into diabetes care from the primary healthcare level, noting that cases of diabetic retinopathy was on the increase among Africans.

Diabetic retinopathy (DR) is a chronic progressive disease of the retinal capillaries (small blood vessels) associated with prolonged raised blood glucose levels in people with diabetes.

Visser cited data from International Diabetes Foundation that showed that 537 million adults aged 20 to 79 years are living with diabetes globally, a number that was predicted to reach 1.3 billion in 50 years.

“The high prevalence of type 2 diabetes continues to rise worldwide and is particularly rapid in low- and middle income countries.

“Most of these countries have limited availability and affordability of healthcare services for screening and treating diabetes-related complications, such as retinopathy, to prevent vision loss,”

According to her, all persons with diabetes are at risk of developing DR, however, those with poor blood glucose and blood pressure management and hyperlipidaemia are most at risk.

Visser, Past President, Vitreoretinal Society of South Africa, emphasised that early detection would lead to timely treatment of DR, which could prevent 95 per cent of vision impairment and blindness.

Also, Dr Asiwome Seneadza, Chairman, Africa Retina Society, said that the theme was timely and critical as efforts are made to navigate the complexities and challenges in delivering advanced retinal care across the continent.

Seneadza said, “That’s why we are advocating for improved diabetes care and regular retinal screening made available and accessible for every individual living with diabetes,” he said.

Similarly, Prof. Bassey Fiebai, Chairman, Vitreo Retinal Society of Nigeria, said the meeting was critical to proffering solutions to the challenge of offering standard retina care, improving outcomes and reducing visual loss from retina related disorders among low to medium income countries.

Fiebai said that the government plays a critical role in providing funding, training of personnel, provision of equipment to improve screening, detection and treatment of retinopathy disease.

The professor noted that retina specialists are few in Nigeria, placing the figure at about 100, stressing that it was inadequate to cater to the teeming population who require eye care.

“Right now in the country, we have just a little over 100 retina specialists. And we know that the population of Nigeria is about 230 million.

“So we’re looking at a situation in which one retina specialist is supposed to cater for 2.3 million people. How does anyone cope?” she queried.

NAN reports that the Annual General Meeting and Scientific Conference of the Africa Retina Society which began on June 26 to June 28, had participants from various African countries brainstorm on enhancing retinal care.


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Cholera outbreak: Tinubu sets up presidential committee to oversee emergency operation centre

President Bola Tinubu has directed the setting up of a presidential committee to oversee the Cholera Emergency Operation Centre, operated by the National Centre For Disease Control.

The Minister of Health, Ali Pate, made this known on Tuesday after the Federal Executive Council meeting chaired by President Tinubu at the State House, Abuja.

He added that the committee’s effort is in addition to state government support to ensure Nigeria makes progress in reducing open defecation.

“The Council then approved a cabinet committee comprising the federal ministries of Health, Finance,Water Resources, Environment, Youth, Aviation, Education because some of our children will be returning to school . In addition to this, the state government, we will co-opt, so that Nigeria makes progress in reducing open defecation because cholera is a developmental issue that requires a multi-sectoral approach.

“The President directed that a cabinet committee be set up to oversee what the emergency operation centre led by NCDC is doing and for the resources to be provided complemented by the state government,” he said.

Pate further disclosed: “At the moment about 31 states have recorded 1528 cases and 53 deaths in Nigeria. That is what we are working through the Emergency Operation Centre that was activated by NCDC on Monday.

“Now we have a cholera outbreak and we discussed extensively in the Council in addition to a new emergence of Yellow Fever specifically in Bayelsa State.

“On cholera we are in the middle of the 7th pandemic globally which is decades in the making. In 2022, the world had almost 500,000 cases of cholera so it is not only peculiar to Nigeria. In 2023 almost 700,000 cases of cholera were reported by the World Health Organization.

“This year more than 200,000 cases have occurred in five regions of the World.”

He emphasised that a multi sectoral approach is required to tackle the outbreak .

“Resources were deployed to 21 states to help them respond to cholera. We are improving awareness of population, handwashing, hygiene sanitation, in addition to treatment with drugs, and intravenous fluids,” he added.

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NCDC reports 1,598 cases of cholera across the country

The Nigeria Centre for Disease Control and Prevention, NCDC, has reported 1,598 suspected cases of cholera across 107 local government areas.

The cholera outbreak is characterised by a case fatality rate of 3.5 per cent, significantly higher than the national expected average of one per cent, underscoring the severity of the situation.

The Director-General of NCDC, Dr Jide Idris, disclosed this on Monday in Abuja while providing an update on the cholera epidemiological situation in Nigeria and ongoing prevention and response efforts at the national and sub-national levels.

Cholera is a severe diarrheal illness caused by the bacterium Vibrio cholerae. The disease remains a significant health challenge, especially in regions with inadequate sanitation and clean water access.

Understanding the transmission mechanism of cholera is crucial to curbing its spread and implementing effective prevention measures.

Idris said: “Government is deeply concerned about the rapid spread and higher-than-expected mortality rate, indicating a more lethal outbreak.”

He emphasised that the fatalities represented significant personal losses, including those of family members, spouses, parents and healthcare workers.

“This situation can be compounded as the rainy season intensifies,” he added.

He disclosed that Lagos State accounted for the highest number of deaths with 29, followed by Rivers with eight, Abia and Delta with four each, Katsina with three, Bayelsa with two and Kano, Nasarawa and Cross River with one each.

He added: “This alarming trend highlights the urgent need for coordinated response to prevent further escalation of the crisis. Sixteen states accounted for 90 per cent of the confirmed cases, with Lagos being the epicentre of the outbreak. Lagos State, having the highest number of cases, has received significant focus, with ongoing support and resources directed to manage the outbreak effectively.”

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