The Prime Minister has come under pressure during one of the busiest weeks of the year for the NHS as winter pressures begin to take their toll. Theresa May is hoping to shift the political narrative away from difficulties facing the health service with the help of a widely-anticipated cabinet reshuffle in the coming days, in which the Health Secretary Jeremy Hunt has been tipped by some to be promoted. Jeremy Hunt made several media appearances in support of the Prime Minister’s decision to sack First Secretary of State Damian Green as the result of a computer pornography scandal in the lead up to Christmas and is the favourite to replace Green if Theresa May decides to again fill the post.

However, there are mixed views on the wisdom of such a move for Hunt from within the Conservative Party. While an ally of the Health Secretary told the Sunday Times that Hunt, “is a peacemaker and negotiator” and would be perfect to fill Green’s role in Brexit discussions with the devolved nations, senior Conservatives have warned that Hunt is considered “toxic” by some sections of the public following his long-running dispute with junior doctors during David Cameron’s premiership.

May apologises for delays to operations

Theresa May has issued an apology to patients for thousands of cancelled elective operations, which were ordered by NHS bosses to free up winter capacity in hospital emergency departments. The Prime Minister said she recognised the difficulty caused for patients by delays and cancellations and said, “I know it’s frustrating, and I know it’s disappointing for people, and I apologise.” May’s apology came one day after she denied the service is in crisis and claimed the NHS is “better prepared for this winter than ever before”.

May’s comments on winter pressures followed a decision by NHS bosses on Tuesday to extend a moratorium on non-urgent medical procedures across England until the end of January. It is estimated that this will result in the postponement of around 50,000 operations in total. The decision was made by a new national emergency pressures panel which has been specifically convened for the first time this winter to respond to significant seasonal stress on the service. Some of the pressures on NHS capacity are being caused by the increasing incidence of admissions for flu as a result of the cold weather. 24 people died from flu last week, which is more than the total number of flu deaths in the final three months of 2016.

Jeremy Hunt joined the Prime Minister in apologising for delays saying, “if you are someone whose operation has been delayed I don’t belittle that for one moment.” However, the Health Secretary sought to downplay the scale of winter pressures this year, saying that, in contrast, hospitals were cancelling operations the night before they were due to take place in 2016. He also argued the NHS has now put in place a “planned, methodical and thoughtful” approach to dealing with increased demand for care in this winter.

Wollaston calls for new taxes as patients wait in ambulances

The Chair of the Health Committee Sarah Wollaston has criticised the government for its approach to NHS finances, saying it needs to “get a better grip” on the challenges facing the service. Wollaston has also called for a new tax on people over the age of 40, specifically to provide additional revenue for the NHS. She argued that the cost of extra funding – predominantly used to support older people in need of additional health and social care support – should not fall disproportionately on younger people and should be spread “across the generations”.

Wollaston argued, “people are happier to pay” taxes which are directly linked to NHS funding, and her proposal gained support from other prominent Conservatives, including Health Committee member Johnny Mercer who called on the Government to examine a ringfenced, “hypothetical tax”. Nick Timothy, the former Chief of Staff to Theresa May, endorsed the concept of increased national insurance contributions from older taxpayers.

Calls for a new approach to taxation come at the end of a week where at least 16 hospitals have declared an emergency situation, and almost 17,000 people were kept in the back of ambulances while waiting to be assessed in A&E. One in six ambulance patients waited 30 minutes or more for admission.

The Government’s management of the NHS has also been criticised by opposition parties and stakeholders across the NHS. Labour Health spokesperson Jonathan Ashworth said, “Tory underfunding and cuts have left our health service more vulnerable than ever” and called on Jeremy Hunt to urgently tell the public “how many more people will be waiting longer in pain and anguish” as winter pressures continue. Lib Dem spokesperson Norman Lamb argued the situation is “wholly predictable”, while Head of Policy at the Patients Association John Kell blamed the policy decisions taken by the Government and said, “ministers must be held accountable for this winter’s crisis.”

GP app providers will be subject to CQC rating

The Department of Health has announced that “all healthcare organisations … that offer regulated care” will now be subject to CQC rating in order to “futureproof” healthcare in England. Currently, the CQC can only inspect and publish findings on, and award ratings to hospital care, social care and GPs. The new powers will expand the Commission’s remit to rate over 800 more practitioners, including independent doctors using apps and digital healthcare. These organisations will be compelled to display their CQC ratings, as is standard procedure for the providers it rates, to “bring increased transparency” to patients and empower them to make informed decisions.

The CQC will launch a consultation this month on how best to carry out rating these providers. It the meantime it will continue to inspect these services and publish findings, and hopes to start awarding ratings to these providers by the end of the year. This further bolsters the CQC’s powers, after its remit was expanded last year to cover independent healthcare providers of services such as cosmetic surgery, misuse services and abortion clinics. The Government has also considered making CQC ratings “the default way [it] presents judgments from all its inspections.”

Health Secretary, Jeremy Hunt, said that the changes will ensure the Department is able to “keep pace with the changing landscape of healthcare” as well as the patients who use it. Sir David Behan, Chief Executive of the CQC, said that the expanded remit will give the public “increased transparency” about the quality of their healthcare service providers. The Department of Health specifically noted Push Doctor and Babylon as examples of independent providers offering digital services that will now be regulated. The widely advertised GP at Hand smartphone app – operated by Babylon – which provides free online consultations with an NHS GP, has caused controversy in recent months as primary care workforce representatives have accused the service of “cheery picking” younger and healthier patients for short-notice appointments.