Mentally ill woman"s treatment in Lismore hospital "deeply distressing", says Greg Hunt

Appalling footage of a mentally ill woman stumbling around a NSW hospital, covered in faeces and falling over at least 25 times before she died of a brain injury, has shocked the public and politicians.

Footage released by the coroner shows the woman, mother-of-two Miriam Merten, locked in a seclusion room for more than five hours at the Lismore Adult Mental Health Inpatient Unit on 1 June 2014.

A nurse unlocks Merten’s room the next morning, before she is left to stumble around the hallway naked, eventually collapsing in a corner before an emergency crash cart is rushed in by staff.

Merten died at Lismore base hospital on 3 June 2014.

A coronial inquest found she died of “traumatic and hypoxic brain injury caused by numerous falls and the self-beating of her head on various surfaces, the latter not done with the intention of taking her own life”.

A senior nurse at the facility was aware Merten had been sedated with psychotropic drugs and fallen on at least one occasion, but failed to take appropriate action, the coroner Jeff Linden found.

A second nurse was also involved.

“The lack of care and compassion showed to the deceased was monumentally disgraceful and appeared to emanate from an: ‘Oh, it’s just Miriam’s mentality,” Linden said in his inquest findings.

“To see a mentally ill person in 2014 at a public hospital in NSW treated in such an appalling manner is really beyond comprehension.

“While this appears not to be a system failure it is clearly a serious human failure.”

The New South Wales Labor party on Friday called for an urgent parliamentary inquiry into the state’s mental health facilities.

Opposition mental health spokeswoman Tania Mihailuk says the incident is a “Don Dale moment” for the NSW mental health system and demonstrates “abhorrent mistreatment and abuse”.

Mihailuk said the government should apologise to Merten’s family and conduct a full and transparent review.

The federal health minister Greg Hunt said the two nurses “are no longer in service”, and the state government had Canberra’s “full support for the strongest possible steps against what was completely unacceptable”.

“I have (seen the footage) … it is deeply distressing,” Mr Hunt said in Sydney on Friday.

The NSW premier Gladys Berejiklian echoed that view.

“We’ll do everything we can to make sure this never happens again,” she told reporters.

Mentally ill woman"s treatment in Lismore hospital "deeply distressing", says Greg Hunt

Labour expels three members over attempt to unseat Jeremy Hunt

Labour has expelled three senior members in Surrey for trying to unseat the health secretary, Jeremy Hunt, by forming a progressive alliance with local Greens and Liberal Democrats to unite behind an NHS doctor standing against him.

Kate Townsend, the South West Surrey party secretary who stood in last week’s local elections, and Steve Williams, a party member for 46 years who sits on the constituency party’s executive committee, were notified of their expulsion this week.

Robert Park, a Labour member for almost five decades who chaired the Surrey Fabians and ran the regional remain campaign, has also been expelled.

Townsend and Williams have been leading figures in the campaign for a progressive alliance between local parties, where the Conservative cabinet minister has a 28,000 majority.

Williams has been working on behalf of Compass, the centre-left thinktank and champion of grassroots progressive alliance initiative, in defiance of the national party, which has said it will not entertain any notion of local party cooperation at election time. Party rules state that members must not support any other candidate for election who is running against Labour.

“We have massive support from the local party,” Williams told the Guardian. “It is such an overkill reaction to a group of people who are trying to unseat the health secretary. There was a campaign meeting last night, we only found out a few hours before that we had been expelled from the party so we weren’t able to go. People were storming out of the meeting, really very, very upset and angry.”

In a letter from the party’s head of disputes, Sam Matthews, Williams was told: “It has been brought to our attention with supporting evidence that you have publicly stated your support for a party that is standing against the Labour party in the 2017 general election, which is incompatible with membership of the Labour party.”

Williams was “ineligible to remain a member of the Labour party and have been removed from the national membership system”, the letter said, adding that he was no longer entitled to attend local Labour party meetings.

The party will consider an application for readmission only after five years, the letter said, though Williams said he was planning to appeal. The letter included supporting evidence, including Williams’ appeal for signatures for a letter to the Guardian supporting Irvine’s candidacy.

“We have been doing our best to unseat Jeremy Hunt, to hold him to account on his record because of what he has done to the health service over the last five years,” Williams said.

The initiative to back the National Health Action party’s Dr Louise Irvine, who received just over 8% of the vote in 2015, has the backing of local Labour leaders, including Townsend. Irvine, a GP, was the chair of the Save Lewisham hospital campaign, which defeated the government in court over the proposals to downgrade A&E and maternity units.

Williams said Irvine was “able, articulate, very capable of being able to hold Jeremy Hunt to account, when the NHS is such a key issue in his constituency”.

Local Lib Dem activists have also agreed not to campaign, after a meeting in Farncombe organised by Compass with members from progressive parties. The Green party has said it will not field a candidate.

Neal Lawson, chair of Compass, said: “Steve Williams has given 46 years of service to Labour and was backing a local doctor to take on Jeremy Hunt and defend the NHS. For this he got expelled by email. Labour is a tribal party in a non-tribal age.”

Park, who also stood for election for Labour last week, told the Guardian he had been expelled after an interview with the BBC’s Today programme in which he expressed cautious support for Labour standing aside.

“I have to say, I was upset,” he said. “It was a blunt, legalistic email message, I joined the party as student in 1963, I had thought particularly that somebody might have phoned to talk to me first, I’ve spent most adult life helping the cause.

“The irony is that [we are] three most loyal Labour members you could hope to get; when people were attacking [Labour leader Jeremy] Corbyn, we’ve stuck by him. Now we’re all out on our neck.”

Park said he still intended to volunteer to help Labour MPs in marginal seats, as well as considering campaigning to help the Lib Dem former cabinet minister Vince Cable regain his seat in Twickenham, south-west London.

“Whatever we do, the likelihood is that Jeremy Hunt going to win,” he said of his constituency. “Nonetheless we’re tired of having a small share of the vote and we do feel that if we get behind one candidate we can stand some chance of denting his majority.”

Labour has selected IT manager David Black to fight the seat for the party after the CLP chair, Howard Kaye, the party’s candidate in 2015, has said he would not stand again. The Lib Dems have also selected a candidate, Ollie Purkiss.

The Green party co-leader Caroline Lucas has called for talks with Corbyn, and the Lib Dem leader, Tim Farron, to make a “series of electoral alliances” in some areas against the Conservatives before the election, though both have publicly rejected her entreaties.

Local Greens made the decision to stand down in the recent Richmond Park byelection, in which the Lib Dems’ Sarah Olney unseated the former Tory mayoral candidate Zac Goldsmith.

The party has also decided to stand aside in several seats at the general election in June, including Ealing Central and Acton, to bolster the chances of Labour’s Rupa Huq in the marginal.

Lucas has called for Labour and the Lib Dems to respond similarly to strengthen her party’s chances of taking the Isle of Wight, where the party hopes to capture the traditionally Conservative seat after its good showing in local elections.

Labour expels three members over attempt to unseat Jeremy Hunt

Bad Brexit deal would be disaster for the NHS, says Jeremy Hunt

A bad deal on Brexit would be “a disaster” for the NHS, Jeremy Hunt has said, as he accused the European commission of deliberately interfering in the general election to undermine the Conservatives.

Ramping up the rhetoric of Theresa May, who last week accused the commission of leaking an unflattering account of talks at Downing Street to disrupt the election, the health secretary warned that a good Brexit negotiation was vital for the NHS.

“We’ve got 27 countries lined up against us,” Hunt told BBC1’s Andrew Marr show. “Some of them appear to think that for the EU to survive, Britain must fail.”

He said of the impact on the health service: “If we don’t get a good Brexit outcome, and we don’t protect the economic recovery, the jobs that so many people depend on, whose taxes pay for the NHS, if we get a bad Brexit outcome, that would be a disaster for the NHS.”

However, pressed on the issue, Hunt refused to specify what sort of bad deal this might involve, or to say whether the UK leaving the UK with no deal and defaulting to World Trade Organisation tariffs, would also affect the NHS.

“We’ve been very clear that no deal is better than a bad deal,” he said, adding: “I’m saying that a good deal would be best for the NHS, but obviously, a bad deal would be the worst possible outcome for all our public services. It would be bad for the country.”

On Wednesday, May used an address outside Downing Street launching the election campaign to accuse the European commission of seeking to influence the election.

“The European commission’s negotiating stance has hardened. Threats against Britain have been issued by European politicians and officials. All of these acts have been deliberately timed to affect the result of the general election which will take place on 8 June,” she said.

May did not specify who this interference was intended to assist. But pushed on the matter, Hunt said he assumed the commission wanted to undermine the Conservatives and help Jeremy Corbyn’s Labour party.

“Well, you’ll have to ask them why they chose to do that, but I think the answer is very clear, that they are trying to leak reports that undermine Theresa May’s position,” he said, when asked who the commission favoured.

Asked specifically if the aim had been to harm the Conservatives, he said: “That must be the presumption, and what we’re saying is that they should not be doing that, because it’s an election for the British people to decide.”

May’s accusation baffled Brussels, where the European commission’s chief spokesman, Margaritis Schinas, dismissed the allegations as electioneering.

“We here in Brussels are very busy, rather busy, with our policy work,” he said. “We have enough on our plate.”

The European council president, Donald Tusk, said the stakes of the Brexit talks were “too high to let our emotions get out of hand”.

He added: “We must keep in mind that, in order to succeed, we need today discretion, moderation, mutual respect and a maximum of goodwill.”

Bad Brexit deal would be disaster for the NHS, says Jeremy Hunt

Hunt broke law by axing NHS 18-week treatment target, says Labour

Jeremy Hunt has broken the law by not forcing the NHS to ensure that patients receive hospital treatment within the stated maximum of 18 weeks, according to legal advice obtained by Labour.

The counsel’s opinion says the health secretary is acting illegally by not obliging NHS England to compel hospitals to treat the required 92% of patients within 18 weeks of being referred by their GP.

The advice, by James Goudie QC, is potentially embarrassing for Hunt as it draws attention to the NHS’s increasingly poor performance against key waiting time targets for A&E care, cancer treatment and ambulances’ responses to 999 calls, as well as the referral to treatment (RTT) requirement. It specifies that at least 92% of all those waiting for non-urgent hospital treatment, such as hip or knee replacement or cataract removals, should wait no more than 18 weeks.

Controversy erupted last month when Simon Stevens, NHS England’s chief executive, announced that he was relaxing the 18-week target so that under-pressure hospitals could focus on more important priorities, in a move critics said meant it was being scrapped. The Royal College of Surgeons accused the NHS of “waving the white flag” on the target and condemning patients already in pain to further suffering due to the extended delays they would now face to get surgery.

Labour peers commissioned the 12-page opinion from Goudie, a barrister specialising in public law and employment law at 11 King’s Bench Walk chambers in London. It says: “I am asked whether the SoS [secretary of state] acted unlawfully by failing to include the 92% RTT target in the mandate to NHS England for 2017-18. My answer is: ‘Yes’.”

It goes on to explain: “This is because the 2012 Regulations and the NHS constitution have the effect that this must be included. The annual mandate cannot lawfully be used to circumvent or undermine by omission the absolute statutory and sub-statutory requirements.”

The mandate is the detailed annual document in which the Department of Health spells out precisely what key priorities it wants NHS England to fulfil in the coming year.

Labour claimed Goudie’s advice showed the government’s NHS plans were “in total chaos”. The party planned to use a motion in the House of Lords on Thursday to try to force ministers to explain what it says is a fundamental breach of patients’ rights under the NHS constitution. Philip Hunt [no relation], Labour’s health spokesman in the Lords, will also challenge ministers to publish the legal advice they have taken surrounding the 18-week target.

“Tory plans for the NHS are in total chaos. Legal advice commissioned by Labour confirms that the government have acted unlawfully in failing to deliver the 18-week treatment target for patients,” said Jonathan Ashworth, the shadow health secretary.

“Almost 4 million people are now on waiting lists because of the neglect and underfunding of this Conservative government and now this year’s NHS mandate is at risk of legal challenge. The government are failing to deliver the standards of care to which NHS patients are legally entitled,” he added.

Labour is now considering what its next move should be in light of Goudie’s advice, including whether it should seek a judicial review to challenge the legality of Jeremy Hunt’s actions over the 18-week target. No decision has yet been made on possible legal avenues it may pursue.

But Hunt last night insisted that he had done nothing wrong and that he had ordered NHS England to start hitting the 92% target again, which hospitals have missed every month since March last year at a time when the total number of patients awaiting treatment has crept up to almost 4 million.

“We do not believe there is a case to answer,” a Conservative spokesman said.

“Indeed, we wholeheartedly reject any suggestion that the government is not committed to the 18-week target, and as the mandate itself clearly states, we are specifically requiring the NHS to return to delivering that standard,” he added. The NHS is now carrying out record numbers of operations and treating 5,000 more people a day than in 2010, the spokesman added.

Hospitals breached the 92% target for the first time in December 2015 since its introduction in 2010. After meeting it again in the next two months, performance slipped to 91.5% last March and has stayed below 92% since. It hit an all-time low of 89.7% last December. In February, a total of 367,094 patients waiting for treatment had already waited for more than 18 weeks, according to the most recent NHS data.

Tim Gardner, a senior policy fellow at the Health Foundation thinktank, said: “The failure of the NHS to treat patients within the 18-week target is a symptom of wider pressures on the system. NHS hospitals are running at or near capacity to cope with growing demand for emergency care, and this limits their ability to perform planned procedures. If funding pressures continue to increase, the NHS will increasingly be forced to make trade-offs to live within its means.

“The government must ensure there are adequate levels of investment to maintain good standards of care in every part of the health and care system.”

Hunt broke law by axing NHS 18-week treatment target, says Labour

Jeremy Hunt orders investigation into baby deaths at NHS trust

The health secretary has ordered an investigation into the deaths of a number of babies at an NHS trust in the Midlands, after seven of them were judged to have been avoidable.

Jeremy Hunt made the move after bereaved families and the local coroner criticised the quality and safety of maternity care at the Shrewsbury and Telford Hospital NHS trust. He has asked NHS England and NHS Improvement to look into an undisclosed number of deaths at the trust in recent years, amid concern that some were not properly investigated at the time.

The BBC said it had obtained details of at least nine suspicious deaths that occurred at the trust between September 2014 and May 2016, seven of which were later deemed to have been avoidable if the newborns had received better care.

Five of the deaths involved apparent failures by staff to correctly monitor a baby’s heartbeat.

Dr Edwin Borman, the trust’s medical director, said the rate of baby deaths at the trust – which handles 4,700 deliveries a year – was no worse than anywhere else in the NHS.

However, he told BBC News: “In the case of foetal heart monitoring, we have identified a number of cases where learning has not been fully implemented. We’ve put systems in place to make improvements.”

John Ellery, the coroner in the June 2016 inquest into the death of Kye Hall at Telford’s Princess Royal hospital, said errors by staff had contributed to the baby boy’s death.

“His death was caused or contributed to by failings at the Princess Royal hospital, Telford, namely a failure to reclassify Kye’s mother as a high-risk case on two occasions and a failure to auscultate [listen to] his foetal heart rate at two critical times prior to delivery,” the coroner said.

Kye was born on 15 August 2015, but he died four days later as a result of hypoxic ischaemic brain injury and birth asphyxia, or serious oxygen deprivation.

The trust accepted during the inquest that some recordings of Kye’s heart rate when he was still in the womb were not taken or written down, and that his mother, Kate Anson, could have been referred to the consultant-led maternity unit when her blood pressure dropped.

Last week, an inquest into the death of a one-day-old girl, from a group B streptococcus infection while in the trust’s care, found she could have lived had she received better medical attention. The trust accepted that Pippa Griffiths would probably have survived if staff had spotted the infection earlier.

Pippa was born at home on 26 April 2016. When her mother, Kayleigh, rang the maternity unit at 6.30pm to voice concern about Pippa’s feeding, staff reassured her. She said she called again at 2.55am the next day to report brown mucus, although midwife Claire Roberts said she did not remember the baby’s mother saying that.

Sarah Jamieson, the trust’s head of midwifery, said afterwards: “We are truly sorry that we were unable to provide the appropriate care that would have prevented Pippa’s death.”

Maternity services at the trust were strongly criticised last year in an inquiry, commissioned by NHS England, into the death of a baby girl, Kate Stanton-Davies, in 2009.

Her mother, Rhiannon, said: “Look at the failings, learn from them, move on. To not do that, they haven’t just killed my daughter, but they have disregarded the value of her life, her memory.”

The inquiry found a “lack of a safety culture” in the maternity unit at the time. It also found staff had not been held accountable for their failings related to Kate’s death, and that lessons needed to improve patient safety had not been learned.

The nine suspicious deaths include those of twins Ella and Lola Greene, who were stillborn in 2014 after staff failed to correctly read and interpret their heart rates. The trust also accepted other inquest findings that poor foetal heart monitoring was a factor in the deaths of Graham Scott Holmes-Smith in 2015 and Ivy Morris in May 2016.

Other deaths under examination include that of Oliver Smale in 2015. The coroner said his death could have been prevented if he had been born earlier by caesarean section.

The Department of Health said: “Earlier this year, the health secretary asked NHS regulators to undertake an investigation at Shrewsbury and Telford NHS trust in light of disclosures that in a number of tragic cases standards of care fell far below those that parents would expect.”

Jeremy Hunt orders investigation into baby deaths at NHS trust

Labour challenges Hunt over dropping NHS waiting times target

Labour has challenged the health secretary over the legal basis for dropping a commitment on NHS waiting times.

The shadow health secretary, Jon Ashworth, wrote to Jeremy Hunt claiming the government and NHS England were acting unlawfully by accepting that the 18-week target would be missed.

NHS England’s chief executive, Simon Stevens, said he expected waiting times to rise slightly as a “trade-off” for improvement in other areas such as hitting the four-hour A&E target and better cancer care.

Longer waits can be expected for planned operationssuch as hip and knee replacements, cataract removal, hernia operations and laparoscopies.

The NHS target is for 92% of patients to be treated within 18 weeks of referra. Ashworth said: “The absolute nature of this legal duty to meet the 92% is reflected in the NHS constitution.

“The NHS constitution isn’t just a pledge by politicians; it’s a legal guarantee about the standards of care that patients can expect to receive in the English NHS. That includes a guarantee to treatment within 18 weeks, which NHS England have now said they can no longer provide because the government has denied them the funding they need.

“Government ministers need to urgently clarify they are not breaching the NHS constitution and must outline the consequences of denying patients their legal right to treatment within 18 weeks.

“As a first step, the secretary of state must publish his department’s legal advice urgently.

“Earlier this week NHS chiefs announced – without any public consultation or changes to the law – that the NHS will no longer be required to meet the 18-week treatment target because the financial crisis has got so bad. It’s utterly unacceptable and a striking admission of how badly the Tories are running the NHS.

“Since Theresa May became prime minister standards of care for NHS patients have been in a rapid downward spiral. She might be prepared to ignore NHS staff and the public but she can’t just ignore the NHS constitution based on legislation voted upon by parliament.”

On Sky News’ Sophy Ridge on Sunday Ashworth said he thought the NHS needed up to £5bn extra funding this year, suggesting the government should scrap tax cuts in order to pay for the health service.

“We can afford the NHS if the government is prepared to put the money in and make different decisions on tax,” he said.

Asked if he was prepared to consider tax increases to fund the NHS, he said: “I am ready to have that discussion with people about how we fund the NHS.”

But he added that money was being wasted because of the “privatisation agenda” and a failure to deal with public health problems such as obesity.

Labour challenges Hunt over dropping NHS waiting times target

Child who died was let down by NHS, Jeremy Hunt tells memorial

Jeremy Hunt, the health secretary, has told the private memorial service for a one-year-old boy who died from blood poisoning that the child was let down by the NHS and the government.

Speaking at the service in Cornwall, Hunt said he had “come here to say sorry” to the family of William Mead, who died after the emergency services failed to diagnose a fatal case of septicaemia.

Hunt told those gathered at Truro Cathedral in Cornwall: “I as health secretary, the government, and the NHS, let down William.

“I’ve come here to say sorry. This weekend William should have been enjoying beautiful Cornish sunshine with his parents.

“We didn’t spot his sepsis before it was too late.”

William’s mother, Melissa Mead, has become a prominent campaigner for better diagnostics of sepsis, saying last year that the NHS system was “broken”.

She has also described her son’s final hours, his symptoms and her repeated pleas to health services in painstaking detail on her blog site.

An NHS England report revealed there were 16 mistakes associated with William Mead’s death. Photograph: PA

The health secretary became aware of the case last year and has taken a personal interest in Mead’s campaign, a Department of Health spokesman said.

The spokesman added: “He went down at the request of the family and was also down there to visit a hospital. He had obviously become quite close to Melissa and they have worked quite a lot on the campaign on sepsis.”

An NHS England report last year found there were four missed opportunities to save William’s life in December 2014. Doctors and the 111 non-emergency helpline failed to diagnose pneumonia and the common but lethal infection of sepsis, and he died within 12 hours of Melissa Mead’s last call.

The report found there were 16 mistakes contributing to his death, which included that the “tickbox” system used by call handlers failed to include “sepsis red flags”.

It added that doctors were under constant pressure not to prescribe antibiotics and that doctors working out of hours were unable to access patients’ medical records.

Melissa Mead (@amotherwithout)

RT: Official Sepsis Public Awareness Campaign Video. Do you know the #SymptomsOfSepsis Please watch & RT to help us save thousands of lives. pic.twitter.com/5jV6ePxBaO

December 14, 2016

Sepsis – which includes common symptoms of fever, increased heart rate and confusion – kills approximately 37,000 people each year in England.

Melissa Mead said on Sunday: “We invited Jeremy to William’s memorial as he’s played a pivotal part in the sepsis campaign and we couldn’t have got it off the ground without his government support.

“Jeremy agreed to come in a personal capacity and it was a very intimate event for friends and family. The relationship that we have shows how productive a constructive approach can have.

“We know William was let down, but William didn’t know blame or regret, only love, and it is with this love that we keep putting one foot in front of the other.”

Hunt has admitted letting the family down and in January 2016 Mead welcomed his apology then.

She said: “We are quite overwhelmed, to be honest. We are just a little family from Cornwall but William is going to make an impact on the world and we are very thankful for that.”

The Department of Health spokesman added that Hunt was working with Mead’s awareness campaign in conjunction with Public Health England and the UK Sepsis Trust.

Child who died was let down by NHS, Jeremy Hunt tells memorial

‘Face-down restraint must end’: an open letter to Jeremy Hunt

Dear Jeremy Hunt

New figures released by Agenda, the alliance for women and girls at risk, have highlighted the routine use of physical and face-down restraint against women and girls in mental health settings. Although government guidance is clear that physical restraint should only be used as a last resort, this research shows that in many trusts it is widespread.

Given that more than half of women who have mental health problems have experienced abuse, restraint not only risks physical harm and can be frightening and humiliating, but being restrained, particularly face-down, can also re-traumatise those with a history of violence and abuse.

Mental health units are meant to be caring, therapeutic environments, for people feeling at their most vulnerable, not places where physical force is routine. That is why we believe face-down restraint must end and other forms of restraint should only be used as a last resort.

Instead, women and girls’ particular needs and experiences, including their histories of trauma, must be taken into account by mental health services and support given to tackle the underlying issues they face.

Katharine Sacks-Jones director, Agenda

Paul Farmer CEO, Mind

Mark Winstanley chief executive, Rethink Mental Illness

Sarah Hughes chief executive, Centre for Mental Health

Kathy Roberts chief executive, Mental Health Providers Forum

Liz Felton chief executive, Together for Mental Wellbeing

Professor Joy Duxbury chair, Restraint Reduction Network

Sarah Brennan chief executive, YoungMinds

‘Face-down restraint must end’: an open letter to Jeremy Hunt

The Guardian view on Jeremy Hunt: he must practise what he preaches | Editorial

“Just how easy is it to speak about things that have gone wrong?”, asked health secretary Jeremy Hunt in a speech he made last year about improving transparency and ending the blame culture in the NHS. Mr Hunt is himself failing badly on this critical benchmark for greater openness. The Guardian this week has revealed that half a million pieces of medical correspondence, including test results and diagnoses for life-threatening conditions like cancer, sat undelivered in a warehouse between 2011 and 2016. Yet it has taken almost a year for the full extent of this failure to emerge.

Mr Hunt was first made aware of the problem in March last year. But he did not inform MPs until July last year, in a 138-word written statement that mentioned neither the scale of the problem nor the potential harm to patients. The incident was confined to a single paragraph buried in the Department of Health’s annual report. While it appears a team was set up in early summer 2016 to look into the problem, much of the undelivered correspondence did not arrive at the GP surgeries of affected patients until November and December last year. No explanation has been offered for why it has taken nine months from Mr Hunt being informed to urgent correspondence finding its way to patients and their doctors. The idea that letters containing test results and diagnoses for life-threatening conditions can go missing for years is a frightening prospect for any NHS patient. According to the government, 500 patients may have suffered serious harm as a result of the missing correspondence.

The way that Mr Hunt and his department have handled this affair seriously undermines his pitch to be an ardent advocate for patient safety. It bears all the hallmarks of a government whose primary concern is not the health of NHS patients, but sneaking out bad news in order to avoid an embarrassing story. Mr Hunt has rightly drawn lessons for the NHS from the airline industry, which radically improved its safety record by improving transparency. He has introduced grading of hospitals on the openness and honesty of their reporting cultures. But he has failed utterly to hold his own department to the standards he expects of hospitals.

It is critical that affected patients are swiftly identified and offered an apology and financial compensation. But patients who have suffered as a result of NHS mistreatment often say that what’s more important is knowing what’s happened to them will never be allowed to happen to others again. This means tough questions need to be asked within Mr Hunt’s department about what went wrong, and what needs to change. How could such a monumental failing go unnoticed by so many for so long? How could the Department of Health fail to hold the responsible private company – which it part owns – accountable for basic standards like the successful delivery of internal correspondence?

These issues will remain relevant when and if the NHS ever completes its much-delayed transition to digital patient records. Mr Hunt said he wanted the NHS to become paperless by 2018; that goal now looks a long way off. There is nothing to suggest a paperless NHS means a more competent NHS when it comes to communicating with patients and updating their records. NHS IT projects have a terrible track record: the last ill-fated attempt to create electronic patient records was abandoned after nearly £10bn had already been spent on it. The creaking IT infrastructure at many hospital trusts has resulted in several serious data failings, including at St George’s in London and the Leeds Teaching Hospitals Trust, often resulting in cancelled operations.

Communications and IT failures are far from the only risk to patient safety. The current NHS funding crisis has crippled the finances of many hospitals, leaving them with staffing levels that fall far below those recommended as safe by the inquiry into the devastating failures at Mid Staffs. Indeed, its chair, Sir Robert Francis, has warned the NHS now faces an “existential crisis” that makes another scandal on this scale inevitable.

Mr Hunt is perhaps the first health secretary to put patient safety so firmly at the heart of his rhetoric. But rhetoric cannot save patient lives. This week’s revelations of cover-up could not run more counter to his agenda to improve transparency in the NHS to reduce avoidable deaths. Mr Hunt must reflect on why – far from modelling the culture he expects from hospitals – he and his department have so badly failed to practise what he preaches.

The Guardian view on Jeremy Hunt: he must practise what he preaches | Editorial

Charity calls on Jeremy Hunt to intervene over blood cancer treatment

A charity has urged the health secretary, Jeremy Hunt, to press the NHS to fund potentially life-saving treatment for blood cancer patients who it claims have been abandoned.

The blood cancer charity Anthony Nolan said the health service should fund second stem cell transplants for people with diseases such as leukaemia who relapsed after their first transfusion of cells. About 16 people a year relapse, and the charity says a second transplant provides a cure for one in three cases.

However, NHS England has said a second transplant is too expensive and provides low clinical benefit when compared with other treatments. The decision not to fund a second round is set to be reviewed in May, and the charity wants Hunt to put pressure on NHS England to change its stance.

Anthony Nolan’s chief executive, Henny Braund, said the refusal to fund a second transplant was unacceptable. “The health secretary must take action for people with blood cancer and blood disorders by raising this issue with NHS England,” she said. “We ask that Mr Hunt meets patients and families affected and take this issue up on their behalf with decision-makers at NHS England. Families are losing loved ones because the NHS is under pressure to make savings.”

In a poll of 1,700 people carried out by Populus on behalf of the charity, 66% of respondents said patients who relapsed after their first treatment should be given a second round, and almost half said it was unacceptable for friends or family to have to foot the bill. Almost six in 10 said the government was not doing a good enough job of making sure the NHS had the money to fund the treatments people needed.

Lisa Hepburn, whose husband Gavin died last year after two attempts to get an individual request for a second stem cell treatment were rejected, said: “There’s no explanation from the NHS; nothing from the heart. I feel for people who are in the situation of having to raise the money themselves. I can’t believe the government can put a price on a person’s life – that’s what they are doing.”

Last week a group of charities wrote to Theresa May urging her to stop the NHS rationing treatment for people with serious illnesses and to find more money for care in next month’s budget.

NHS England had not responded to a request for comment at the time of publication.

Charity calls on Jeremy Hunt to intervene over blood cancer treatment

Jeremy Hunt: NHS problems completely unacceptable

Jeremy Hunt has said that performance in some parts of the NHS is “completely unacceptable”.

The health secretary said there was “no excuse” for some of the problems being seen in the health service and that some of the care being offered was not what anyone would want for their family.

His remarks, in an interview with the BBC, came after official figures for December and leaked January statistics for waiting times in England showed consecutive months of the worst delays in A&E since a four-hour target was introduced 13 years ago.

Earlier, one of his key advisers, Patrick Carter, had said that hospitals were under such extreme pressure that they were in a state of war.

On Thursday figures emerged showing that the number of A&E patients seen within the target of four hours fell to a record low of 86% in England in December, while those waiting longer than 12 hours to be admitted to a hospital bed doubled to more than 2,500 in 2016. The leaked January figures suggested a worse performance on A&E waiting times, with NHS England meeting its four hour target in 82% of cases.

The number of people waiting more than two months to start cancer treatment after an urgent referral was at a record high of 25,157 in 2016, and the proportion of patients receiving hospital treatment within 18 weeks fell below 90% for the first time since 2011.

Hunt said there was already a “big transformation programme” under way in the NHS with the aim of treating more people at home or in the community to ease burdens on hospitals.

But he said the changes would take time and said progress had been “disappointingly slow” in some areas.

“It is incredibly frustrating for me,” said the health secretary. “I am doing this job because I want NHS care to be the safest and best in the world. That kind of care is completely unacceptable. No one would want it for members of their own family.”

He said there were no excuses for cases such as that of 89-year-old Iris Sibley, who was stuck on a hospital ward at Bristol Royal Infirmary for more than six months because a nursing home place could not be found for her.

“It is terrible for Mrs Sibley but it is also very bad for the NHS,” Hunt said.
He insisted the government was addressing problems in the social care system which are preventing many elderly and frail patients from being discharged from hospital – so-called “bed-blocking”.

Hunt added: “The prime minister has been very clear: we recognise the pressure’s there. We recognise there is a problem about the sustainability of the social care system. That has to be addressed and we are going to do that.”

Barrister Sir Robert Francis, whose 2013 report uncovered poor care in Mid Staffordshire, said the NHS was facing an “existential crisis” which made a further similar scandal inevitable.

Francis, a non-executive director at the Care Quality Commission, told the Health Service Journal there was an “increasing disconnect” between what is said nationally about the NHS and “what people on the ground feel or see is going on”.

“Let’s make no bones about it, the NHS is facing an existential crisis,” he said. “The service is running faster and faster to try and keep up and is failing, manifestly failing.

“The danger is that we reach a tipping point; we haven’t reached it yet, but there will come a point where public confidence in the service dissipates.”

Jeremy Hunt: NHS problems completely unacceptable

Jeremy Hunt accused of compromising weekday hospital care

The health secretary, Jeremy Hunt, has been accused of compromising the care patients receive during the week by not taking forward his pledge to hire more junior doctors to help deliver a seven-day NHS.

The Liberal Democrats’ health spokesman, Norman Lamb, said that with juniors now having to work more at weekends, already under-staffed hospitals had fewer medics on duty on weekdays.

He said Hunt had done little to make good on the hiring pledge he made in parliament during the year-long dispute over junior doctors’ contracts.

“My fear is that unless you can guarantee that there will be more junior doctors employed, imposing a change which involves more hours being worked at weekends will inevitably reduce the numbers of hours worked during weekdays when the pressure is at its greatest,” Lamb said. “This could result in real safety concerns.”

In a letter to Lamb, Hunt failed to provide any detail of how many more junior medics would be trained and employed this year or any other year before the end of this parliament in 2020.

He has previously acknowledged the potential for too few doctors being on duty between Monday and Friday as a result of the new contract he imposed in October on all 54,000 junior doctors working in the NHS in England.

Hunt told Lamb that it was up to hospital trusts to expand their junior doctor workforce, raising doubt that his previous assurance would be acted on.

Nor did the letter provide any detail on how many extra trainee medics would join the NHS this year, despite Hunt having told Lamb in the House of Commons on 5 September that he would give him a number.

“This letter from Jeremy Hunt fails to reassure me,” Lamb said. “There appears to be no clear plan as to when more junior doctors will be employed and yet the changes are being imposed immediately.

“There seems to have been no assessment of the number of additional junior doctors needed to ensure that additional weekend hours won’t have a dangerous effect on weekday cover. Jeremy Hunt has failed to provide the evidence to back up his claim that the problem will be addressed by additional junior doctors.”

When Lamb first raised the prospect of shortfalls in weekday medical rotas affecting care standards in a Commons debate on the dispute on 19 May last year, Hunt told him: “The short answer is that we need to increase the NHS workforce.”

Hunt’s letter, however, simply restated the government’s longstanding pledge that there would be 11,500 more doctors by 2020 than there were in 2015.

Dr Nadia Masood, a member of the Justice For Health campaign group and the British Medical Association’s junior doctors committee, said she shared Lamb’s concerns about weekday care.

“Weekday care is already suffering. The NHS is struggling every day of the week. So yes, if we are going to remove more doctors from weekday shifts to staff the weekends, weekday care will deteriorate. We need more doctors every day of the week, not just weekends,” she said.

Masood said she had never believed Hunt’s pledge to recruit more junior doctors, “because he and the government have repeatedly shown themselves to be deceitful with NHS-related issues to further their own political agenda, for example [their claims about] £10bn extra funding to the NHS.”

She said ministers and Health Education England, the medical training and education agency, “have no idea how many doctors we actually need. They are making it up as they go along, which is a staggeringly incompetent way to handle something as valuable as our National Health Service”.

In his letter to Lamb, Hunt said: “Health Education England does not expect significant change in the overall numbers of training posts and trainees, but it cannot say how many there will be at any point in time.

“The number of non-consultant non-training medical staff employed is for providers [NHS trusts] to determine based on the workforce required to deliver services … It is therefore difficult to provide the expected total number of junior doctors by grade.”

The Department of Health said: “The new junior doctors contract is making it easier for hospitals to roster doctors at weekends as well as improving patient safety right across the week. Working with Health Education England, we will ensure that the NHS has a further 11,000 doctors by 2020 – as well as increasing the number of medical training places by 1,500 in a year’s time.”

Jeremy Hunt accused of compromising weekday hospital care

Jeremy Hunt says calls for more NHS money are a "misjudgment"

Jeremy Hunt has said calls for more money for the NHS are a “misjudgment” less than a year after the health service received a “good settlement” from the government.

The health secretary was reacting to comments from Chris Hopson, the head of NHS Providers, the body that represents hospitals across England, who said on Tuesday that NHS trusts “simply cannot deliver all that they are being asked to deliver on the funding available”.

There have been repeated calls for more money, with charities, thinktanks and royal colleges all saying the NHS requires extra funding.

The chancellor, Philip Hammond, offered no extra cash for the NHS or social care in his autumn statement. He repeated the government’s claim that the NHS will receive an extra £10bn in funding to 2020-21 – a figure that has been challenged by MPs on the Commons health committee and health experts.

MPs have said the government is misleading the public over the “incorrect” figure, saying it is only being achieved through reductions in other areas of health spending outside of NHS England’s budget, such as public health and investment in training.

They said the real increase was £4.5bn while the King’s Fund thinktank has put the figure at £4.2bn.

According to the Health Service Journal (HSJ), Hunt, who is attending the NHS Providers conference in Birmingham, said of Hopson’s speech: “I read Chris’s speech, and I thought it was a very thoughtful speech, and indeed I think he’s a very thoughtful person when it comes to the challenges facing the NHS.

“But I did think it was a misjudgment for NHS Providers, less than a year after they had a settlement for the NHS which they themselves described as a good settlement, to say that there isn’t enough money.

“And the reason is that when we’re negotiating with the Treasury for extra support for the NHS, if less than a year ago you’ve got the biggest settlement that any government department got, in a period when most government departments have seen their budget cut, and less than 12 months later you’re saying, ‘there isn’t enough money, please sir can I have some more’, then you devalue the currency.

“What you do is you risk the NHS not being at the table in these discussions going forward because people will say, ‘whatever we do it’s not enough’.”

Jeremy Hunt says calls for more NHS money are a "misjudgment"

Former NHS director sues Jeremy Hunt for religious discrimination

A former director of an NHS trust is suing Jeremy Hunt for religious discrimination after he was effectively barred from applying for positions following his public opposition to gay adoption.

Richard Page has lodged a claim at the employment tribunal, saying his televised comments in 2015 that it was in the best interests of a child to have a mother and father stemmed from his Christian faith.

His remarks led to him being sacked as a magistrate in March for serious misconduct, after 15 years on the bench. Two years earlier, the lord chancellor and lord chief justice reprimanded Page after finding his religious beliefs, rather than evidence, had influenced his decisions during a family court hearing.

Page, 70, was also a non-executive director at the Kent and Medway NHS and social care partnership trust. In March, following a complaint by the trust’s LGBT staff network, Page was suspended for the final three months of his four-year term in office.

In August, the NHS Termination of Appointments Panel told Page “it was not in the interests of the health service for you to serve as a non-executive director in the NHS”, in effect barring him from applying for directorships in the future.

Page, a former NHS manager from Headcorn, Kent, is bringing a claim against the health secretary and NHS Improvement, which has the power to appoint non-executive directors. He is pursuing a similar case against the lord chancellor over his sacking as a magistrate.

In a TV debate on Christians in public life in March 2015, Page said: “My responsibility as a magistrate, as I saw it, was to do what I considered best for the child, and my feeling was therefore that it would be better if it was a man and woman who were the adopted parents.”

In a video on the website of Christian Concern, which is backing his case, Page denied he was homophobic and claimed that more than 6,500 emails had been sent to the Kent NHS trust in his support against one complaint “from the LGBT people”.

He said: “This is the second public sector organisation that has got rid of me. This, I feel, is completely wrong because it’s discriminatory against my opinions and the fact I was doing what I considered to be right.

“The political correctness makes people be frightened, or makes them think they’re the only ones that believe this way, and yet they obviously are the majority … There are people standing up against the so-called politically correct views.”

Andrea Minichiello Williams, of Christian Concern, said freedoms in the UK were being “catastrophically eroded by political correctness and fear”.

“The comment that a child needs a mother and a father is a belief held by Christians, and many others around the world. Everything that Richard Page does, his whole belief system is rooted in his Christian faith. Beliefs arising from the Christian faith continue to be lawful beliefs in our country.”

She said government assurances that equality legislation would not lead to the removal of people who expressed Christian views while holding public positions had turned out to be baseless.

“If it is possible to suffer the detriment of losing your position at work for expressing lawful Christian views, the situation is crucial. There is, in effect, a religious bar to office for Christians solely; those politically correct institutions would not do the same to other faiths.”

A spokesperson for NHS Improvement said: “We are unable to comment on ongoing court cases.”

Former NHS director sues Jeremy Hunt for religious discrimination

Sick pay and work assessments to be reviewed, Jeremy Hunt reveals

The system of sick pay and GP “fit notes” is to be reviewed by the government, as Jeremy Hunt, the health secretary, highlighted the growing cost of long-term sickness to the NHS and suggested getting people back to work had major benefits for health.

The review will be announced in a draft consultation document published by the Department for Work and Pensions (DWP) on Monday, which will also examine changes to the controversial work capability assessments (WCA) undergone by disabled people in order to obtain welfare.

Ministers released little detail about how sick pay and fit notes, previously known as sick notes, would be changed, but said they wanted to “support workers back into their jobs faster and for longer”. It could involve a greater move towards people having a phased return to work after they are signed off sick and more contact between employers and sick employees.

Hunt said there was a £7bn cost to the NHS of treating long-term health conditions that keep people out of work, and suggested that employment could be a part of recovery. “This green paper launches a wide-ranging debate about recognising the value of work as a health outcome,” he said. “With all the evidence showing that work is a major driver of health, this is a big opportunity: to make sure that people get the support they need, improve their health, and benefit the NHS all at the same time. I hope that health professionals will contribute their expertise so that we can ensure the best possible outcomes.”

Hunt was backed by Duncan Selbie, the chief executive of Public Health England, who said health, wellbeing and happiness were “inextricably linked to work”. Selbie said: “People in work generally have better health, so it makes perfect sense for the government to do all it can to support employers to close the gap around employment, disability and illness and to enable people to work when they can.”

The consultation document is aimed at helping to get disabled people and those with long-term conditions back into work, with a specific focus on mental health and musculoskeletal conditions such as arthritis.

Damian Green, the work and pensions secretary, appears to be unwinding some of the policies of his predecessor, Iain Duncan Smith, by reconsidering the work capability assessment. He announced at the Conservative party conference that people with severe, long-term health conditions would no longer have to be reassessed for their benefits under the WCA.

The new review will consult on scrapping the process that puts disabled people into two groups of being unable to work or capable of some work.

“When things need improving, like the work capability assessment and fit notes, we mustn’t shy away from big decisions,” he said. “We must be bold in our ambition to help disabled people and those with health conditions. This green paper marks start of our action to confront the attitudes, prejudices and misunderstandings that, after many years, have become ingrained within the welfare state, within the minds of employers and across wider society.”

However, Debbie Abrahams, the shadow work and pensions secretary, said the review of the disability benefit assessment process did not go far enough. “For Damian Green to claim that this Tory government is confronting the negative ‘attitudes and prejudices’ that it has spent six years encouraging is ridiculous,” she said. “It is an insult to the hundreds of thousands of disabled people who have been on the receiving end of their callous social security regime, like my constituent who was sanctioned after having a heart attack during his jobcentre appointment.

“I have announced that Labour will scrap the work capability assessment and the Tories’ punitive sanctions; anything less is tinkering at the edges.”

Sick pay and work assessments to be reviewed, Jeremy Hunt reveals

Jeremy Hunt promises better mental health services for children and adolescents

Jeremy Hunt has promised to tackle the “big problems” and failings in NHS services for children and young people with mental health problems which he says are causing “too many tragedies”.

The health secretary singled out children and adolescent mental health services (Camhs) as “the biggest single area of weakness in NHS provision at the moment” in an interview with the Health Service Journal.

Hunt pledged to make support and treatment for young people a priority in an interview in which he said he wanted to continue in his role for another two or three years so he can oversee permanent improvements to the NHS.

He said that too many young people and families are being let down by the NHS because of problems in the availability of services, which meant that problems were being left untreated, sometimes for years.

Schools should work more closely with NHS Camhs teams and more schools should have counsellors on their premises to try to ensure more young people got help faster, he said.

“I think we are letting down too many families and not intervening early enough when there is a curable mental health condition, which we can do something about when a child is eight or nine but if you leave it until they are 15 or 16 it’s too late.

“There are big problems with the capacity in Camhs services but it’s not just there, but [also] what happens in schools. Very few schools have a full-time Camhs worker,” Hunt told the HSJ.

“I think this is possibly the biggest single area of weakness in NHS provision at the moment. There are too many tragedies because children develop eating disorders or psychosis or chronic depression, which is then very difficult to put right as they get older,” he added.

The Guardian revealed this month that almost a quarter of a million children and young people aged 18 and below are being treated for mental health problems by the NHS in England every month, but that that was a significant underestimate of the true scale of the problem as only 60% of the 63 NHS mental health trusts supplied data to NHS Digital, which collated the figures.

Jeremy Hunt promises better mental health services for children and adolescents

Jeremy Hunt can’t fix the NHS. No one now believes a word he says | Polly Toynbee

Expect trouble. On Tuesday, health secretary Jeremy Hunt and NHS England head Simon Stevens appear before the Commons health committee. Sarah Wollaston, GP and chair, has already said she wants no one quoting the mythical “£10bn extra” the government pretends the NHS has received, yet Hunt brazenly used it again on the Today programme.

Thankfully, Stevens is unlikely to indulge in the same delusional fantasies about the state of his service. He already warned the public accounts committee in September of this “incredibly financially challenging period”, and “incredible” is the word he should cleave to. As every trust is forced to produce a financial plan that balances on paper, most – in private – admit these are fairy-tales; Chris Hopson of NHS Providers makes plain these pigs won’t fly. Hunt relies on threats and micro-managing. Just yesterday he put another three debt-ridden trusts into “special measures” to warn others their heads will be on Whitehall spikes. But there’s safety in numbers: he can’t sack them all.

Theresa May has said there is no more money: the NHS must save £22bn by 2020, despite three quarters of trusts being up to their ears in debt and missing waiting targets by miles. If she could cut police costs by 20%, why can’t the NHS, she asks. Because crime has dropped like a stone over recent decades while NHS need heads skywards, with growing numbers of the old, and collapsing social care. She risks a brutal brush with NHS reality before long.

But that’s not all. By Friday all 44 areas have to produce a sustainability and transformation plan (STP), unleashing vehement local protest against any mergers or closures.

After Lansley’s catastrophic 2012 act blew the NHS into myriad competing fragments, this re-reorganisation was meant to repair the damage and glue the fractured parts together again – a good idea. Stevens devised STPs to bind each area into a single unit, combining GPs, mental health and hospital services in one budget as a coherent whole. That might mean amalgamating maternity or A&E departments, rationalising stroke or cardiac care. Good idea, in theory.

Junior doctors protest in London during April. Photograph: Joe Pepler/Rex/Shutterstock

But these plans collide with the £22bn “savings”, so how will local people trust the good intentions of these plans? NHS England has rightly taken fright: the Health Service Journal reveals there have been orders requiring each area to send every STP announcement to the headquarters communications team to make sure they “articulate tangible benefits for patients” in language that is “clear and compelling”. But it may take more than “compelling” language to assuage local fears.

Few of these plans have yet been agreed, allowing rumours and fears to fester – and when they do emerge, the government can expect no backing, not even from their own MPs and councillors. Expect every politician, irrespective of party, to dash to join the local “Save Our Hospital” demo. Any who pause to suggest some plans might be good for patients will be mown down in the stampede. Bandwagon campaigners will join every protest, regardless.

A cluster of hospital protesters went to Downing Street and the Commons last week, with petitions about closures from Barnstaple, Dewsbury, Chorley, Huddersfield, Grantham and St Helier. Each has their own circumstance, so it’s well-nigh impossible for local people to know which units should be “saved” and which rightly closed.

Among them were protesters about the Horton hospital in Banbury. At last week’s prime minister’s questions, the Tory MP for North Oxfordshire, Victoria Prentis, asked an impassioned question: “Does the prime minister share my sadness that the majority of Banbury’s babies cannot be delivered, as I was, at the Horton general hospital? Will she join with me to put pressure on the trust to reopen the unit?” The PM replied: “Every effort is being made …”

Horton swears they’ve moved heaven and earth to hire doctors but none would come: there’s a 24% vacancy rate

The Horton maternity unit closed abruptly this month after failing to hire middle-grade doctors, leaving a midwife-led unit. Part of the Oxford University Hospitals, its HR director swears they have moved heaven and earth to hire doctors but none would come: there’s a 24% vacancy rate in the district. The Horton obstetric unit lost its validation for training doctors as too few babies were being born there to qualify, so junior doctors won’t apply. They are still advertising, promising to reopen if they can recruit. Managers spell out the situation in painstaking detail, answering every possible query. But all this is to no avail.

A vociferous local Keep the Horton General campaign gathered 5,000 people to hold hands round the hospital, amid longstanding suspicions that it might be axed despite a plan to rebuild it. Every party supports the protest, with their Tory MP as militant as the rest. She says she doesn’t trust the management: “They make decisions about us without us.” She and the campaigners mistrust whatever they are told.

The Banbury Guardian relishes the story, as the local press always does. “It’s lovely how the community has come together,” Prentis says. Banbury businesses are offering any obstetric doctor recruited free shirts, free beer, cheap accommodation and discounted fees at a local private school. A packed meeting roasted NHS managers about the journey time for mothers in labour to travel to the John Radcliffe in Oxford. Nothing creates such feelgood community cohesion as a local NHS threat.

Talking to both sides, I am inclined to believe the managers’ good faith. But with deeper cuts scheduled for the years to 2020, can anyone know for certain where they might fall? At the Witney byelection, the Horton and other Oxfordshire NHS closures feature prominently. How Tory MPs get away with it beats me: they voted for these NHS cuts.

Watch this pattern repeated around the country as STP plans unfold. “Clear and compelling” language may not be enough when the NHS professionals, even the doctors, struggle to be believed. In the fog of war, with suspicions rife, local people have no way of detecting the good plans from dangerous cuts. As Stevens warned MPs: “Let’s be clear, there are going to be significant challenges, there will be choices, there will be controversies.”

The tragedy is that STPs were a progressive way to reunite NHS community, hospital, GP and social care services. But with no capital for rebuilding and even less for day-to-day spending, they risk wreckage. The cuts dig deep. How long before Simon Stevens decides to walk away?

Jeremy Hunt can’t fix the NHS. No one now believes a word he says | Polly Toynbee

Plan to end NHS reliance on foreign medics could backfire, Hunt told

Leading doctors are warning Jeremy Hunt that his plan to make the NHS “self-sufficient” with homegrown medics will not work and poses “a major risk” to the health service.

In a letter to the Guardian, the presidents of two of the profession’s medical royal colleges tell the health secretary that his move has demoralised overseas doctors already working in the NHS and could deprive it of the long-established supply of foreign medics upon whom it depends.

The intervention by Professor Jane Dacre, president of the Royal College of Physicians (RCP), and Clare Marx, her counterpart at the Royal College of Surgeons (RCS), is a direct challenge to Hunt, who unveiled his new approach to tackling the NHS’s lack of doctors at last week’s Conservative party conference.

The NHS in England would have all the home-trained doctors it needed by 2025 and end its reliance on medics who come from scores of other countries, he pledged.

“While the recent announcement by the secretary of state of 1,500 extra medical school places is welcome, as over a quarter of current NHS doctors are from overseas, the extra places will not in themselves produce a self-sufficient UK medical workforce and we will still need our overseas doctors,” Dacre and Marx state in their letter.

“The announcement has led to our colleagues from overseas feeling that they may not be as valued as UK doctors and is affecting morale. We cannot let this happen.”

They also warn Hunt that his plan could backfire because medicine is now “an international profession” characterised by “free movement of doctors around the world”.

Highlighting the important role overseas doctors perform in the NHS they add: “This model has served the UK and the NHS well for decades. Moving away from that model is a major risk to the success of the NHS.”

The RCP represents about 20,000 hospital doctors across the UK, both consultants and trainees, while the RCS represents 13,178 surgeons in UK-wide hospitals.

Hunt won widespread acclaim for his plan. However, while applauding his determination to tackle chronic understaffing in the NHS, medical organisations pointed out that the extra 1,500 newly qualified doctors a year it is intended to produce will not be ready to start treating patients for a decade or more, and even then are unlikely to prove enough on their own to meet the rising demand for healthcare driven by the ageing and growing population and rise of lifestyle diseases.

Dr Mahiben Maruthappu, the chairman of the UK Medical Students’ Association, has also voiced concern about Hunt’s plan. Contradicting the health secretary’s claim that many would-be doctors are being denied places at university, he said: “Some medical schools are actually struggling to fill their places, meaning that these ambitions may also not be practical. I also believe that creating a health service that is 100% self-sufficient, one that only trains homegrown doctors and one that doesn’t take people from overseas and vice versa, is bad for medicine and bad for patient care.”

Dr Mark Porter, chairman of the British Medical Association, endorsed Dacre and Marx’s views. “If the government’s plan is to train more UK doctors and stop recruiting from abroad, it will not address the staff shortages in any way. There simply won’t be enough doctors for the number of patients walking through our hospital and GP surgery doors.

“The reality is that training this number of extra doctors will not make the NHS self-sufficient by 2025. But the question should be whether we want or need it to be. The government should not underestimate the vital skills and expertise that overseas doctors bring,” he added.

Plan to end NHS reliance on foreign medics could backfire, Hunt told

Jeremy Hunt promises to end NHS reliance on overseas doctors after Brexit

Jeremy Hunt is to pledge that the NHS in England will be “self sufficient” regarding doctor numbers after Britain leaves the European Union, as he sets out a package of measures aimed at reducing its reliance on foreign-trained medics.

The health secretary will use his speech to the Conservative party conference on Tuesday to promise that medical schools in the UK will be allowed to offer up to 1,500 extra training places every year, and released figures that said that one in four NHS doctors have been trained abroad.

Hunt will stress that foreign-trained doctors do a “fantastic job”, and say that “we want EU nationals who are already here to be able to stay post-Brexit” – but he will also ask: “Is it right to import doctors from poorer countries that need them while turning away bright home graduates desperate to study medicine?”

He wants NHS England to reach the target in 2025. “Of course it will take a number of years before those doctors qualify, but by the end of the next parliament we will make the NHS self- sufficient in doctors,” Hunt is to add.

Remain campaigners warned in the run-up to the referendum that the NHS, which relies heavily on foreign staff, would be hit if EU workers could no longer travel freely to work in the UK. Data from the General Medical Council records that 30,472 doctors come from the EU and other countries in the European Economic Area, while 71,139 were trained elsewhere in the world outside the UK.

Hunt hopes that by boosting the number of places now, he will have a pipeline of British-trained doctors ready in time. There is rapidly accumulating evidence that doctor shortages are causing serious problems, including the part-closure of A&E units at hospitals in Chorley, Lancashire and Grantham in Lincolnshire.

The move represents a partial U-turn by Hunt, as until now he has repeatedly responded to evidence of understaffing by pointing out that the NHS in England has more doctors now than when the coalition took office in 2010. Currently half of those people applying for medical school are rejected, because of the limits on the number of places.

A Royal College of Physicians report last month, which said the NHS was understaffed and overstretched, irritated health secretary Jeremy Hunt. Photograph: Carl Court/Getty Images

Before individual medical schools are allowed to lift the cap on training places, they will have to show the government they are taking steps to attract students from deprived economic backgrounds.

Trainee doctors will have to work in the NHS for four years before they can accept overseas postings in an attempt to avoid a rapid exodus of people trained in the UK. Many young doctors head to Australia and elsewhere overseas, and increasing numbers say they want to go abroad as the protracted junior doctors dispute has dragged on.

Medical organisations welcomed what the British Medical Association said was Hunt’s belated recognition that the NHS is under-doctored, especially in specialities such as A&E, paediatrics, anaesthesia and psychiatry. But they warned that the health service would not benefit from the extra medics for another decade and that others were were needed to tackle doctor shortages.

“While it is welcome that he has finally admitted the government has failed to train enough doctors to meet rising demand, this announcement falls far short of what is needed”, said Dr Mark Porter, the BMA’s chair. “We desperately need more doctors, particularly with the government plans for further seven-day services, but it will take a decade for extra places at medical school to produce more doctors. This initiative will not stop the NHS from needing to recruit overseas staff.”

The Department of Health is expected to publish a consultation paper on the details of the plans later in the autumn.

Hunt was irritated last month when a report from the Royal College of Physicians, which represents hospital doctors, said that the NHS was “underfunded, under-doctored [and] overstretched.”

Welcoming Hunt’s plan, RCP president Prof Jane Dacre said: “The RCP has long argued that rota gaps and staff shortages are the greatest threat to patient safety and have significantly contributed to low morale among junior doctors. The NHS needs more doctors, and this dramatic increase in medical school places will help relieve many of the pressures faced by the NHS in the long-term, and support a more sustainable workforce.”

Dr Simon Clark, workforce officer for the Royal College of Paediatrics and Child Health, cautioned that “with 30% of doctors deciding to take a break from medicine in the UK for a period of time before they take up speciality training, government must address the retention, attrition and career hiatus that occurs.” Ministers would need to ensure that the extra doctors would be deployed in the areas of England which are facing the greatest shortages, he added.

Labour’s shadow health secretary, Diane Abbott, said: “It appears that Hunt has taken a chapter from the Hard Brexiter’s Myth book. The idea that we can be self-sufficient in medical staff is nonsense.”

“The true picture is that the NHS has never been in a more perilous state and the Tories are cutting the health budget by £22bn.

“The reality is that Hunt has lost the trust of the medical profession and is the least popular health minister in recent history. Morale among NHS staff is at rock bottom and Hunt has shown once again just how little regard he has for the hard-working people that keep our health service running.”

The first of the extra places, which could eventually increase the number of trainee doctors by up to a quarter, will start to become available from 2018-19.

The Department of Health, which subsidises medical students by funding their clinical placements in hospitals, will pay for the expansion from its existing budget.

It plans to offset part of the cost – expected to be £100m in total by 2021 – by forcing foreign medical students to pay for their own clinical placements.

That will increase fees for medical school for students from overseas – but Department for Health sources pointed out that the current £9,000 a year is far lower than the fees for other prestigious international medical schools.

Jeremy Hunt promises to end NHS reliance on overseas doctors after Brexit

Jeremy Hunt acted illegally over junior doctors, court hears

Jeremy Hunt acted illegally and beyond his powers by deciding to impose a new contract on NHS junior doctors, the high court has been told in a legal challenge to the health secretary’s handling of the year-long dispute.

The court on Monday began a two-day judicial review of the legal challenge to Hunt brought by five junior doctors.

Their group, Justice for Health, claims that the health secretary has acted ultra vires (beyond his powers)by choosing to force new terms and conditions on 54,000 trainee medics in England despite their overwhelming opposition.

A barrister leading Hunt’s legal team told the judge, Mr Justice Green, that there was no evidence that NHS employers did not want the contract and that the claim was “wholly without substance”.

Hunt suffered an early setback when the judge rejected a claim by his counsel, Clive Sheldon QC, in pre-hearing legal argument that Justice for Health’s claims should be thrown out. Refusing Sheldon’s plea, Green said at the outset of the first session of legal argument that “this is plainly a serious case” which, in his view, “requires full judicial review”.

Green planned to issue his judgment on 28 September, he said, days before junior doctors across England are due to take part in the first five-day strike in the long-running dispute. The strike is planned to start on 5 October, the day the contract is due to be imposed on all trainee doctors below consultant level. The six previous walkouts held since January have lasted one or two days.

Justice for Health, whose action has received £300,000 in crowdfunding from 10,000 supporters, wants the court to overturn Hunt’s decision to use what he called his “nuclear option” of imposition, and rule that he broke the law in choosing to push it through.

Its legal argument states that the campaign group, consisting of Dr Nadia Masood, Dr Ben White, Dr Francesca Silman, Dr Amar Mashru and Dr Marie-Estella McVeigh, “seeks an order quashing the decision of the secretary of state; [and] declarations that the secretary of state had no power to make the decision which he purported to make on 6th July 2016, that the purported imposition was unlawful and that the secretary of state has acted unlawfully”.

Jenni Richards QC, for Justice for Health, said that while Hunt was entitled to recommend a contract, he did not have the power to impose one. The health secretary had “acted in breach” of his “requirements of transparency, certainty and clarity” and behaved “irrationally”, she told the court.

The junior doctors claim that, despite stating publicly when the dispute began last year that he was imposing the contract, Hunt had then switched tack and insisted he had merely made a non-binding recommendation that revised conditions of employment.

Richards also claimed that Hunt had ignored a series of studies of mortality rates among patients admitted to hospital when he began claiming in July 2015 that as many as 11,000 patients a year admitted on a Saturday or Sunday die unnecessarily because too few doctors are on duty – the “weekend effect”.

Giving evidence for Hunt, Sheldon said the secretary of state had decided not to “compel” NHS employers to use the new contract, but to “approve” it. “This case is redundant,” Sheldon told the judge. “There is no evidence at all that there is any NHS employer who doesn’t wish to introduce these new contracts.”

Jeremy Hunt acted illegally over junior doctors, court hears