Health

Sajid Javid working on radical plan to merge social care with health in England

Sajid Javid plans for a new national care service under which health and social care would be delivered by the same organisation are being actively considered by the government for inclusion in a white paper next month, according to senior Conservatives and Whitehall sources.

The idea of local authorities and the NHS taking joint responsibility for social care, perhaps working from a single combined budget for the first time, would amount to one of the most far-reaching reforms since the NHS was founded in 1948.

At present, local authorities have responsibility for running social care services in their own areas. Critics say there is, as a result, insufficient incentive for cash-strapped councils to develop better care for people in their homes or in the community, as it is cheaper for them if those in need go into hospital where the cost is met from the separate NHS budget.

The result is that many people who could be cared for at home or in the community end up occupying much-needed hospital beds.

Similar systems operate in Wales and Northern Ireland, although there are variations in how much care is paid for by the state. The Scottish government is holding a consultation, due to end next month, on proposals for a National Care Service.

It is believed that health secretary Sajid Javid is examining how a new integrated service that would deliver better care and free up NHS beds across England could be delivered. It is understood there would be national standards for care, and conditions for carers.

The Observer has been told that prime minister Boris Johnson was keen to announce plans to integrate health and social care services last month when he revealed that National Insurance contributions would rise by 1.25 percentage points from next April, to raise £12bn a year for the NHS and social care. But at that time Downing Street remained unclear about how an integrated system could best work, so an announcement was put back.

Under the most radical option of all, local authorities would be stripped of any involvement for social care, which would come entirely under the NHS. Sources say, however, that this would involve too great an upheaval and prove hugely unpopular with councils, many of which are Tory controlled. Councils have already lost much of their responsibility over education.

Last night Tory MP and former health under-secretary Dr Dan Poulter, who works part time as an NHS psychiatrist, said: “There is a growing expectation that a substantive health and social care white paper will emerge in the next few weeks aiming to establish a national care service.

“If integration is to be a success, it is essential that reform does not just deliver parallel commissioning of health and care services but also services commissioned through a single pooled budget. Unified health and social care budgets are the only way to deliver both a more efficient health and social care system as well as properly joining up for the benefit of patients what is currently a badly fragmented system.”

Former Tory Cabinet Minister Damian Green, who has written extensively about social care added: “Running social care jointly between local authorities and the NHS would be an interesting idea but would of course still leave big questions about how you attract a bigger and better paid workforce, how you ensure appropriate housing so that people do not go prematurely into residential care.”

In his party conference speech last week, Johnson hinted at integration. He said: “In 1948, this country created the National Health Service but kept social care local. And though that made sense, in many ways generations of older people have found themselves lost in the gap.” He added it was not just about providing more money but reforming the system. “This government that got Brexit done, that is getting the vaccine rollout done is going to get social care done.”

The Covid-19 pandemic brought the social care crisis even more sharply into focus. Currently a shortage of about 120,000 care workers means 300,000 people are waiting for local authorities to assess their needs or provide care. In addition, many elderly people who end up in hospital because of poor local provision of care cannot free up beds once they are better because there are no places in residential care homes.

There are about 17,000 homes in England, most run as independent small businesses funded by local authorities or paying residents, making coordination with the large hospital trusts difficult.

Shadow health secretary Jonathan Ashworth said: “Social care is in desperate need of wholesale reform but the cap Boris Johnson announced fails to provide the fix he promised. It’s vital care and health services are brought closer together to provide personalised care so people can stay at home and not be forced into a home.

“That’s why I’ve long advocated national care services, locally delivered within national standards, to provide the quality care people deserve.”

Sally Warren, director of policy at the King’s Fund, said: “In reality, people mean different things when they talk about bringing social care into the NHS. For some it means having social care services delivered by the NHS. For others, it means some shared accountability for how health and care services work together. Rather than spending energy shuffling responsibilities from local government to the NHS or vice versa, the important thing is to focus on improving the coordination of services so they work together to improve health and wellbeing.”

Health

Bayelsa records 98% immunisation coverage

Bayelsa has recorded a 98 per cent coverage in the first round of the 2025 National Immunisation Plus Days (NIPDs) programme conducted from the May 3 to May 6.

Mr Lawrence Ewhrudjakpo, deputy governor of the state, disclosed this during a meeting of the state’s taskforce on immunisation in Yenagoa on Wednesday.

He said that the government’s ultimate target was to achieve 100 per cent coverage in subsequent immunisation campaigns.

Ewhrudjakpo lauded the WHO, UNICEF, the Ministry of Health and other critical stakeholders for the feat achieved so far.

He, however, urged the partners not to rest on their oars as much still have to be done to achieve its target of 100 per cent immunization coverage.

He underscored the need for early preparations ahead of the second round of 2025 NIPDs scheduled for July.

The deputy governor assured the partners that funds for the programme would be released not later than two weeks to its commencement.

He directed all council chairmen to flag-off the second round of the 2025 NIPDs programme at any community other than their respective local government headquarters.

The deputy governor urged the chairmen to meet with the traditional rulers, school proprietors, and religious leaders in their areas to sensitise them on the importance of immunisation.

He also called parents, schools and churches to allow children to participate in the immunisation programme.

”The state government is serious about enforcing its public health law and executive order on compulsory immunisation.

“We have taken our immunisation coverage up to 98 per cent. But we want to take it to 100 per cent this time around, and that is why we have convened this meeting.

“We are also going to make an upward review of the logistics to reflect the present economic realities in the country,” he said.

Presentations by Dr Marcus Oluwadare of the WHO, and Dr Gbanaibulou Orukari, Director of Disease Control, Bayelsa State Primary Healthcare Board, revealed that area councils scored high percentage in the coverage.

They, however, identified poor workload rationalisation, data falsification and lack of commitment on the part of some personnel.

According to Oluwadare, we commend the Deputy Governor of the state for flagging off the NIPDs and chairing all the state ERMs in spite of his tight schedule.

“Bayelsa State was the only state to have full complements of her stakeholders in attendance during the April NIPDs in the whole of Nigeria,” he said.

Health

NCDC records 832 Lassa fever, Mpox cases, 135 deaths

The Nigeria Centre for Disease Control and Prevention (NCDC) has confirmed the country has recorded 832 confirmed cases of Lassa fever and Mpox.

Speaking during a press briefing on Friday in Abuja, the agency’s Director General, Dr. Jide Idris, revealed that 132 fatalities were recorded from Lassa fever and three from Mpox.

While acknowledging a recent decline in Lassa fever infections during epidemiological week 16 (ending April 20, 2025), he warned that the overall risk remains high, particularly in endemic regions.

“Cumulatively, as of week 16, Nigeria has reported 4,253 suspected cases of Lassa fever, 696 confirmed cases, and 132 deaths, resulting in a case fatality rate of 19.0 percent,” he stated.

Dr. Idris attributed recent improvements to intensified surveillance, treatment efforts, and enhanced community engagement. He emphasized, however, the continued need for vigilance and collaboration to sustain progress.

Regarding Mpox, the NCDC boss disclosed that three deaths have been recorded in 2025—two in Abia and Ebonyi States in week 10, and one recently in Rivers State involving a patient co-infected with HIV and tuberculosis. As of week 16, 723 suspected cases and 136 laboratory-confirmed cases of Mpox have been reported across 35 states and the Federal Capital Territory (FCT). The national case fatality rate currently stands at 2.2 per cent.

“The epidemic curve reveals multiple peaks in Mpox cases, indicating ongoing transmission. While most states have reported suspected cases, confirmed infections are heavily concentrated in Nigeria’s southern and central regions,” Dr. Idris noted.

To address these outbreaks, the NCDC has activated its Emergency Operations Centre (EOC), deployed National Rapid Response Teams to affected states, and prepositioned essential medical supplies, including personal protective equipment and laboratory consumables. Five additional Mpox diagnostic laboratories have also been optimized in Bauchi, Kano, Cross River, Rivers, and Enugu States.

“Healthcare workers are undergoing specialized training in infection prevention, case management, and cerebrospinal meningitis (CSM) care. Community outreach is being reinforced through public awareness campaigns, media engagement, and targeted health communication strategies,” he added.

On cerebrospinal meningitis, Dr. Idris reported a consistent decline in new cases and fatalities over the last three weeks.

He attributed the improvement to effective vaccination, early treatment, and adaptive surveillance strategies tailored to real-time data.

“Although the situation remains serious, strong national and state-level coordination is showing positive results. The response will continue until full containment is achieved and states take full ownership of the CSM Incident Action Plan,” he said.

Dr. Idris also expressed concern about the rising Mpox trend since its reemergence in 2017, with significant spikes recorded between 2022 and 2024, positioning Nigeria among the most affected countries globally. He warned that underreporting and delayed data entry remain challenges that need urgent resolution to ensure accurate and timely outbreak response.

A national mortality review for the recent Mpox deaths is being planned to further assess response effectiveness and identify areas for improvement.

The NCDC reaffirmed its commitment to safeguarding public health through timely surveillance, transparent reporting, and coordinated national response mechanisms aimed at reducing disease burden and preventing future outbreaks.

Health

Only 89 doctors left in Kwara Govt hospitals amid ‘Japa’ crisis – Health Board

The Executive Secretary of the Kwara State Hospital Management Board, Abdulrahman Malik, disclosed that there is an acute shortage of medical doctors in the state-owned hospitals.

Speaking at the state interministerial press briefing for the first quarter of 2025 on Tuesday, April 29, Malik said that due to the ‘Japa’ syndrome, doctors do not want to take up appointments with the state government, even when the government is ready to recruit them.

He lamented that while between 180 and 200 doctors are required in the government service, only 89 of them are available in the service.

He said the number of available doctors only recently became 89 from 86 when three who had left the service returned after the government introduced a new and improved salary for the doctors’ services.

The hospital board’s boss said the government had been trying to attract doctors to the state service with improved salaries and facilities that could encourage them to stay, especially in the rural areas where many of them do not want to go.

He also disclosed that the government has introduced an intern nurses programme for the training of nurses who would replace many nurses who had left the service for abroad.

“The mass exodus of health professionals is severely affecting our capacity to provide adequate care,” the official said.

“Gov. AbdulRahman AbdulRazaq has approved an upgrade in the salaries of our doctors to match federal pay in a bid to retain the few we have left.

“The revised salary structure has led to the return of three doctors who had previously resigned, bringing the total number on the state’s payroll to 89.

“However, the figure still falls short of the estimated 180 to 200 physicians needed to serve the state’s population effectively.

“Nigeria’s doctor-to-patient ratio is currently estimated at one doctor to over 5,000 patients, far below the World Health Organisation’s (WHO) recommended one doctor to 600 patients.”