Sue Gray finds ‘failures of leadership and judgment’ in report on Downing Street parties

Sue Gray’s heavily-abridged report into the partygate scandal has blasted “failures of leadership and judgment” in 10 Downing Street and the Cabinet Office.

Andrew Woodcock 

The report considered a total of 16 separate social events at 10 Downing Street and other government departments which took place while Covid regulations imposed strict limits on gatherings anywhere in the UK.

And it revealed that the Metropolitan Police inquiry launched last week will focus on 12 events – including the ”bring your own booze” party on 20 May 2020 when Boris Johnson joined around 40 No 10 staff to drink alcohol and eat picnic food from trestle tables in the Downing Street rose garden, as well as an alleged party in the prime minister’s flat on the evening of the resignation of former aide Dominic Cummings on 13 November 2020.

The 13 November gathering may be of particular significance in determining whether Mr Johnson survives the scandal, as he has previously denied in a written response to a parliamentary question that it even took place.

In a scathing comment on the culture at No 10 under Boris Mr Johnson’s leadership, the Whitehall mandarin wrote: “Some of the gatherings in question represent a serious failure to observe not just the high standards expected of those working at the heart of government but also of the standards expected of the entire British population at the time”.

The report led to renewed demands for Mr Johnson’s resignation.

Liberal Democrat leader Sir Ed Davey said: “Everyone knows Boris Johnson broke the rules and lied to the country. It’s time Conservative MPs did their patriotic duty, listened to their constituents and stood up for decency by sacking Boris Johnson. He must go before he does our country any more harm,”

And Labour deputy leader Angela Rayner said: “I’ve spoken to constituents, people on the street, people on trains, primary school children, care home residents, and not a single person needs Sue Gray to tell them what to think about Boris Johnson.

“He made the rules, he broke the rules, he is unfit for office.”

She said it was “the most absolute failure of any prime minister” and Mr Johnson had “failed in his number one duty as leader of our country” and should immediately resign.

The long-awaited report was published by Downing Street at 2.30pm after being delivered to Boris Johnson at 11.20am on Monday. The prime minister was due to give his response and be grilled by MPs an hour later in a statement to the House of Commons.

After an eleventh-hour intervention by police, senior civil servant Ms Gray was required to strip the report of all but “minimal” references to alleged breaches of Covid regulations in parties and social gatherings in No 10 and Whitehall departments.

Ms Gray said that the police request had made it impossible for her to deliver a “meaningful report” on the full range of events which took place in No 10 during 2020 and 2021.

“I am extremely limited in what I can say about those events and it is not possible at present to provide a meaningful report setting out and analysing the extensive factual information I have been able to gather,” she said.

She described her 12-page report as an “update” on her inquiries, suggesting that a fuller report may be published when the police investigation is concluded.

And she said she will “ensure the secure storage and safekeeping of all the information gathered until such time as it may be required further” but will not share it with Mr Johnson or anyone else in government.

Only four events mentioned over the course of the controversy were not of interest to the police – a photograph taken on 15 May 2020 which showed Mr Johnson and wife Carrie with No 10 staff drinking in the Downing Street garden; a leaving do for aide Cleo Watson on 27 November 2020; a pre-Christmas gathering at the Department for Education on 10 December 2020; and an online Christmas quiz at No 10 on 15 December 2020.

The report did not mention Mr Johnson by name and made direct criticism of individuals for what took place in No 10.

And Ms Gray made clear she was not in a position to pass judgement on whether any Covid breaches amounted to breaking the law, insisting that that was a matter for law enforcement agencies.

She also said that she did not regard it as appropriate, while the police inquiry is ongoing, to deliver a verdict on whether individual gatherings breached guidance and regulations.

But she found: “There were failures of leadership and judgment by different parts of No 10 and the Cabinet Office at different times.”

And Ms Gray concluded: “A number of these gatherings should not have been allowed to take place or to develop in the way that they did.

“There is significant learning to be drawn from these events which must be addressed immediately across government. This does not need to wait for the police investigations to be concluded. “

The report acknowledged that Downing Street staff were in an unusual position during Covid lockdowns, as they were permitted to attend their workplace under a special exemption.

But Ms Gray made clear that this did not provide an excuse for breaching rules, noting that the same conditions applied to “key and frontline workers across the country who were working under equally, if not more, demanding conditions, often at risk to their own health”.

She said: “It is important to remember the stringency of the public health regulations in force in England over the relevant periods and that criminal sanctions were applied to many found to be in breach of them.

“The hardship under which citizens across the country worked, lived and sadly even died while observing the government’s regulations and guidance rigorously are known only too well.”

And she said: “Against the backdrop of the pandemic, when the government was asking citizens to accept far-reaching restrictions on their lives, some of the behaviour surrounding these gatherings is difficult to justify. “

Ms Gray raised concerns about the ability of Downing Street staff to raise concerns about gatherings and breaches of social distancing rules over which they felt uneasy.

“Some staff wanted to raise concerns about behaviours they witnessed at work but at times felt unable to do so,” she said.

“No member of staff should feel unable to report or challenge poor conduct where they witness it. There should be easier ways for staff to raise such concerns informally, outside of the line management chain.”

And she appeared to suggest that too little support had been given to principal private secretary Martin Reynolds, who has been targeted for blame for organising the 20 May garden party.

“Too much responsibility and expectation is placed on the senior official whose principal function is the direct support of the prime minister,” said the report. “This should be addressed as a matter of priority.”

Ms Gray said the report looked at a series of gatherings whose “necessity for work purposes has been open to question”.

Her team interviewed more than 70 individuals with knowledge of the events – some more than once – and examined relevant documentary and digital information, including emails, WhatsApp messages, text messages, photographs and official records.

The investigators also had access to entry and exit logs for government buildings in order to build up a picture of when individuals were arriving and leaving – and to pick up mass departures late in the evening after events took place.

Ms Gray said her investigative work is now “essentially complete” – leaving open some room for her to add further information which arises during the police investigation before releasing her final verdict.

Sue Gray’s update: the general findings



Every citizen has been impacted by the pandemic. Everyone has made personal sacrifices, some the most profound, having been unable to see loved ones in their last moments or care for vulnerable family and friends. It is with that context in mind that I make the following general limited findings

General findings

i.                     Against the backdrop of the pandemic, when the Government was asking citizens to accept far-reaching restrictions on their lives, some of the behaviour surrounding these gatherings is difficult to justify.

ii.                  At least some of the gatherings in question represent a serious failure to observe not just the high standards expected of those working at the heart of Government but also of the standards expected of the entire British population at the time.

iii.                  At times it seems there was too little thought given to what was happening across the country in considering the appropriateness of some of these gatherings, the risks they presented to public health and how they might appear to the public. There were failures of leadership and judgment by different parts of No 10 and the Cabinet Office at different times. Some of the events should not have been allowed to take place. Other events should not have been allowed to develop as they did.

iv.                  The excessive consumption of alcohol is not appropriate in a professional workplace at any time. Steps must be taken to ensure that every Government Department has a clear and robust policy in place covering the consumption of alcohol in the workplace.

v.                    The use of the garden at No 10 Downing Street should be primarily for the Prime Minister and the private residents of No 10 and No 11 Downing Street. During the pandemic it was often used as an extension of the workplace as a more covid secure means of holding group meetings in a ventilated space. This was a sensible measure that staff appreciated, but the garden was also used for gatherings without clear authorisation or oversight. This was not appropriate. Any official access to the space, including for meetings, should be by invitation only and in a controlled environment.

vi.                  Some staff wanted to raise concerns about behaviours they witnessed at work but at times felt unable to do so. No member of staff should feel unable to report or challenge poor conduct where they witness it. There should be easier ways for staff to raise such concerns informally, outside of the line management chain.

vii.                 The number of staff working in No 10 Downing Street has steadily increased in recent years. In terms of size, scale and range of responsibility it is now more akin to a small Government Department than purely a dedicated Prime Minister’s office. The structures that support the smooth operation of Downing Street, however, have not evolved sufficiently to meet the demands of this expansion. The leadership structures are fragmented and complicated and this has sometimes led to the blurring of lines of accountability. Too much responsibility and expectation is placed on the senior official whose principal function is the direct support of the Prime Minister. This should be addressed as a matter of priority.


 The gatherings within the scope of this investigation are spread over a 20-month period – a period that has been unique in recent times in terms of the complexity and breadth of the demands on public servants and indeed the general public. The whole of the country rose to the challenge. Ministers, special advisers and the Civil Service, of which I am proud to be a part, were a key and dedicated part of that national effort. However, as I have noted, a number of these gatherings should not have been allowed to take place or to develop in the way that they did. There is significant learning to be drawn from these events which must be addressed immediately across Government. This does not need to wait for the police investigations to be concluded.

Breaking news: Lockdown party report delivered to Downing Street

Unlikely to be a Black and White day more a “Gray” day.

Report likely to be posted in the public domain here after all the niceties are observed on who sees it first, second, third etc Welcome to GOV.UK ( Owl /news/uk-politics-60195620

Boris Johnson has been handed Sue Gray’s report into Downing Street parties, ahead of its expected public release later.

Planning applications validated by EDDC in week beginning 17 January

National Trust reveals first of 20 planned ‘green corridors’

The National Trust has unveiled plans for a “green corridor” to link the centre of Bath to the surrounding countryside and create new habitat for wildlife.

Tess de La Mare

It is the first of 20 such corridors first announced in January 2020 and will run through 40 hectares of riverside meadows newly acquired by the trust.

Bathampton Meadows, on the banks of the Avon was previously a mixture of farmland and council-owned land, and was once mooted as the site of a proposed park and ride.

The trust has plans for a programme of hedgerow and tree planting along the three-mile route to create a network of foraging habitat to help the declining greater horseshoe bat.

It also intends to improve wetlands to support wading birds and provide a boost for wildflowers and insects.

The corridor is aimed at helping people living in the town centre get closer to nature. A consultation on the proposals is due to start in the spring.

The National Trust has acquired Bathampton Meadows (Tom Boden/PA)

The National Trust has acquired Bathampton Meadows (Tom Boden/PA)

The National Trust has plans to create a further 19 green corridors in England, Wales and Northern Ireland by 2030.

Hilary McGrady, director-general of the National Trust, said: “These routes will improve access to nature for those living in urban areas who may feel disconnected from the countryside or cannot access rural areas easily.

Research has shown that engaging with nature is good for our wellbeing and that those connected to nature are likely to do more to help protect it.”

She added: “Connecting up green spaces isn’t just good for people, it’s also good for wildlife, allowing animals and birds to move from one habitat to another.”

The official start and end point of the corridor has yet to be determined, but should start close to Bath Abbey and is expected to finish in the village of Batheaston.

The green corridor will provide new habitat for wildlife (National Trust images/PA)

The green corridor will provide new habitat for wildlife (National Trust images/PA)

Tom Boden, general manager for the trust’s Bath properties, said: “With the meadows now protected forever, we will consult closely with the local community and stakeholders over the coming months to develop an exciting vision for the land to benefit both people and nature.”

He continued: “Hedgerow and tree planting to include the creation of an orchard will particularly help the current greater horseshoe bat population, a nationally rare and dwindling species, by providing wider, more connected foraging habitat on neighbouring land.

“Blossoming trees in the orchard will also be good for attracting pollinators.

“We’re also aiming to create new wildflower meadows to help insects such as the small blue butterfly, and areas of wet woodland planted with trees like willow, birch and alder to attract wading birds such as snipe and scarce native birds like siskin or willow tits.”

The trust is also considering how it can improve cycle access along the route.

Councillor Richard Samuel, deputy leader at Bath and North East Somerset Council, said: “Transferring Bathampton Meadows to the National Trust ensures the land is protected forever against inappropriate development, and it also supports our commitment to tackle the climate and ecological emergency.

“The transfer will provide much improved public access and an enhanced open space.”

‘Impossible’ for Covid inquiry to start on time as PM stalls, experts warn

It is “impossible” for the public inquiry into the government’s response to the Covid pandemic to begin on time after Boris Johnson delayed preparations for it, experts are warning. 

The prime minister is accused of shunting the investigation – which he pledged would begin in “spring 2022” – to the “bottom of the government’s to-do list”, after dragging his heels on agreeing its scope.

Now hearings will not be possible before the summer after hold-ups appointing a chair and agreeing on terms of reference, think tanks that have studied previous inquiries say.

There are fears of further delays with the government “in paralysis” over the Partygate scandal, with one source saying a promised consultation on draft terms is not expected imminently.

A former head of the civil service, Sir Bob Kerslake, has told The Independent he will demand answers from the government, saying: “I am concerned if the inquiry is going to be delayed.”

The Institute for Government warned it was now “very hard to see how the inquiry can begin until the end of May or June, based on previous inquiries such as Grenfell”.

The King’s Fund echoed the criticism, saying it is now “impossible for the inquiry to now start its work in earnest in the spring”.

“The public inquiry is too important to be shunted yet again to the bottom of the government’s to-do list,” Sally Warren, The King’s Fund’s director of policy, told The Independent.

The fresh delay has angered the families of Covid victims after Mr Johnson rejected several pleas to start the inquiry sooner.

He has been accused of stalling in order to prevent likely damning conclusions coming out before a general election in spring 2024, with public inquiries typically taking at least two years.

Lobby Akinnola, spokesperson for Covid-19 Bereaved Families for Justice, said: “Once the inquiry is officially set up, it becomes an offence to tamper with or destroy evidence. But until that happens, there’s a risk of key evidence being lost. After the attempts to cover up Partygate, that is especially worrying.”

Mr Johnson finally announced the inquiry last May but failed to appoint a chair – former Court of Appeal judge Heather Hallett – until just before Christmas.

He said draft terms of reference would be released “in the new year” but they have yet to be published.

In the Grenfell inquiry, it took two-and-a-half months between publication and hearings getting underway, but the Institute for Government (IfG) warned the Covid inquiry will be “far more complicated”.

The range of controversies is vast, including the timing of lockdown decisions, the scientific advice sought, testing and PPE, the discharge of infected patients into care homes and the initial decision not to close borders.

Many key decisions were devolved, which means there is a need to delve into the handling of the response in Edinburgh, Cardiff and Belfast too.

“Engaging the public and other parties in a consultation on those terms of reference is likely to be more complicated than the Grenfell consultation, because of the sheer scale of people and organisations who will want to be involved,” said Emma Norris, the IfG’s director of research.

“It was always clear that this would be a complex inquiry to set up, so it was important to begin in earnest as soon as possible – so the government should have started earlier.”

Mr Johnson defended his stalling on the grounds it would “weigh down” scientific advisers and take up “huge amounts of officials’ time” if the pandemic flared up again.

In the Commons last week, he appeared to pre-judge the inquiry, when he boasted to MPs: “We have the fastest-growing economy in the G7 and we have got all the big calls right.”

But an inquiry last year by two Tory-led Commons committees was damning, calling his response “one of the most important public health failures the United Kingdom has ever experienced”.

Delaying lockdown in March 2020 – as herd immunity was explored – and failing to protect elderly and vulnerable people in care caused thousands of avoidable deaths, it said.

The cabinet office declined to discuss the reasons for the delay in publishing draft terms of reference, when panel members will be selected, or whether office space for the inquiry has been secured.

A spokesperson said: “As the prime minister has previously stated, the Covid inquiry is set to begin its work in spring 2022.”

Devon covid on way back up

After dropping over the past few weeks, covid cases have once again risen in all parts of Devon.

Joe Ives, local democracy reporter

In the latest complete seven day period (to Sunday, 23 January) the county recorded 12,745 new cases, 2,290 more than in the previous week. The 22 per cent rise takes the infection rate across Devon to 1,120 per 100,000 of the population, higher than the national average of 954.

The Devon County Council, which excludes Plymouth and Torbay, recorded the largest spike, with a 29 per cent (+1,816) rise. Its 8,176 new cases take the area’s infection rate to 1,009 per 100,000.

Torbay continues to have the highest infection rate in the county, with 1,270 cases per 100,000 of the population. The latest figures record 1,730 infections in the Bay; 181 (12 per cent) more than the previous week.

Plymouth’s 2,839 new cases are 279 (12 per cent) more than the previous week. The infection rate is 1,080 per 100,000 of the population. 

The spike is a setback for the city’s health services. Speaking recently Kevin Baber, chief operating officer of Plymouth Hospitals said the number of people waiting for treatment at Derriford is 40,000; up 10,000 since the beginning of the pandemic.

More than 3,000 people have been waiting over a year and 461 patients, primarily needing elected orthopaedics or spinal surgery, who have waited over two years.

Mr Baber said the pandemic has taken a toll on NHS workers in Plymouth, noting “an increasing number of staff who are off sick with stress, anxiety, depression and covid PTSD.”


As of the most recent data (from Wednesday 25 January) 240 patients with covid were in Devon’s hospitals. The majority (188) are in Derriford. 

Twenty-seven people are being cared for at the RD&E in Exeter, while a further 25 are being treated in Torbay Hospital.

Three patients in Devon are in mechanical ventilation beds. 


Nineteen people died within 28 days of receiving a positive covid test across Devon in the most recent complete seven-day period (to Sunday 23 January), six more than last week. 

Ten people died in the Devon County Council area, which excludes Plymouth and Torbay. Five deaths were recorded in Torbay and four in Plymouth.

Across Devon, a total of 1,518 people have now died within 28 days of a positive covid test.


Eighty-eight per cent of people aged 12 and above have had their first dose of a vaccine in the Devon County Council area, which excludes Plymouth and Torbay, with 83 per cent receiving both doses. Seventy per cent have now had their ‘booster’ dose.

In Plymouth, 85 per cent have had one dose, while 79 per cent have had both. Fifty-nine per cent have had the booster.

In Torbay, 86 per cent have received one dose, while 8q per cent have had both jabs. Sixty-five per cent have had their third vaccine.

The national rates are 91, 84 and 65 per cent respectively.

Devon Covid dashboard shows cases rising in all age groups except 60 to 79 year olds (cases to 25 Jan)

Has Exeter based construction giant Midas lost its Golden Touch?

“One of the South West’s largest employers, the Exeter-based construction giant Midas, has reportedly filed a court notice of its intention to appoint an administrator.”

Steve Hindley, the Executive Chairman of the Midas Group, is also Chair of the “Great South West” which seems to have set itself up to take a leadership role for promoting economic growth across a number of neighbouring Local Enterprise Partnerships in the peninsular. 

In February 2020, with incredibly bad timing, “The Great South West” sent a report to Savid Javid just as he was replaced by Rishi Sunak, see: “The Great South West pitches to the wrong man. A week is a long time in politics” . Then the pandemic broke.

In July 2020 The Great South West appeared to be defunct, but it re-emerged in time for the G7 to publish a new, green, way forward in June 2021. This “greening” report, however, was  written by none other than one of the main polluters of our rivers and seas, the Pennon Group.

Currently we await Michael Gove’s “levelling up” White Paper, supposedly this week, but who knows what the government’s agenda is these days.

Concerns over future of SW construction giant

Colleen Smith 

The £290million turnover company filed the notice for itself and its main subsidiary Midas Construction Limited, the UK’s leading building trade resource Construction News revealed.

It follows a DevonLive exclusive yesterday which revealed that work had come to a virtual standstill on three major hotel construction projects worth £40m-plus in Torbay.

Midas is one of the region’s largest employers, with more than 400 people directly employed and supporting more than 10,000 jobs in supply chains.

The Exeter-headquartered business is ranked as the ninth largest in the Top 150 businesses in Devon and Cornwall 2021.

A notice of intention (NOI) typically means that a company will formally appoint an administrator within 10 days, unless it can find an alternative financial solution to its problems first. It follows the resignation of Midas Group’s commercial director Scott Poulter at the end of December and a nine-page Registration of Charge was posted on Companies House in mid January.

Administration is often used as part of a company restructure if the business is deemed viable. Directors can purchase some or all of the assets, and set up a ‘newco’ to move forward and save the business.

Midas is one of the region’s largest employers, with more than 400 people directly employed and supporting more than 10,000 jobs in supply chains.

The Exeter-headquartered business is ranked as the ninth largest in the Top 150 businesses in Devon and Cornwall 2021.

If they do enter administration there will be eight weeks in which to save the company, with sale as a going concern often the preferred option.

After months of concern within the building trade, fears for the company’s future mounted this week after the Fragrance Group spoke publicly to DevonLive about its fears for the lack of progress over the last three months at its twin £30m new hotel builds on Paignton seafront.

At the same time work ceased at the £11m construction of the Premier Inn in Torquay on The Terrace.

The company said its projects had been affected by the pandemic, Brexit, and labour and material inflation and shortages. “We are working closely with all our stakeholders to resolve the situation,” it said in a statement issued this morning.

A number of subcontractors have today revealed that they are owed five-figure sums by the company, whose HQ is in Pynes Hill, Exeter, and with offices stretching across the South West from Southampton to South Wales.

Last year the company reported a £2m pre-tax loss for the first time in it’s 40 year history. Midas is one of the UK’s largest privately-owned construction and property services companies.

Singapore-based Fragrance Group appointed Midas to build the two new hotels on Paignton seafront in January 2020, but after three months with little progress on the build their patience ran out this week.

A spokesperson for the group told DevonLive : “Over the past three months, the Fragrance Group has become increasingly concerned by the very limited progress on our two new Paignton seafront hotel developments, located on the neighbouring sites of the former Park Hotel and Lighthouse club.

“We are in constant discussions with the main contractors and are now reviewing our options to complete the development of these hotels.

“Our priority is to deliver these two new seafront hotels which mark a vital investment in the wider Torbay. We can confirm that the Fragrance Group is committed to Torbay.”

Torbay Council contracted Midas to build the £11m Premier Inn at The Terrace in Torquay. But after work stopped on site this week a council spokesman said on Thursday: “We are working with Midas to identify any issues that may be affecting the site and any required solutions.”

Midas works primarily in the commercial sector and also delivered jobs in the residential and education markets, with much of its work in the South West. In Torquay they are also currently building a new Special Educational Needs department at St Cuthbert Mayne school.

A spokesman for Midas told DevonLive yesterday: “As is well known in the industry there are issues relating to Brexit, Covid, ongoing shortages of materials and labour, and significant cost inflation, which are providing challenges to project delivery and timescales.

“We are working closely with all our stakeholders to resolve the situation.”

Former councillor to pay almost £50,000 after unsuccessful High Court challenge

A former Hartlepool councillor will have to pay almost £50,000 in legal fees after an unsuccessful High Court challenge to void a result in the May 2021 local elections.

Laura Love

The hearing took place following a petition from Bob Buchan over claims of damaging information in Labour’s campaign material shortly before the 2021 local elections.

Mr Buchan, who previously represented the Independent Union on the borough council, missed out on being one of three councillors elected in the Fens and Greatham ward to Labour’s Jennifer Elliott by 609 votes to 619.

After hearing evidence on Thursday, judge Philip Kramer on Friday concluded the statement in the election material related to “political conduct and character”, rather than a “personal” attack, and ruled in favour of Cllr Elliott.

He said: “The exercise of a vote in committee is a political act, the councillor is discharging a political function.

“Politicians are entrusted to take these decisions on the public’s behalf and when they discharge that trust, they are undertaking a political act, which is correctly characterised as political conduct.”

The defence submitted legal costs of just under £79,000 to the court, with the judge ruling Mr Buchan must pay just over £48,000 of this, after questioning and analysing the fees.

Speaking at the hearing Mr Buchan, said he had kept his legal costs to “about £3,500” and noted he will have to seek “support from family and friends” to pay the defence’s fees.

Speaking after the result, Mr Buchan said: “I’m naturally disappointed with the outcome of this case.

“The reason I brought this case in the first place is that Jennifer had informed 700 residents in the village I voted in favour of a controversial development, when it has now been proven in open court and accepted by Jennifer that this was not true.

“I am astounded that the defence team asked for almost £79,000 and I’m grateful for the judge for slashing the bill down by almost £30,000.”

The fees must be paid within 28 days, however Mr Buchan was told he can make a request to pay in instalments.

The case revolved around a Labour campaign letter just days before the May local elections, which claimed Mr Buchan had voted in favour of a controversial development for 18 council homes in Hill View, in Greatham, which was approved in January 2021.

The former councillor reiterated he was not at the meeting when plans were approved, and voted against a similar previous application in July 2020.

Judge Kramer ruled there was “no dispute” Mr Buchan did not vote in favour, as he was not present at the meeting .

During the hearing, Cllr Elliott had said it was an “honest mistake” in stating Mr Buchan had voted for the application.

However Mr Buchan had said he felt there had been an “attack on his reputation and good standing in the community” with the comments made in election material.

Speaking after the case, Cllr Elliott said she was “very pleased” with the court’s ruling and she is now focused on continuing to “fight for the residents of Fens and Greatham”.

She said: “I would like to thank all those who have supported me through a stressful and unpleasant time.

“I am looking forward to getting back to what really matters.”

Judge Kramer, speaking at the start of proceedings, had said if Mr Buchan had been successful, the result of the election would have been “void” and “have to be rerun”.

GPs nationalised in Javid plan to reduce hospital admissions

GPs would be nationalised under plans from the health secretary to make them do more to keep patients out of hospital.

Chris Smyth

Sajid Javid is considering radical changes to the 70-year-old structure of the NHS that could see many family doctors directly employed by hospitals instead of running their own surgeries.

He has told Boris Johnson that there are “considerable drawbacks” to the system under which GP surgeries are in effect independent contractors paid per patient by the NHS.

A review of primary care planned by Javid will look at how to better integrate GPs with hospital care as part of attempts to do more to stop people developing serious illness.

Sources insisted there would be no forcible state takeover of GPs, who are likely instead to be given incentives to link up with hospital trusts.

The plans are likely to provoke resistance from doctors who said that the independence of GPs boosts innovation and offers value for taxpayers’ money.

Javid is keen to accelerate the pace of reform in the NHS as he feels pressure to deliver tangible progress in exchange for billions of pounds in extra funding.

He is reviewing hospital management to hold NHS chiefs more closely to account as well as considering “academy style” hospitals with more freedoms, which he hopes will start taking over GPs.

This month he wrote to the prime minister setting out his ideas for NHS reform, telling Johnson that he had “an ambitious agenda that has the potential to be a central plank of your domestic policy legacy”.

He suggested setting up a “new National Vaccination Service” to free surgeries from the need to administer regular Covid boosters, which could keep on some of the non-medical vaccinators employed during the pandemic to administer routine immunisations.

GPs in England were told to prioritise boosters before Christmas, but this week they were told by NHS England to “restore routine services” now that demand for jabs has dropped off.

In the letter, seen by The Times, Javid said: “Whilst there are some strengths to the system of primary care, it’s also clear that the historic separation of general practice from the wider healthcare system as created in 1948 comes with considerable drawbacks including an underinvestment in prevention.” He says he will launch “an independent review of the future of primary care”, to look at “workforce, business models and how GPs work with the other parts of the NHS such as hospitals”.

This month, The Times reported that Javid was considering a new class of “reform trust” in the NHS, modelled on the academy school scheme. The letter said that they would “drive innovation with the freedom to improve outcomes by pioneering approaches including by bringing together primary and secondary care”. The idea has been dubbed the Wolverhampton model after the city’s hospital took over GP practices and cut emergency admissions.

Martin Marshall, the head of the Royal College of GPs, said the current model “delivers exceptional benefits for the NHS”, and that the main problem was a lack of qualified staff. “There has to be a very good reason for changing a model that works well” for all.

Aren’t GPs already run by the NHS?

Although GPs are the front door to the health service, practices have never been owned by the government but are owned and managed by GP partners, whose pay in effect comes out of surgery profits.

How are GPs paid?

Surgeries get a fixed sum per patient, currently £155 a year, with extras for hitting targets on chronic conditions and for offering extra services, with allowances for extra staff such as pharmacists.

Why is the NHS set up like this?

It was a compromise struck as Nye Bevan set up the NHS facing resistance from the British Medical Association and others, who compared the plans to Nazism. To buy off their opposition, he allowed consultants to carry on seeing private patients and GPs to remain independent small businesses.

What is the case for reform?

Joining up care and preventing chronic illness is a key goal of health systems globally. Some argue that the divide between GPs and hospitals hampers this integration. Hospitals lack the opportunity to prevent disease while GPs lack the resources and financial incentives to prevent disease they do not pay to treat.

What is the case against?

GPs are established, developing long-term local links and are responsive to patients, not looking to the NHS hierarchy and an unresponsive bureaucracy.

Are any GPs paid a salary?

Yes, and the number is growing as fewer younger doctors want the responsibility of in effect running a small business. The number of salaried GPs in England has gone from 6,650 in 2009-19 to 11,000 in 2019-20, a rise of 65 per cent. GP contractors have fallen 27 per cent from 26,400 to 19,250.

What does nationalisation mean in practice?

Javid’s allies insist family doctors will not be forced to hand over their surgeries. They are more likely to be offered incentives to become part of larger NHS organisations, often hospitals.

What will this mean for patients?

The goal is a more seamless link between doctors and specialists, meaning problems picked up quicker and patients given help staying well. Critics say the changes will not address the fundamental problem of falling GP numbers.