How long can Jeremy Hunt duck blame for the NHS’s failings?

http://www.theguardian.com/society/2015/jul/21/jeremy-hunt-duck-blame-nhs-failings

Version 0 of 1.

Jeremy Hunt’s big speeches carry the same recurring message. The health secretary is a huge fan of the NHS, admiring of its many strengths and passionate about its importance in national life. But he is also the champion of patients, safety, transparency and ever-higher standards of care, and the scourge of anyone and anything he deems to be thwarting his ambition to create the world’s best, safest, most open, most efficient and soon-to-be 24/7 health service. With few exceptions, the media laps it up and rarely challenges Hunt’s narrative. He is a class act, in that sense at least.

Related: Mr Hunt, you’ve got us doctors wrong. That’s why I set up #iminworkjeremy | Anonymous

Last week’s speech at the King’s Fund, which he called “my most important as health secretary”, capped two months of post-election initiativitis and was a classic of the genre. It had big, bold themes (“the democratisation of healthcare”); eyecatching announcements (Martha Lane-Fox to drive the take-up of digital health technology); cheeky claims (that the Conservatives are now “the true party of the NHS”); and, of course, a big story: that he will impose a new contract on well-paid, inflexible consultants if they don’t agree within six weeks to work weekends to help create the seven-day NHS, which the “out of touch” British Medical Association obstructs so shamefully.

In the first of his three set-piece speeches since 7 May, to the NHS Confederation in June, Hunt gushed about being back for a second stint at the Department of Health. “I am incredibly grateful to have the chance to work with the NHS over this very challenging period in its history.”

Some of those who know him well tell a different story, of a cabinet member who hoped he was heading to a different office in the post-election reshuffle but finds himself – a classically short-termist minister – having to deal with a rapidly accumulating set of deep-seated, difficult issues, many of which he did nothing bold or meaningful to sort out in his first spell at the department. One close colleague talks about a series of “timebombs” – worsening staffing shortages, the impossibility of NHS England’s £22bn efficiency savings, the failure to build up health services outside hospitals, on which the future depends – which will go off sooner or later.

Hunt knows his initial post-Mid Staffs focus on safety and quality of care will not sustain him over the next few years, and that he needs a big new message. The NHS needs to put its house in order financially while somehow fulfilling David Cameron’s pledge of becoming the world’s first truly 24/7 health service. But there is a second, more subtle message underlying all of this: none of the NHS’s problems are Hunt’s fault.

Related: Jeremy Hunt raises doubts about long-term future of free NHS

Its large and fast-ballooning deficit? That’s because the regulator, Monitor and the Trust Development Authority, didn’t keep a lid on things, but they will now be merged into a new organisation (NHS Improvement) under new leadership. Ensuring the NHS is transformed to become fit for the future? That’s down to Simon Stevens and his wonderful Five-Year Forward View. Extra money? The government has guaranteed £8bn by 2020. Waste in the NHS? It needs to crack on with that now that Lord Carter has identified £5bn of potential savings, and patients must use finite NHS resources wisely. The rising toll of long-term conditions? People need to show more personal responsibility. Declining performance on key NHS waiting times, such as at A&E and for cancer treatment? That’s for NHS England to explain. A winter crisis? See above.

There is an obvious inadequacy to this partial, self-serving script. A chat with Norman Lamb, until recently Hunt’s ministerial colleague, elicits a few hard truths the health secretary will inevitably have to confront. Continued cuts to social care will continue to add to the NHS’s burden. The £22bn of savings won’t materialise, which could give the government a major problem and also mean the NHS will not be able to implement the new models of care everyone agrees need to be brought in, and need to work.

Without an agreed, cross-party plan to tackle all this, says Lamb, “I fear that the system will crash. And the consequences of that would be disastrous.” These are among the really important issues that Hunt should be talking about honestly, rather than constantly shifting blame. Reality will get him in the end.