Political survivor continues at Health

After a morning of fevered speculation to the contrary, Jeremy Hunt is staying at the Department of Health. When he was first appointed, there were two common assumptions. Firstly, with no background in health or evidence of extensive thought on the topic, there would be no clear agenda he would doggedly pursue. Secondly, he would seek to keep health out of the headlines after the tumultuous Lansley years.

On the former, we have all been proved wrong. Perhaps the need to prepare the Government’s response to the Francis Report led Hunt to discover the quality and safety agenda or perhaps this was always a driving (if hidden) passion. Either way, he picked it up and ran with it. There are many architects of the new Care Quality Commission, but none would have been given the chance to do their work without his political leadership. In the face of severe financial challenges, he has refused to take his foot off the quality and safety pedal, despite accusations that it was his priorities that were fuelling deficits. The result has been a shift in priorities; whether this survives the financial reset remains to be seen.

On the latter point, if the task was to keep health quiet, then Jeremy Hunt failed. And failed spectacularly. From stories about failing hospitals and financial crises to the dispute with junior doctors which is still not resolved and will – for many – define his stint at Health, the NHS has proved to be noisier than ever. However, this is to ignore his political achievement. Labour may have retained its historic lead on the NHS, but Hunt did enough to neutralise it as a political issue. Health was never going to be an election winner for the Conservatives, but Jeremy Hunt did enough to ensure it was not an election loser. Following the controversies over the Health and Social Care Act and a period where expenditure flatlined and the gap between demand and resources grew, this is no small accomplishment.

Health, much like the Home Office, is a brief where things happen. More often than not it is a graveyard rather than a springboard for political careers. Jeremy Hunt’s longevity demonstrates both his political skill, but also the recognition of what a tough job Health is. Out of money, with performance plummeting (the 18 week target has now been breached) and serious industrial relations ongoing, this will not have been an attractive job for ambitious ministers seeking a move.

There is, of course, much unfinished business. The financial ‘reset’, delayed from this week and surely at risk if there had been a change in Secretary of State, is now likely to go ahead. With Hunt still at the helm, there is less likely to be a radical change of direction on the money.

When he left Downing Street, Jeremy Hunt professed himself to be pleased. He will, however, know that his toughest days at Health are still to come.