Sir Chris Ham

the NHS has been in decline since 2010 because successive govts have failed to heed the warning signs of deteriorating performance #comments-top" target="_blank" rel="nofollow noopener">kingsfund.org.uk/publications/r…

The electoral valley of death

Totally surreal situation now: 1) Wes Streeting was preparing to launch today but may now delay because he is said to be struggling to get the numbers. His people deny this - they say he has the numbers - but say that things have changed and more cabinet ministers are going over the top and pressing for Starmer to go. But... 2) Keir Starmer insists he is going nowhere. The number calling for him to go remains at 92 - where it's been for the last 24 hours - equivalent to nearly a third of backbenchers. His allies say that good news on economy and NHS makes his case for him. He is going fo fight on 3) Enter Angela Rayner. The former Deputy PM says she has been cleared by HMRC and doesn't rule out a challenge is Streeting succeeds in triggering a contest 3) None of this is remotely sustainable. How can you have a senior Cabinet minister publicly positioning himself for a run at Number 10? How can you have a third of backbenchers publicly calling for the PM to go. 4) Someone - either Streeting or Starmer - will have to give. Otherwise the government is going to be paralysed for the forseeable future, with Starmer in office but fighting for his life and Streeting ready to go but refraining from firing the starting gun.

Who else leaves @DHSCgovuk and who takes their place? Big changing of the guard at crucial time

Starmer's authority is now crumbling. But even those most committed to a new Prime Minister should pause for thought about what it means for Britain in the world. For all his many, many domestic missteps, Keir Starmer has genuinely led on Ukraine, make tough calls with Trump and rebuilt relations with Europe by working intensely with President Macron and Chancellor Merz. Labour in government was shocked at how quickly it was swamped by foreign affairs from Gaza and Ukraine, to Trump and Iran. This isn't going to change. However Starmer's challengers have no foreign policy experience, no geopolitical worldviews, no foreign affairs teams and no experience in explaining our place in the world and its tumult to the public. But if they succeed that will be half their job. What's the plan for a geopolitical pivot to Europe? What's the strategy to deal with Trump and our fragmenting Western alliance as China's Axis of Authoritarians deepens? What's next for Britain's extensive diplomatic and security role when it comes to Ukraine? Who will be maintaining key connections to the White House? Changes at the top are often necessary. But they are delicate and not cost free internationally. In diplomacy so much is bound up in personal connections and trust built up over time. Building since 2016, these musical chairs at the top have now become so intense, with Prime Ministers lasting roughly two years and Foreign Secretaries now annuals, our allies and partners are frustrated. I've heard from European and Gulf leaderships first hand it is hardly worth investing diplomatically in a counterpart who's suddenly gone and thus hardly worth investing in Britain.

There is an escape route for Labour from certain disaster at the general election: use their Commons majority to ram through PR. It’s cynical, + they’d never govern alone again, but it locks Reform out of No10. The left (Lab, Gr, LD) still have a majority over the right in the UK

must read on the politics of public health reform Inside Number 10: The Politics Behind The Smoking Ban | The King's Fund kingsfund.org.uk/insight-and-an…

must read on the politics of public health reform Inside Number 10: The Politics Behind The Smoking Ban | The King's Fund

"Escribir es pensar". Escribir nos obliga a pensar, no de forma caótica y desordenada, sino de manera estructurada e intencionada. Artículo de Nature que señala que es una herramienta para descubrir nuevas ideas nature.com/articles/s4422…

@wesstreeting your most important legacy may well be Tobacco and Vapes Bill. Shout it from rooftops! @pollytoynbee @natashaloder @RSylvester1

@jburnmurdoch @John_Stepek Where do persistent inequalities in health fit into this assessment? Is reducing inequalities the best route to improving popn health following work of @MichaelMarmot and others?

@John_Stepek Yep, it’s ~entirely this, and healthy life expectancy (always a somewhat dubious blend of two very conceptually and methodologically different measures) looks increasingly unfit for purpose in a world where people answer health questions about mental not physical health.

I have qualms on the "healthy life expectancy" story. Looking at the underlying data, it's driven by a deterioration in under-55s - older people actually reported a modest improvement in health. So a good bit of this appears to be downstream of the decline in youth mental health

@NickCohen4 @adwooldridge It’s been the story for several years but few people have paid attention - go back to Wanless in 2002 and various reports from @MichaelMarmot on inequalities. Requires cross govt action and long term vision and commitment to tackle. In short supply…

We are becoming sicker earlier and dying younger. The collapse of public health in the UK ought to be the lead story this morning theguardian.com/society/2026/a…

@parthaskar @HealthFdn @KamranAbbasi @DrLKVaughan @DrAsifQasim @DrSelvarajah @DrSteveTaylor @doctor_katie @ShivaniM_KC @DrAmirKhanGP @iDrSunny @doctor_oxford These reports are reminding us of the time and not taking us far in making improvements

Hot on the heels of the below? Now comes the report from @HealthFdn "The global comparison, based on World Health Organization data, compared the UK to other nations in western Europe, the Nordics, North America and Oceania. It is now ranked 20th out of 21 with only the US seeing its population live for fewer years in good health" The basic tenets of a healthcare system is to reduce mortality where possible, improve quality of life And this is where the UK is at. Worth many holding relevant roles to reflect on that one. For absolute shame who push policy- and don't have the humility to reverse when they see results harming the population you serve.

@kchalkidou @JeremyFarrar This is not inevitable. The national health inequalities strategy in England in the 2000s brought measurable reduction in inequalities. Requires cross govt action and long term commitment based on political leadership

Deep inequalities in healthy life expectancy between affluent and deprived areas have widened. The gap between the most and least deprived deciles in England is now 19.4 years for males and 20.3 years for females. health.org.uk/reports-and-an… HT @JeremyFarrar

Expecting Tobacco and Vapes Bill to receive Royal Assent. Big day for public health when it happens @wesstreeting

Good work w @NHSEngland & @DHSCgovuk re: referral processes This isn’t a ‘win’ it’s what it should always have been Next: the need for a safety framework when we face exceptional demand Secure that & we start on the new contract Alternative? GP Collective Action from May 1st

🚨Brian Barry-Murphy in the immediate aftermath of promotion: “It’s been an incredible day. "To see our supporters, the extraordinary scenes towards the end of the game… the swell of support we have is incredible for this club." Relief 💙 walesonline.co.uk/sport/football…

@JoeHMK very good to hear your important work on food in hospitals showcased today on R4 Food programme today. If only the rest of the NHS could do this

Their choice meant they could say ‘For all age groups, the potential benefits outweighed the potential harms’, but this was not true in early April. The appropriate graphic clearly shows why under-30s were offered alternative vaccines.

Delighted to see the Covid Inquiry used one of our Winton Centre graphics in their vaccine report (p 215). But they chose the 'medium' exposure (February), rather than the more relevant 'low' exposure (March). I think this is misleading.

@doctor_katie @parthaskar @DrSteveTaylor @AbbieSBrooks @GoggleDocs @DrSelvarajah @ShivaniM_KC @WilmotEmma @drpratikc @DrAmirKhanGP @doctor_oxford This quote from DHSS policy document 1975: ‘By and large the non-hospital community resources are still minimal’ - has aged well. A community investment standard covering staff and funding is needed to tip the scales over several years

@profchrisham @parthaskar @DrSteveTaylor @AbbieSBrooks @GoggleDocs @DrSelvarajah @ShivaniM_KC @WilmotEmma @drpratikc @DrAmirKhanGP @doctor_oxford Thank you for clarifying!

Let me make a prediction. Over the last two decades - much work has gone on in #NHS to improve #Diabetes care Namely improving CV death, amputation rates etc On the back of some amazing work from primary care- led by GP colleagues This folly-led by senior leadership- stemming from some deep rooted mistrust in GPs ? Will reverse those gains made in #Diabetes care. Bookmark this. Early signs are already there. Not in #T1Diabetes as dependant on Technology But certainly in #T2Diabetes Improving outcomes in chronic disease management sits -apart from self management & peer support- with access to trained professionals. What this country is doing in healthcare is astounding. @kamleshkhunti @ctmarshallceo