We recently ran a series on the reforming Conservative Ministers who are delivering Grown-Up Government: Michael Gove, Theresa May, Francis Maude, Iain Duncan Smith and Chris Grayling. Does Jeremy Hunt belong among them?
It can be argued that the Health Secretary’s role is different. All five of the Secretaries of State named are carrying out structural reform or confrontational change (or have been). Grayling has battled with the probation service over rehabilitation, Duncan Smith has the Universal Credit, Maude has locked horns with the civil service, Gove overhauled exams and expanded academies, May has got to grips with the police. By contrast, Hunt was sent to Health to quieten it down rather than stir it up, after the turbulent experience of Andrew Lansley and his Health Bill.
However, there is an intriguing counter-case. Hunt maintains that reform and conflict don’t have to go together – and points to his adoption of two tools from the Gove textbook: transparency and accountability. The Health Secretary’s drive to bring back the family doctor isn’t simply about persuading fewer people to make A & E their first port of call (and thus stave off the three-times-avoided-to-date NHS “winter crisis”). It is also part of a deliberate effort to raise standards. Just as teachers have Ofsted, so doctors will have Hunt’s Care Quality Commission (CQC).
The CQC will not confine itself to GPs. It is already at work in hospitals. Eighteen of them have been put in special measures – with crack squads parachuting in from the centre to raise standards. Meanwhile, the Health Secretary is planning to expand the MyNHS data information service, which shows quality indicators for hospitals, social care, public health and so on. Patients may eventually trawl it, but Hunt’s real target audience is NHS professionals themselves. The Health Secretary believes that providing data raises standards, and claims that 5000 more nurses are now in place as a result. His speech to the King’s Fund today on personalising records is another means to this end.
Amidst a service in which 70 per cent of staff vote Labour – or so the Department of Health says – change that works can only come with consent. It is true that the NHS cannot continue indefinitely to have its budget protected while other departments continue to be squeezed, and Hunt is not introducing the kind of startling changes – such as more co-payment – that one suspects a future Labour Government will eventually have to make. But he is quietly working away to his end. Lansley wanted to devolve many decisions to NHS England. By contrast, Hunt is interventionist – and political.
The Health Secretary wants to know each “never incident” in the NHS on a day-to-day basis, in an echo of Nye Bevan listening out for falling bedpans. And he also sees his task at the centre as taking the fight to Labour over the Mid-Staffs horror and the state of the NHS in Wales.
Labour has enjoyed a poll lead over the Conservatives on health for time out of mind. Hunt’s task is to stop it getting larger and to start leading a counter-attack. This site’s readers seem to think he is succeeding: he is now fifth from the top in our Cabinet league table. But there is that final winter under this Government to come.