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Continuity represents both a challenge and an opportunity for our ambitious Health Secretary

Ben Jones

Following the ‘night of the blonde knives’, Secretary of State for the Department of Health and Social Care, Matt Hancock MP is one of few Cabinet Ministers left standing.  The temporary feeling of continuity at DHSC is welcome but may not endure.

Matt Hancock is likely to be disappointed having missed out on one of the Great Offices of State. It follows a frenzied summer for the Health Secretary, in which he launched his own leadership campaign, which was then aborted so he could declare loyalty to the favourite, and was omnipresent across the media in defending the eventual winner, Boris Johnson.

But what he lacks in promotion he gains in extension: remaining at Health and Social Care allows him to see through some of the priorities from his first year in the role to completion.   After succeeding Jeremy Hunt at DHSC just over a year ago, Hancock chose three key NHS priorities as prevention of ill health, the greater adoption of technology and investing in workforce.

Alongside these, the new Prime Minister has unexpectedly put the NHS near the top of his agenda, with three big health pledges made outside Downing Street that will breathe new life into the debate.  Mr Hancock’s task is to turn these pledges into workable policies to sell both within the NHS and to the public.

So as Hancock returns to Victoria St, how much progress has he made against his original pledges, and where is further attention required?

Prevention of ill health

The prevention Green Paper was rushed out at the last minute under pressure from the outgoing Prime Minister, Theresa May. As a result, it has struggled to gain traction amid reports of Johnson’s opposition to the sugar tax and many of the other policies in the Green Paper.  While the public are generally supportive of wider public health initiatives, the Prime Minister and Cabinet colleagues are more sceptical and favour a laissez faire approach. Indeed, Boris has said he will scrap further ‘sin taxes’ but it will be up to Mr Hancock to actually deliver a policy that suits all parties here.

Hancock progress 2/5

Greater adoption of technology

This is arguably the area that Mr Hancock has seen the most progress.  If he had left the Department, doubt would have been cast over the future of NHSX, the formation of which seemed a personal crusade.  Although Hancock’s belief that technology can solve a lot of problems affecting the NHS has supporters, he will need determination to sell the idea in a way that permeates across the system.

Hancock progress 4/5

Workforce

The Interim NHS People Plan, whilst well-written, contained no new spending commitments.  Attention is now firmly fixed on the full review to come after the October Budget, which itself will be dependent on Brexit negotiations.  There are still many more questions than answers here, across issues ranging from immigration policy to restoring nursing bursaries.

Hancock progress 2/5

What are some of the upcoming challenges?

While Mr Hancock might be disappointed now, a general election in the next 12 months will probably lead to another change in either the Cabinet or a change in Government.  Ever the optimistic self-starter, he will be keen to get back to business whilst keeping one eye on future opportunities.  DHSC has been reported as the most prepared Government department for a no-deal Brexit, but Hancock needs to ensure this continues as 31 October approaches.

He will also have to manage other political sensitivities like social care.  While the new Prime Minister has said he will fix the social care crisis “once and for all”, Mr Hancock faces a difficult task on delivering this in practice.  Having been closely involved in the delayed Social Care Green Paper, Hancock at least benefits from prior knowledge of the issues and possible solutions.

Regardless of the timing of a general election, the Conservatives’ running of the NHS will be guaranteed to feature as a key campaign issue.  Ironically, the tenure of Boris Johnson in Downing St could therefore depend on how competently Hancock can run the Department he so desperately wanted to leave.