Life after Jeremy

I remember when Jeremy Hunt was seen as the pragmatic, non-ideological alternative to Andrew Lansley. But since the junior doctors dispute blew up, he appears to have lost his political marbles.
He’s never really understood health, but as long as he kept quiet that didn’t matter too much: Lansley had disconnected the levers connecting Whitehall to the front line anyway. But since the dispute has forced him out in the open, his lack of understanding and respect for the complicated and messy business of healthcare has been exposed. His latest outburst about Googling children’s rashes is just the culmination of months of cloth-eared pronouncements.
For a while on social media, the more forthright medical types have been calling for him to resign. I doubt this will happen, but there seems a good chance that he will be reshuffled away, given that doctors’ loathing of him is now a significant barrier to resolving the dispute. But would whoever comes in be any better?
I hate to break it to people, but the new health Secretary would still be a Tory. Let’s say for the sake of argument that Nicky Morgan is moved from education, which seems the best guess given how well she cleared up Gove’s mess.

She would still be operating within a stagnant funding envelope, with rising demand and a manifesto promise of 7 day services. She won’t get more money from the treasury. She could try to drive public health, prevention and self-care up the agenda in order to limit growth in demand, but that takes years to bear fruit, and Hunt’s rash debacle shows how careful politicians have to be when taking work away from doctors (clue: they don’t like it).

So she needs to finesse the 7 day services issue. In one sense this seems possible- by making it clear that she’s only interested in safety at the weekend, not convenience, she can neutralise a lot of medical opposition to the plan. She might then be able to work with the Royal colleges and other organisations to come up with a plan.

Unfortunately, this may not help the juniors. Their hospital work is primarily about acute presentations, and with GP imploding, inevitably the NHS will need a lot of them at the weekends. Of course we could re-shape funding, sort out primary and social care and train other professionals to take on wider roles (but remember about taking work away from doctors…): all these laudable things take time, and Morgan will need bodies on the ground to keep things moving. She can’t do this without making weekend staffing cheaper, overall.

So Jeremy may well go in the spring… but having helped to remove him, the juniors might benefit least from his demise. Which is kind of typical.

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