At last, a Health Secretary who puts patients first

Published in The Daily Mail (December 27th, 2013)

As in every other walk of life, the ending of the political year offers an opportunity to pause and reflect on the previous 12 months. Hostilities in Westminster have been typically rumbustious — but, for all the sound and fury, little has changed.

The same three party leaders are standing in largely the same position in the polls, two of them locked in the increasingly-fractious embrace of Coalition. The electoral arithmetic still favours Labour, for all Ed Miliband’s wobbles, as the 2015 General Election looms on the horizon. Yet beneath the surface, the tectonic plates may be quietly shifting — and in unexpected ways.

Ask which Tory minister has done most to put Labour on the back foot, and many might nominate  Chancellor George Osborne. Certainly, he has a renewed swagger after economic results that appear triumphantly to vindicate his austerity policies, making his opposite number Ed Balls look grotesquely out-of-touch. Some might, perhaps, pick the energetic Education Secretary Michael Gove or the enigmatic Home Secretary Theresa May.

Yet one surprising figure stands out: Health Secretary Jeremy Hunt, who has placed himself as the patient’s champion as he seeks to salvage our National Health Service.

Crucially, Hunt’s efforts have seen Labour lose the moral lead on what has traditionally been its most hallowed ground. He has also played a key role in making the public rethink what for too long has been a self-delusion over the sanctified status of the NHS.

What makes Hunt’s success all the more striking is that 14 months ago, many commentators and rivals, surprised he was still in the Cabinet, had written him off as an over-promoted lightweight.

Undeniably, his performance as a minister had been pretty forgettable, cruelly symbolised by the moment when Radio 4 presenter James Naughtie, in an awful Spoonerism, mangled Hunt’s name with his title as Culture Secretary.

Then Hunt was left clinging to his job by his fingertips after the unhealthy closeness of his relationship to Rupert Murdoch’s media empire was exposed in a series of embarrassing emails and toe-curling texts.

Indeed, I was perplexed when Downing Street insiders endlessly praised his abilities. Hunt is highly personable, presentable and plausible on TV, but I was more struck by the obvious lack of connection with his job in charge of the nation’s arts and sport.

My scepticism was widely shared, and there were raised eyebrows when Hunt was promoted to Health Secretary in a Cabinet reshuffle last year rather than, as many suspected he might be, sacked.

Yet from the start he did something rare. He planted himself on the side of patients in both word and deed, in place of the usual appeasement of the professional bodies who have dominated discussion on the NHS for so many years with such tragic consequences.

The harsh truth is that from its inception, the NHS has been run to suit the needs of people working in it — and politicians were terrified of challenging them, given the public’s respect for doctors and nurses.

Labour’s Aneurin Bevan famously ‘stuffed the mouths’ of doctors with gold to buy support for the foundation of the NHS, a tactic repeated by Tony Blair when he handed out contracts making our GPs the highest paid in the West while abandoning out-of-hours work.

In hospitals, all-powerful consultants used to take a perverse pride in the length of their waiting lists since they said it proved they were popular. At every suggestion of reform, unions screamed in protest that the service was being wrecked.

The apogee of all this came with last year’s Olympics, when the world looked on bemused as our opening ceremony spent 20 minutes praising a public service that was actually a disaster area.

As the parent of a profoundly-disabled child, I had seen the alternative reality of how bad care could be for highly-vulnerable patients behind Danny Boyle’s Disney-like fantasy. I had been disturbed to witness arrogance, deception, rudeness, poor care and potentially fatal mistakes — alongside instances of great dedication and kindness, of course, from doctors and nurses.

When politicians collude with professionals to sanctify a service, corrosive behaviour calcifies under the surface — with those fighting for change or highlighting mistakes being ignored.

This became clear after it emerged that patients at two Mid-Staffordshire hospitals suffered shocking mistreatment, followed by separate scandals that revealed uncaring nursing staff, cruelty in care homes, silenced whistleblowers and failed managers being given huge pay-offs.

The great merit of Hunt’s response was that — overwhelmingly — he sided with the patients rather than those who had failed them. He ordered tough new inspection regimes for hospitals, GPs and social care.

He confided in a friend: ‘My mission is to be honest for the first time with the public that there are real problems within the NHS, without compromising the founding principles of equal care for duke and dustman.’

He was particularly struck by a conversation with Paul Corrigan, a former adviser to Tony Blair, who said the key moment in Labour’s attempts to raise school standards was when it became politically possible to admit that some places were ‘failures’.

He also says his time as a beleaguered Culture Secretary has inspired him to act with more speed since he had seen the unpredictable nature of politics.

Above all, Hunt understands that all patients, especially the elderly and disabled, want identified medical staff in charge of their treatment rather than being passed from pillar to post. As he wrote in Tuesday’s Mail, every hospital bed now will bear the name of the responsible doctor and nurse.

Therefore he has promoted patient power and a culture of openness while demanding better care. His forceful words are backed by his decision to spend one day a week on the health frontline making beds, answering phones and even visiting a mortuary, seeking to understand the fiendish complexity of Europe’s biggest employer.

This approach challenged a service where 14 out of the 150-odd acute hospital trusts in England and Wales have now been placed in special measures for their inadequacy.

Not only is this long overdue but it’s also smart politics. For Labour looks badly wounded — with Hunt’s opposition number, Andy Burnham, having been embarrassingly exposed as one of the Labour health secretaries who allowed shoddy practices to fester.

It was, after all, Labour — self-styled party of the NHS — that ignored repeated warnings from patients and staff about the Mid-Staffs horrors, then refused calls for a public inquiry that could have saved scores of lives.

Hunt has pressed ahead in his quietly forceful style despite squeals from staff unions and accusations of meddling from jobsworth bureaucrats, oblivious to their own records of failure. 

Only a few days ago, he was criticised for personally telephoning hospital bosses who had missed targets for A&E treatment. Yet, far from being grounds for censure, many find such hands-on management deeply reassuring.

His efforts ensure Hunt has recovered some ground for his party on its most vulnerable issue. This follows the success achieved by David Cameron while in opposition (with his personal support for the NHS) which was deeply damaged in government by the woefully-bungled reforms under Hunt’s predecessor Andrew Lansley.

It has to be said that Hunt has made some mistakes, such as overseeing the botched launch of the new 111 helpline and — unforgivably — standing by Sir David Nicholson, the NHS chief who should have been sacked over the Mid-Staffordshire scandal.

Also, the ongoing crisis in A&E could explode — particularly with the shortage of consultants reported today by the Mail. And there is a deafening lack of discussion over how Britain can afford a modernised health service in which costs are outstripping budgets. 

But at least we have in Jeremy Hunt a Health Secretary who bravely refuses to treat the National Health Service as a sacred cow, who recognises its imperfections and who is attempting to put patients first.

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