Monthly Archives: June 2026

NHS Recovery and Productivity: Diagnostics are the place to start

Drawing on his experience as a Health Minister and Chair of the Health and Social Care Select Committee, GK’s strategic advisor Steve Brine argues that diagnostics are the critical but often overlooked foundation of NHS recovery, productivity and prevention.

Diagnostics rarely grab headlines in the way that waiting lists do. Yet during my time as a Health Minister, and later as Chair of the Health and Social Care Select Committee, I came to a simple conclusion – if you want to improve outcomes, reduce elective waits and modernise the NHS, they are the place to start.

The reality is that no patient can begin the right treatment until the clinicians know what is wrong. Whether it is cancer, heart disease or a musculoskeletal problem, diagnosis is the gateway through which every effective pathway runs.

Too often, however, diagnostics are viewed as a ‘supporting service’ rather than the critical infrastructure on which the entire system rests.

That is why I have been encouraged by the development of Community Diagnostic Centres (CDC’s) under the last government and continued under this administration.

The concept is straightforward but powerful; bring scans, tests and investigations closer to where people live, rather than requiring patients to navigate busy acute hospitals. It is one of the clearest examples of the much-discussed shift from hospital to community becoming more than words on a page and something that patients can see.

When I was a Minister, we spoke frequently about prevention and early intervention. Now it’s the talk of the town.

For my money, diagnostics sit at the heart of both. A CT scan, MRI scan or PET scan (Positron Emission Tomography, which is particularly important in cancer diagnosis and treatment planning) is not simply a test. It is an opportunity to identify disease earlier, provide reassurance quicker, and avoid patients deteriorating while waiting for answers.

As Select Committee Chair, I often heard evidence about the pressures facing the NHS workforce and the challenge of delivering constitutional standards. The current debate about the 18-week elective target is important, but it is worth remembering that elective recovery ultimately depends on diagnostic recovery. You cannot clear waiting lists if patients are waiting months for scans, endoscopy or reporting.

That is why diagnostics should be seen as a productivity issue as much as a clinical one. Faster access to tests means quicker clinical decisions, more efficient use of outpatient appointments and better use of operating theatres. Every delayed diagnosis creates friction elsewhere in the system and, most important of all, spikes anxiety in patients. The dreaded diagnosis ‘odyssey’.

The challenge now is ensuring that CDC’s become a permanent part of NHS infrastructure rather than simply a waiting-list initiative. That means investing not only in buildings and scanners, but also in the workforce; radiographers, radiologists etc.

If ministers are serious about restoring performance (which as we will explore further in this series of blogs I am writing for GK Strategy is only part of the story), improving cancer outcomes and delivering care closer to home, it’s hard to look past diagnostics as the place where the next chapter of NHS reform must begin.

Social media: how the government is trying to regulate an industry that moves faster than itself

The Online Safety Act 2023 was hailed by the then Conservative government as a world-leading piece of legislation that would protect children and adults online. The act places new responsibilities on technology and social media platforms to protect users from harmful content, particularly children, and grants Ofcom extensive enforcement powers, including the ability to levy fines of up to 10% of global annual revenue for non-compliance. The legislation was designed to create a safer and more age-appropriate online environment without fundamentally restricting access to digital platforms.

Less than three years later, the Online Safety Act has proven to be already out of date, leading to new policies exploring an outright ban of social media sites for under 16s. The political debate has shifted from regulating content to regulating access itself.

Australia took the first leap, being the first major democracy to announce its own social media ban for under 16s in December 2025. Since then, the debate in Westminster has not dissipated. A UK-wide ban has been endorsed across the political spectrum, with proponents including over 60 Labour MPs, Conservative Party leader Kemi Badenoch and London Mayor Sadiq Khan.

The government has so far taken incremental steps to more stringently regulate access to sites ahead of potentially endorsing an outright social media ban. A crackdown on phones in schools was pursued in 2024, and the 2025 Violence Against Women and Girls strategy included measures to prevent school-aged boys developing harmful misogynistic attitudes – which the government believes has largely been driven by online content. In early June 2026, the Prime Minister also announced a new requirement for tech companies to devise technological solutions that can detect and block children seeing or sharing indecent images. This announcement followed only a few weeks after safeguarding minister Jess Phillips resigned from government, criticising the Prime Minister’s inaction and delay on this very matter.

No piecemeal policy interventions have yet delivered enough protections for parents, teachers and policymakers to feel that young people are safe online. This has paved the way for a government consultation in early 2026 testing the waters on age restrictions for social media. The consultation, which the government is due to provide a full response to this summer, proposed removing or limiting addictive features such as ‘infinite scrolling’ and introducing a minimum age for social media access.

For social media companies, technology platforms, advertisers and organisations that rely on digital engagement with younger audiences, the policy implications are significant. Potential further restrictions on access, platform functionality or age verification requirements would have commercial, operational and regulatory consequences across the digital ecosystem. Businesses should also expect growing scrutiny of recommendation algorithms and engagement-driven design features, as well as the effectiveness of existing safeguarding measures.

This is a political argument that is leading down one path – and that is on the side of restrictions on children’s access to social media.

The government’s hesitancy to invoke such an interventionist ban is likely to come under growing pressure from politicians from across the political spectrum who are eager to introduce greater protections for children online, including through new age restrictions. The government cannot afford to weather another scandal in this area. The direction of travel appears clear, but the details remain up for debate. Organisations with a stake in the outcome should ensure their voice is part of the conversation, helping to shape a regulatory framework that is both effective and proportionate, and that properly reflects the practical, commercial and technical implications of impending policy change.

Community pharmacy settlement brings stability, but long-term challenges remain

As a former Pharmacy Minister, I watch the annual community pharmacy contract negotiations with interest because I know how important they are. This year’s settlement is notable for one reason above many in that it was agreed! That may sound like a low bar, but in today’s NHS it is anything but.

At a time when ministers find themselves in dispute with almost every part of the health workforce, the fact that Government and Community Pharmacy England have reached an agreement matters.

Negotiation remains preferable to imposition. It provides stability, certainty and, perhaps most importantly, a platform for future reform. The settlement itself is better than many in the sector (including me) were expecting. Indeed, compared with the rest of primary care, community pharmacy has secured one of the stronger funding settlements available anywhere in the NHS.

Minister Stephen Kinnock deserve praise for recognising that pharmacies cannot carry on indefinitely with rising costs. The increase in funding, the uplift in retained medicines margin and the write-off of historic over-delivery all sit on the positive side of the ledger.

But we should be honest about what this settlement is – and what it is not.

It is not a recovery plan. The uncomfortable truth is that a decade long funding gap – which I absolutely take my share of responsibility for – has not been closed. The additional investment announced for 2026/27 is largely consumed by increased activity levels and of course inflation. This matters because while the settlement should help stabilise the sector, I suspect it will not halt pharmacy closures.

There is another challenge too. I have great respect for Community Pharmacy England but there will come a point where it must decide whether it believes a deal is acceptable or not.

Last year, and now this, we hear of an agreement reached quickly followed by explanations setting out why the agreement is not good enough. I understand why this occurs, but it is not a position that can be sustained indefinitely and many in the sector will feel that. Ministers won’t much care so long as it’s done and they will come to rely on that.

At some point, the sector, government and negotiators alike need true alignment on what success actually looks like. The government’s clear priority in this settlement is independent prescribing. As a manifesto commitment and a central part of the neighbourhood health agenda, it is easy to see why ministers are keen to deliver here.

The principle is absolutely right. For years I have argued that community pharmacy is one of the NHS’ most underused assets. Everyone should want pharmacists diagnosing, prescribing and managing more patients – ‘hospital to community’ as they say.

My concern is whether the funding stamped on this settlement will be enough to deliver independent prescribing at a meaningful scale. Training people is vital. Creating the capacity, infrastructure and incentives to make independent prescribing a systemic part of community pharmacy practice is another challenge.

My verdict? This is a better deal than many anticipated and best in class in primary care. It provides some level of stability and demonstrates that constructive negotiation is still possible with this government.

But stability is not transformation.

The question facing us all is whether the settlement represents the first step towards a realised clinical future for community pharmacy – or merely another year spent managing decline, albeit a little more slowly.

This article from Steve Brine also appears at the Chemist + Druggist online magazine.

View from the US: the Republican congressional agenda

Erin Caddell of GK Strategy’s American partner Anchor Advisors unpacks the Republican congressional agenda ahead of the midterm elections taking place in November

Over the decades, American conservative political thought has often manifested itself in treatises that have called for sweeping policy changes, often employed as rallying cries heading into elections. The Mandate for Leadership, published in 1979 by the right-wing think tank Heritage Foundation, laid the groundwork in part for Ronald Reagan’s presidency starting in 1981, detailing proposals for lowering regulations on industry, reining in the influence of the federal bureaucracy and cutting taxes to spur economic growth that continue in conservative orthodoxy to this day. The 1994 Contract with America served as the blueprint for then-U.S. Rep. Newt Gingrich and his GOP colleagues to seize control of the House of Representatives later that year for the first time in 40 years, proposing a series of reforms to social programs, tax and spending cuts and changes in the workings of government itself. And Project 2025, chaired by Heritage with support from numerous U.S. conservative groups, provided a detailed plan for a conservative presidency, from domestic to trade to foreign policy, many elements of which have been enacted or attempted in Trump’s second presidential term.

With the U.S. midterm elections now less than six months away, what is the conservative manifesto of 2026? It is notable that across a number of conservative groups aligned with the Trump Administration and current GOP leadership in Congress – Heritage, America First Policy Institute, Conservative Partnership Institute, American Compass – there exists no recent document summarizing an overarching conservative policy vision. Yet with all 435 members of the House of Representatives and one-third of the Senate up for election in November, it is valid to ask what more the GOP hopes to do should it defy history – as we have pointed out in prior editions of this column, the president’s party has lost House seats in 18 of 20 midterm elections held since 1946 – and maintain control of both houses of Congress for the final two years of Trump’s second term. Even if Republicans lose control of the House and/or the Senate, the policy proposals they put forth today will guide their actions as a minority party in Congress; the ways in which they support Trump’s executive actions in 2027 and 2028; and even, yes, how the party moves beyond the Trump presidential era with a new Republican candidate for president in November 2028.

To address this question, we focus on a January 2026 report, “Restoring America’s Golden Age”, released by the Republican Study Committee (RSC), a group of 188 conservative House members (87% of the total 217 current House Republicans). The RSC report is structured as a high-level annual federal budget proposal. Continuing the spirit of the Department of Government Efficiency (DOGE) initiative early in Trump’s second term, the RSC identifies numerous federal programs for funding reduction or elimination it views as wasteful or unnecessarily driven by progressive ideology (see below).

Select programs targeted for reduced or zero funding by the Republican Study Committee

Program	Agency
National Institute of Food and Agriculture	Agriculture
Office of the Under Secretary of Farm Production and Conservation	Agriculture
Climate Hubs	Agriculture
Manufacturing Extension Partnership	Commerce
National Institute of Standards and Technology	Commerce
National Science Foundation	NM
Environmental and Natural Resources Division	Justice
Equal Employment Opportunity Commission	NM
Office of Clean Energy Demonstrations	Energy
Advanced Research Projects Agency – Energy (ARPA-E)	Energy
State and Community Energy Programs	Energy
Federal Insurance Office	Treasury
Entrepreneurial Development Program	Small Business
EPA Research and Development	Environment
Diesel Emissions Reduction Act Grants	Environment

Source: Republican Study Committee, Restoring America’s Golden Age, 07.01.2026

We detail two of the policy themes outlined in the report we view as especially relevant for US-focused investor and corporate clients of Anchor and GK: tax and defense policy:

1. Tax – don’t get too comfortable. The RSC report makes clear that Republicans continue to view the tax system as an activist policy tool even following last year’s passage of the One Big Beautiful Bill (OBBB), which expanded and made permanent a number of the corporate and individual tax cuts enacted during Trump’s first year as president. The report speaks glowingly of Trump’s decision on his first day in office in his second term to withdraw from a deal negotiated by the international Organisation of Economic Co-operation and Development (OECD) during the Biden Administration to impose a global minimum tax rate and other restrictions on multi-national corporations. RSC members and other critics argued the OECD deal was unfair to U.S.-based international corporations. In response, RSC member Rep. Jason Smith (R-MO), chairman of the tax-writing House Ways & Means Committee, introduced a bill in 2025 to impose retaliatory taxes on U.S.-active companies and investors whose countries levy selective taxes on U.S. firms, targeting in particular the digital services taxes (DSTs) that have been imposed on multinational tech firms by the UK and some EU Member states. Nicknamed the “revenge tax” or the Section 899 tax for the new title of the U.S. code it would have created, global investors breathed a sigh of relief when the provision was removed from the OBBB following opposition from a number of foreign entities active in U.S. markets. However, the RSC whitepaper is one reminder that the protectionist Republican sentiment that led the Section 899 bill to be proposed is still very much alive within the conservative Republican caucus, and could return under a future GOP-controlled Congress or White House. The RSC budget also supports other tax policies that reflect the populist, anti-corporate sentiment prevalent in today’s GOP, including ending the tax-exempt status of bonds sold to finance professional sports stadiums.

2. Defense – Hawks unbowed. Even before the start of the U.S. and Israeli military action against Iran in late February, a number of Republicans had joined Democrats in criticizing President Trump’s January 2026 proposal to increase U.S. defense spending in the coming fiscal year to US$1.5 trillion, some 44% higher than current levels. The RSC proposal is a good reminder that while some in the GOP argued Trump’s number was too high, support for the U.S. defense sector runs deep among conservative Republicans. The RSC whitepaper is supportive of numerous new defense spending initiatives, from expanded missile production to accelerated shipbuilding, enhanced cyber-security defenses to increased support for domestic rare-earths production to reduce dependence on China as a source of critical minerals needed for military equipment. Interestingly, the RSC report endorses “sustained American support for our NATO allies,” including funding for “frontline NATO states through defense cooperation and deterrent capabilities – one area of potential daylight between the House GOP conservatives and their president. But “Restoring America’s Golden Age” highlights that support for the U.S. military – and higher defense spending – remains a core tenet of both the Trump Administration and congressional conservatives (the RSC has released several statements supporting Trump’s Iran strategy since the war’s start). Should Republicans maintain control of Congress into 2027, Trump and his allies would likely take another run at securing a big jump in defense spending during his last two years as president, regardless of the Iran conflict’s outcome.

Growth vs Guardrails: Reeves and the FCA’s contrasting visions for consumer finance regulation

GK’s Joshua Owolabi assesses Chancellor Rachel Reeves’ and FCA Chief Executive Nikhil Rathi’s differing perspectives on consumer finance regulation and the potential impact on the sector

The Chancellor Rachel Reeves insists that the government’s main objective is to facilitate economic growth and believes that the UK’s regulatory bodies should support this objective. In January 2025, the Chancellor wrote to several regulators, including the Financial Conduct Authority (FCA), directing them to ‘tear down regulatory barriers’ that hold back economic growth. This view is likely to have a significant impact on the regulation of consumer finance during the rest of this parliament (expected to end in 2029).

Since the 2008 financial crisis, the FCA and its predecessor the Financial Services Authority, have generally preferred to strengthen consumer finance rules to prevent the harm to consumers that occurred following the crisis (e.g. consumers being forced into high-interest loans without fully understanding the long-term impact on their finances). The pressure placed on the FCA could result in a reversal of long-term regulatory trends in the consumer finance sector, reducing compliance requirements on businesses across the sector.

Across several consumer finance sub-sectors, such as mortgages, motor finance, and personal loans, the FCA has spent the last decade implementing stricter measures to prevent the mis-selling of products and services, and to protect consumers from taking on excessive debt. These efforts culminated in the implementation of the Consumer Duty in July 2023. The Duty is a regulatory framework requiring firms to prioritise consumers’ needs. Firms must proactively identify the specific needs of each of their customers and prevent risks that could result in financial harm. This involves providing customers with clear financial advice on products like hire purchase agreements, which are common in the motor finance industry, so that they can make informed choices. It also involves making it as easy as possible for customers to switch or cancel products without incurring unnecessary debt.

Rachel Reeves’ belief that financial services regulation should encourage innovation, competitiveness, and increased risk taking in lending and investment is at odds with recent FCA consumer protection measures. This has resulted in contrasting messages from Reeves and FCA Chief Executive Nikhil Rathi. While Rathi has said the FCA will support innovation and economic growth, he has voiced concerns that the push to prioritise growth will result in an increase in financial scandals. He has warned the government and parliamentarians that there may need to be an ‘enduring acceptance’ of these failures as regulations are relaxed. Rathi’s concern is not a surprise. Since his appointment as Chief Executive in 2020, he has consistently emphasised the importance of consumer protections and market stability. Under his leadership, the FCA has prioritised improving affordability checks so that firms are not just doing basic credit checks and consumers understand the true cost of products.

An area where major change is likely to occur, despite Rathi’s reluctance, is in the balance between regulation and access to credit. Reeves has argued that excessive regulation can make it harder for consumers to borrow money, slowing economic growth. As a result, the government announced in May 2026 that it would reform the Consumer Credit Act 1974 (CCA), which established standard procedures for credit and hire agreements and sets out consumers’ rights when dealing with businesses in those sectors. The government says that its reform of the CCA is focused on modernising consumer credit rules so that they better reflect the realities of today’s digital financial market. It has stated that its main objective is to improve the quality and clarity of information provided to consumers. The government argues that current disclosure requirements are outdated, overly complex, and often overwhelm borrowers with lengthy legal documents that are difficult to understand. The government has said that the CCA reforms will help consumers make better-informed financial decisions and reduce the risk of individuals taking on unsuitable or unaffordable credit.

The government is likely to say that the primary reason for reforming the CCA is its desire to protect consumers. However. the push for economic growth and deregulation in financial services is what is truly driving these reforms. In reality, the core goal of the reforms is to reduce the number of detailed regulatory requirements that are entrenched in legislation and to give the FCA more power to amend regulations quickly without the passing of new legislation. By giving the FCA greater responsibility for setting consumer credit rules, the government hopes to create a more agile regulatory system that can respond more quickly to innovations in financial products, such as fintech and embedded finance. This is likely to lower compliance costs for businesses in the consumer finance market and reduce the likelihood that they fall foul of rules relating to the way in which credit agreements are written or structured.

Ironically, the changes to the CCA, including the increased role of the FCA in modernising credit rules, will place greater power in the hands of Rathi to regulate consumer finance, despite the difference in views with the Chancellor. Rathi will now need to oversee the implementation of changes to the CCA, while also overseeing other consumer finance reforms that have already been announced. For example, the FCA has said that it will complete a review of the Consumer Duty before the end of 2026 to understand firms’ approaches to monitoring consumer outcomes and how well consumers understand risk. The FCA believes that some firms are struggling to provide clear evidence that they are improving outcomes for consumers or that their advice is specific to each individual customer’s needs. This means that there is a scenario where firms will have requirements relating to affordability checks reduced by the CCA reforms, only to see new requirements placed on them to collect data on consumer outcomes following the review of the Duty. The implementation of both these reforms is an unenviable task for Rathi, as he seeks to balance pressure from the Treasury to support economic growth with his own regulatory agenda. The FCA will need to engage with firms to ensure that they are fully aware of the expected changes to the regulatory framework and that firms are not confused by the mixed messaging from the Treasury and the regulator itself.