As with all new Prime Ministers, Theresa May will enjoy a political honeymoon and, with the Labour Party in disarray, will have some breathing space as she establishes her premiership.
However, she will inherit an overflowing in-tray. Once she has appointed her Cabinet and junior ministerial team, her attention will turn to negotiating Brexit and, more immediately, maintaining calm in the markets and establishing her political authority. She will also need to navigate thorny domestic issues, not least in the field of health.
Theresa May is a highly experienced politician and the longest-serving home secretary since Henry Matthews in 1892. Nobody is questioning her competence or endurance, but how will she fare – and what does she think – on health issues?
May has little heritage on health and it remains to be seen as to whether it will be as much of a priority for her as it has been for David Cameron. As Home Secretary, May’s public statements on the NHS have almost all been tangential: discussing immigrants’ rights to access NHS services, the need for better mental health provision to ensure that individuals with mental ill health do not end up in police cells and the need for blue light collaboration to increase the efficiency of the emergency services.
We can expect her to approach health issues with characteristic caution. An immediate consequence of her appointment is that the Department of Health will delay the much-trailed ‘reset’ of NHS finances – which had been scheduled for tomorrow – and, with it, a much needed focus on restoring financial control in the NHS. It remains to be seen how long it will take for the new Prime Minister and her team (including a new Health Secretary?) to accept the protestations of the Department of Health that an announcement of ‘cuts’ to the NHS has to be made.
One thing the health sector will need to get used to is a lower priority for some of David Cameron’s personal priorities in health. Support for access to cancer drugs, funding for the 100,000 Genomes Project and action on dementia will all have to earn their place in the new Prime Minister’s heart and head, which they took for granted under her predecessor.
Theresa May’s views on health are, however, not a blank canvas. She was diagnosed with type 1 diabetes in 2012 and her experiences in managing her condition, as well as her interaction with NHS services, will inevitably inform her thinking. As a patron of the National Rheumatoid Arthritis Society (NRAS), a charity based in her constituency, she will be well-briefed on the issues involved in staying in work with a long-term condition. Likewise, her role as a constituency MP will have brought her plenty of exposure to the issues experienced by struggling hospitals (Wexham Park is one of her local hospitals).
It is also worth noting that Fiona Hill, one of Theresa May’s closest advisers and someone who is expected to follow her into Downing Street, served as the Conservative Party’s health press officer during the mid-2000s. Her experience of the issues might be a little dated, but Hill nonetheless has an instinctive grasp of the politics of health.
The absence of an extended leadership contest has denied Theresa May the opportunity to make a commitment to further NHS funding. But her advisors will know that with NHS spending featuring prominently in the referendum campaign and NHS finances teetering on the brink, this will be an issue that will not go away. Brexit might mean Brexit, but it must surely also mean more money for the NHS. The question will be when, how much and with what strings attached to it.
Then there is the issue of the junior doctors. It remains to be seen what action the BMA may take in response to the decision of its members to reject the contract on offer. Theresa May already has experience in taking on public sector unions through her tussles with the Police Federation at the Home Office. It is unlikely that she will want to contemplate further concessions on the contract, but this will be a big call for her and whoever occupies the hot seat at Richmond House to make.
Health may not be close to the top of the new Prime Minister’s agenda. But events are likely to mean it cannot stay that way for long.