ABHI Membership

Happy Friday lovely people, even the superstitious among you who have yet to get out of bed today. How good was the ABHI conference this week eh? We do tend to hype it up a bit, pointing out that it is the best you will get, produced by the industry for the industry and you could spend an awful lot of money and get an awful lot less. Although the fact is that there is really nothing else quite like this event, because very few people have the convening power of ABHI and the associated ability to bring together the top of the shop of some of the most important organisations in the delivery of health and care in our country alongside people who are doing some amazing things at a local level. It is ok to turn up the hyperbole if you can deliver, and I think it is fair to say our team delivered.

There are a couple of things I really enjoy about conference these days, not least that for the past few years I have had very little to do with the actual organisation. Yes, and this year was no exception, colleagues do reach into my little black book to fill the occasional gap, and when key speakers from major organisations pull out late in the day, I tend to get asked to do the bad cop routine and point out what a wasted opportunity with a major stakeholder it would be not to field someone of appropriate seniority. Although, in truth, I am more of a pantomime villain than a hardcore, Malcolm Tucker-like enforcer. The lack of operational responsibility means that as well as not having to endure the on the day angst experienced by Luella, Steve and Bayode, I can sit back and take in what is coming from the stage. There is never room for complacency or laurel resting, but it is, nevertheless, good to hear our work acknowledged and think, as some of us grow ever older, what we might be leaving by way of legacy from our time as custodians of your Association. Particularly fulfilling, therefore, was listening to MHRA Chief Executive, Lawrence Tallon who delivered our opening keynote. It would have been hard to imagine that so much of the time and energy of someone like me would have been spent on the fine details of product regulation in recent years, or that I might have been described in the official journal of the society of Regulatory professionals as an “expert” something which I continue to find very, very funny. Sorry Steve.

But to hear Lawrence’s remarks about our contribution to the development of new, sovereign regulatory arrangements was to consider the impact we have made. There were two, obvious headline areas of progress. Recognition and reliance. Four years ago, recognition of CE marking was off the table, now it is almost a done deal. Two years ago, the prospect of a meaningful reliance route involving products approved via US FDA 510K was not close. Now, whilst there is work to be done, things are looking much more promising, and the two Regulators now even have liaison Executives operating in each other’s backyards. There was one more, very significant advance Lawrence referred to which might have escaped the notice of those of you that are not policy wonks or geeky legislative watchers (guilty as charged M’lud). Lawrence stressed the importance of provisions in the ongoing Health Bill to give the MHRA the powers it needs to licence medical devices, and whilst it may have been a surprise to most that the Regulator does not have the ability to actually regulate HealthTech, Primary Legislation was the only option to allow it. 12 months ago, Downing Street was adamant that the text of the Bill was locked in, and there was no opportunity for the MHRA in this particular instrument. Now the necessary is in there and progressing, unmolested, towards the statute books.

It was also gratifying to hear NICE CEO Jonathan Benger deliver an address stressing such a heavy future focus on HealthTech by the Institute, while the admirable Dan Gilpin from our friends in Leeds articulated just what a key role our sector has to play in the delivery of Neighbourhood Health.

The other thing that I enjoyed about spending time with you, was the ego strokes I received from those who spend your Friday afternoons with me. As I have mentioned previously, I have considered, on a number of occasions, retiring the Blog which has been limping on now for over a decade. If I ever get serious about doing so, I will avoid Conference. Thank you so much to the many people who took the time to tell me in person how much they enjoyed reading this claptrap each week, and to Chris Florey, from the wonderful GS1, no spoiler alerts required this time, because even if you missed the Rugby last weekend, it all went pretty much as expected. (P.S. do tune into our session later this month with the GS1 team to get your head around the draft GB Unique Device Identifier [UDI] regulations).

In the outside world, Louise Casey has been out and about getting people braced as more details of her “Big Conversation” on care enter the public domain. I am not sure it needs a years-long Inquiry by the noble Baroness to tell us we already know. That our populations (it is not just a British problem) have aged but the underpinning social welfare systems have not adapted. It is a classic post-Fordist economy problem, people are progressively contributing more and more and getting back less and less, and that is a message people do not want to hear and not a message other people looking to secure their votes want to deliver. Casey makes the point that services for older people and adults with disabilities had been developed in a largely uncontrolled and unintended way, unlike the deliberate design of the NHS in 1948. As a result, she suggests that a postcode lottery had developed with different levels of services available depending on where people live. She also highlights the rather uncomfortable truth that the fees that self-funders pay are much higher than councils were charged for people entitled to state support. She also makes the equally uncomfortable point that care services, such as home adaptations and personal care like helping people out of bed and with washing, were simply not valued enough.

Case in point was Covid, and I think we all knew, even at the time, we were over cautious with our children inflicting generational harm, while throwing our old people under a bus. Last month the Covid Inquiry published a report which said the care sector appeared to be "something of an afterthought" in the early stages of the pandemic, allowing Covid to spread like "wildfire". The findings, Casey asserts, were "so awful" and "a national shame". Her final recommendations for services for older people and adults with disabilities, including care homes, will be published next summer. It comes as her commission publishes research showing England is an international outlier for having no "clear system of stewardship" for social care, unlike countries such as France and Germany. The UK market is dominated by private providers which has led, according to the Baroness, the Regulator (the Care Quality Commission) being a "spectator at the site of a car crash".

My old mate Roy Lilley did another of his great, data informed pieces on the workforce crisis behind it all this week and that was pretty uncomfortable too. England had 96,000 vacant adult social care posts in 2025/26. In home-care, nearly one in eleven posts was vacant. The overall vacancy rate has fallen from its 2022 peak, but overseas recruitment has pretty-well collapsed. The number of people starting direct care jobs in the year they arrived in the UK fell from 105,000 to 30,000 in two years and more than one in four care workers and nearly one in three nurses leave care jobs within a year. Skills for Care predicts another 410,000 roles will be needed by 2040 if staffing grows in line with the +65yrs population. Good luck with that, and it merely steels my own resolve not to live for too long.

There was at least some good news for our beleaguered health and care service this week. On 26 October, the BMA confirmed two days of consultant strike action in England on 25 and 26 November, but on Wednesday announced that the planned strike action has been paused to allow for further discussions. Although the two sides still seem some distance apart. The BMA insists pay has to be on the table, but the DHSC says that any topics for negotiation have to demonstrate productivity improvements. It also points out that Health and Social Care Secretary Yvette Cooper has said she cannot justify increased pay for some of the highest earners, at the expense of patient care. The BMA, for its part, points to a reduction in real-terms pay of 25 per cent since 2009. I think this one will be a runner.

As I predicted, last weekend I did not manage the full eight hours of free to air international Rugby Union from the kitchen island, although I did manage to squeeze out prep for Saturday dinner longer than I might have done. I also played a bit of a blinder on Sunday, not least by doing a garden centre run during which we secured bulbs, compost and horticultural grit as well as a random, very high quality outdoor cum indoor Spanish chair for 25 quid, the matching bar stool of which we acquired at an equally impressive knockdown a couple of years ago. Turns out they were samples at a price point even the more well-heeled citizens of Walsall could bear. Anyway that, and a full weekend of dog walking brought me enough brownie points to watch the England Australia game while the Doctor, dodgy knee replacement and all, did literally heavy lifting in the garden. Ok, that might not make me Husband of the Year material, but we did go on to pay our first visit of the season to Birmingham’s famous Christmas market, 21 years since it was the scene of our first date, and a celebratory Keralan dinner while Daughter had yet another social engagement.

More Nations Championship to follow this weekend, including tonight the thrilling prospect of France v the Saffers, a game in which the French scrum half, Antoine Dupont, by some distance the best rugby player that has ever lived, will start at fly half. If you do not know quite how remarkable that is, you need to tune into the coverage later on and find out. Otherwise we cannot be friends.