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Jeremy Hunt narrowly survived the cabinet reshuffle – so what now? Jeremy Hunt narrowly survived the cabinet reshuffle – so what now?
(about 1 month later)
The scene: a bar not far from Westminster last Thursday evening, midway through Theresa May’s brutal realignment of the government she now leads. A big crowd of officials from the Department of Health, NHS England and other national NHS bodies, and health writers, had gathered to mark Sam Lister’s last day as the DH’s director of communications. Lister, a former health editor of the Times, has been a key member of Jeremy Hunt’s inner circle during the health secretary’s record 46-month stint at Richmond House.The scene: a bar not far from Westminster last Thursday evening, midway through Theresa May’s brutal realignment of the government she now leads. A big crowd of officials from the Department of Health, NHS England and other national NHS bodies, and health writers, had gathered to mark Sam Lister’s last day as the DH’s director of communications. Lister, a former health editor of the Times, has been a key member of Jeremy Hunt’s inner circle during the health secretary’s record 46-month stint at Richmond House.
Despite widespread respect and affection for Lister, the chat was more about his boss, Jeremy Hunt, the great reshuffle survivor who – despite earlier reports that he was being sacked – defied expectations when he was retained in post. Surprise among the top brass at the DH, NHS England and key NHS arm’s length bodies was matched by disappointment and no little frustration. They resent Hunt’s constitutionally improper attempts to control supposedly semi-independent bodies like NHS Improvement. They expected and wanted change.Despite widespread respect and affection for Lister, the chat was more about his boss, Jeremy Hunt, the great reshuffle survivor who – despite earlier reports that he was being sacked – defied expectations when he was retained in post. Surprise among the top brass at the DH, NHS England and key NHS arm’s length bodies was matched by disappointment and no little frustration. They resent Hunt’s constitutionally improper attempts to control supposedly semi-independent bodies like NHS Improvement. They expected and wanted change.
Related: NHS boss says promise of £8bn in extra funding may be far from enough
“We’re stuck with the bugger,” said one middle-ranking NHS official who is close to DH boss-class thinking. “Everyone at DH director general level was expecting him to go. Him staying was clearly not the plan, was it? And Hunt wasn’t desperate to stay; he wanted to go. So it’s a very strange situation.” Hunt’s “toxicity” over his handling of the junior doctors’ dispute, and alienation of the NHS workforce more generally, also cropped up regularly. A Tory MP had greeted Hunt’s reprieve thus: “It’s very brave of the PM to keep him.”“We’re stuck with the bugger,” said one middle-ranking NHS official who is close to DH boss-class thinking. “Everyone at DH director general level was expecting him to go. Him staying was clearly not the plan, was it? And Hunt wasn’t desperate to stay; he wanted to go. So it’s a very strange situation.” Hunt’s “toxicity” over his handling of the junior doctors’ dispute, and alienation of the NHS workforce more generally, also cropped up regularly. A Tory MP had greeted Hunt’s reprieve thus: “It’s very brave of the PM to keep him.”
Seen as a play, this is act III of Hunt at Health. He did well in his first stint – from September 2012 until last year’s general election – by majoring on overdue improvements to safety and quality of care in the wake of Robert Francis’s report into failings at Mid Staffs. Since 2015, he has fared much worse, though. He triggered an unnecessary row with trainee medics, antagonised hospital consultants, and continued spouting half-truths about NHS funding.Seen as a play, this is act III of Hunt at Health. He did well in his first stint – from September 2012 until last year’s general election – by majoring on overdue improvements to safety and quality of care in the wake of Robert Francis’s report into failings at Mid Staffs. Since 2015, he has fared much worse, though. He triggered an unnecessary row with trainee medics, antagonised hospital consultants, and continued spouting half-truths about NHS funding.
So what now? Hunt’s chances of making good depend on three things: his own talents, capacity for self-reinvention and a willingness to listen; how May and her new chancellor, Philip Hammond, want to play the NHS; and unforeseen or uncontrollable events, such as visible deterioration in care quality or a Brexit-worsened staffing crisis.So what now? Hunt’s chances of making good depend on three things: his own talents, capacity for self-reinvention and a willingness to listen; how May and her new chancellor, Philip Hammond, want to play the NHS; and unforeseen or uncontrollable events, such as visible deterioration in care quality or a Brexit-worsened staffing crisis.
Hunt’s in-tray contains plenty of risks and precious few opportunities for easy wins. The Commons health select committee this week demolished as fiction his insistence that the government has given the NHS all the money Simon Stevens asked for in the Five Year Forward View in 2014(Stevens already did that last month, albeit more subtly, in his speech to the NHS Confederation).Hunt’s in-tray contains plenty of risks and precious few opportunities for easy wins. The Commons health select committee this week demolished as fiction his insistence that the government has given the NHS all the money Simon Stevens asked for in the Five Year Forward View in 2014(Stevens already did that last month, albeit more subtly, in his speech to the NHS Confederation).
Ceaseless demand, continuing cuts to social care and and the inadequacy of medical provision outside normal working hours gives little reason to think that NHS England and NHS Improvement’s soon-coming joint plan to “reset” the service’s finances will get the provider deficit down to the hoped-for £250m gap. May obviously had her reasons for reappointing Hunt. So will she and Hammond surprise us by increasing the NHS’s budget this autumn? Political necessity may mean they have to. Public appetite for greater NHS investment, revealed in the EU referendum, makes that harder to resist, though in the uncertain post-Brexit financial outlook is harder to deliver. The likelihood, as yet unappreciated, that the Stevens-ordered “sustainability and transformation plans” will mean widespread reconfiguration of hospital services – and thus political trouble, starting this autumn – will also test May’s and Hunt’s skills.Ceaseless demand, continuing cuts to social care and and the inadequacy of medical provision outside normal working hours gives little reason to think that NHS England and NHS Improvement’s soon-coming joint plan to “reset” the service’s finances will get the provider deficit down to the hoped-for £250m gap. May obviously had her reasons for reappointing Hunt. So will she and Hammond surprise us by increasing the NHS’s budget this autumn? Political necessity may mean they have to. Public appetite for greater NHS investment, revealed in the EU referendum, makes that harder to resist, though in the uncertain post-Brexit financial outlook is harder to deliver. The likelihood, as yet unappreciated, that the Stevens-ordered “sustainability and transformation plans” will mean widespread reconfiguration of hospital services – and thus political trouble, starting this autumn – will also test May’s and Hunt’s skills.
Without a change of tack, Hunt is likely to become the minister for the visible deterioration of the NHS – think Stephen Dorrell 1995-97. To survive and prosper, he will have to start being honest about how serious NHS understaffing is, stop depicting health professionals as lazy or unprofessional, somehow raise flagging staff morale, get real about delivering a “truly seven-day NHS” with no extra money or bodies, and start to offer hope that an NHS finally freed of austerity may once again be a place of pride, progress and improvement for staff, patients and maybe even politicians.Without a change of tack, Hunt is likely to become the minister for the visible deterioration of the NHS – think Stephen Dorrell 1995-97. To survive and prosper, he will have to start being honest about how serious NHS understaffing is, stop depicting health professionals as lazy or unprofessional, somehow raise flagging staff morale, get real about delivering a “truly seven-day NHS” with no extra money or bodies, and start to offer hope that an NHS finally freed of austerity may once again be a place of pride, progress and improvement for staff, patients and maybe even politicians.