‘I’m entitled not to listen to Sage’: an interview with Sajid Javid

Sajid Javid has big plans for the NHS – if Covid lets him

9 October 2021

9:00 AM

9 October 2021

9:00 AM

In six years Sajid Javid has had six cabinet jobs. He has been culture secretary, business secretary, communities secretary, home secretary and chancellor — and, just over 100 days ago, he was made Secretary of State for Health. When we meet on stage for an interview at Tory party conference, I ask him about his credentials for the job. He has none. ‘But that’s not unusual for a health secretary,’ he chirps. And experience? He has visited a few hospitals. He then offers the story of his early run-in with the NHS.

As a child, he had his appendix removed in hospital. ‘Next thing I remember is being back at home in bed, being cuddled by teddy and feeling much better.’ Soon he was in pain again. ‘I go to the hospital, they do a scan and it turns out they left an instrument inside me.’ His mother, he says, was so traumatised that she still can’t remember the details. ‘She thinks it was a pair of scissors, but isn’t sure.’ Five-year-old Javid’s abdomen was reopened and the object was retrieved.

It’s an experience which might have persuaded Javid of the need for reform of the country’s healthcare system. But in recent years, the Tories have instead positioned themselves as cheerleaders for the NHS. Javid’s predecessors, Matt Hancock and Jeremy Hunt, wore an NHS lapel badge to work every day. Boris Johnson proclaimed that the Conservatives are the ‘party of the NHS’ as he announced its third funding increase in four years. The latest cash injection is funded by a tax rise, in defiance of the Tories 2019 manifesto pledge — a pledge that was put there at the insistence of the then chancellor, Sajid Javid.

How does Javid feel about arguing for — and then breaking — a manifesto pledge? Covid, he says, changed everything. ‘I can’t think of any manifesto in 2019 talking about a global pandemic, the biggest health challenge in living memory. This is a seismic event,’ he says. ‘We’re spending billions a year on vaccines, we’re spending billions on PPE. All these new treatments, they’re costing billions. No one could have foreseen that.’

But the money isn’t being spent on the pandemic, I say. It’s supposed to finance Boris Johnson’s great settlement of long-term care for the elderly. ‘Gradually, over time, it will shift more and more into adult social care,’ he says. Several Tory ministers privately worry that this ‘gradual’ shift might never take place and that the extra cash will disappear into what many regard as the NHS black hole.

When Javid took over as Health Secretary, Britain was in the final stage of lockdown. The original reopening date, 21 June, had been delayed for four weeks and polls showed that 70 per cent of the public wanted restrictions to continue beyond 19 July. Javid argued for reopening. He says that the negative side effects of lockdown, such as the seven million people who would have ordinarily come forward to the NHS but instead stayed at home, made a compelling case. ‘I was told that there were possibly 100,000 undiagnosed cancers. And people were going to die because they didn’t get spotted in time… Then there are mental health problems. Especially among young people. They increased 30 to 40 per cent in some cities, a 50 to 60 per cent increase in referrals.’

He has done enough jobs in government, he says, to know what damage lockdown would inflict more widely. ‘My job isn’t just to be thinking about only my department and nothing else. I have to think about the country, the national interest and about the impact of lockdown on education, all those kids who missed normal schooling. The jobs, the life chances.’

Sage modelling on 7 July warned there could be up to 29,000 people in hospital by the middle of August if the government reopened on 19 July. In reality, hospital occupancy peaked at 6,400 in the middle of September, lower than any of the Sage scenarios. Many of the Sage models have been wildly wrong during the pandemic. Isn’t it time to move on from Sage, or at least ask why a bias seems to have crept into its modelling? ‘They’re an independent group. They’re entitled to come to their own decisions and I’m entitled not to listen to them. Because I’m a minister and I have to make the decisions.’

One of those decisions is to fire thousands of care-home workers because they refuse to be vaccinated. I ask if this is a bit unfair on those who have already recovered from Covid and may have natural immunity, which — according to several studies — is at least as good as vaccine-acquired immunity. It’s not a conversation he wants to get into. ‘We have to keep it as straight-forward as possible,’ he says, adding that 92 per cent of care-home staff are now vaccinated.

So are 92 per cent of NHS staff: will his no-jab, no-job policy apply to the unjabbed 8 per cent? ‘It may do. I’m consulting on that right now.’ Firing 95,000 unvaccinated frontline NHS staff would be quite an undertaking.

Javid says he wants to be ‘a big reformer for the NHS and for social care’. What kind of reform? He’s ambitious, he says, but his agenda is still being put together. Previous governments have had a strange approach to the NHS, he says. ‘They’ve either sort of thrown cash at it or they’ve gone for the reform. But I think it’s a false choice. It’s got to be cash and reform together,’ he says. ‘There’s a huge supply–side element to it.’

Our conversation, hosted by the thinktank Policy Exchange, was in front of a standing-room-only crowd in a small conference room in Manchester. Almost no one was masked. I ask him what the official advice is now. ‘Be cautious and make your own decisions,’ he says, with a smile. ‘It’s not more detailed than that.’

The official advice is, in fact, quite a bit more detailed. It recommends wearing ‘face coverings in crowded and enclosed spaces where you come into contact with people you don’t normally meet’ — guidance cheerfully ignored by the Health Secretary, most members of the government and almost everyone at the conference in Manchester. Rightly or wrongly, the Tories are ready to move on.

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