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Jeremy Hunt: “It’s a rabbit hole to try and change how the NHS is structured”

The former health secretary and 2019 Tory leadership candidate on Blue Wall Toryism, health policy and social care.

By Anoosh Chakelian

This article was originally published in May 2022.

Jeremy Hunt’s impressive corner office in parliament has a Thames view that sweeps across hallmarks of the London skyline — the London Eye, the Shard, at least two bridges.

But it’s the interior that is most eye-catching. Lining the long window sills are photos of the Conservative MP — who served in three cabinet roles under David Cameron and Theresa May for nearly a decade — meeting the Archbishop of Canterbury, Bill Clinton, Prince William, the Pope, Posh Spice.

Russian dolls of the health secretaries leading up to Hunt (who was Britain’s longest-serving health secretary, in post from 2012-18) decorate a bookshelf; without his successors Matt Hancock and Sajid Javid up there, he’s still the biggest matryoshka. He even has framed the Spectator’s unpublished alternative cover for had he beaten Boris Johnson in the 2019 Tory leadership election — “Hunt wins”.

It is not décor coy about ambition.

Fitting, then, that Hunt was in the mood to reflect on his political future. During an interview on the New Statesman Podcast, the chairman of the Health and Social Care Select Committee said that he wouldn’t “rule out going back into front-line politics in the future”.

Would he serve in Johnson’s cabinet if invited at the next reshuffle? “I wouldn’t rule it out; it’s not top of my list,” Hunt replied. “I think Sajid Javid is doing a brilliant job as Health Secretary. I think he’s very committed. You don’t know what’s going to happen in the future in politics, but I am very happy where I am, doing what I’m doing.”

How about running for the leadership again? “Well, I don’t rule it out. I don’t think now is the best time for a leadership contest because we’re in the middle of a horrific war in Ukraine and Britain has been, I think to a lot of people’s surprise, the most robust member of the Western alliance. But who knows what the future holds?”

In a parallel universe it could have been Hunt who led the country through the pandemic years. We spoke just before the civil servant Sue Gray’s report on Downing Street parties was due to be published and before photos of the Prime Minister toasting aides in a booze-strewn room were leaked.

When I asked if there would have been parties in Hunt’s No 10, he replied mildly: “I hope not.” He suggested partygate was part of Johnson’s “personal” brand of leadership.

“Look, I was health secretary for six years, so I wouldn’t have made some of the mistakes that Boris made in the pandemic, but I would have made different mistakes that he didn’t make,” he said. “And I think that’s the nature of that job. They’re very personal, and the mistakes you make are very personal.”

“I was health secretary for six years, I wouldn’t have made some of the mistakes Boris made in the pandemic”

As Conservative MP for South West Surrey, described in these pages as “the last Cameroon”, Hunt is perhaps the embodiment of the Blue Wall Toryism that has felt precarious ever since the party lost the green and pleasant suburban enclave of Buckinghamshire, Chesham and Amersham, in a by-election last year. Since then the party has been shedding council seats, from Tunbridge Wells to Witney to Mayfair, in local elections. Hunt admits he is concerned about his party’s appeal in what he describes as southern “heartlands”. “We should remember that we got a majority in 2019 because we are a coalition of Blue and Red Wall seats,” he said. “If you look at the Australian election results, you can see the dangers of alienating your more suburban conservative voters, who have those more socially liberal views. We need to keep that coalition together.”

On 23 June there will be a by-election in the true-blue rural Devonshire constituency of Tiverton and Honiton, caused by the resignation of its MP, Neil Parish, who admitted watching pornography in parliament. Hunt urged his party to “show we are in touch with the concerns of those voters. We need to show people that we understand local concerns, rural concerns, the concerns of farmers, but also show that as a party we do care about our heartlands as well as the potential new areas that we would like to join our coalition”.

[See also: On the Covid front line]

Yet during his time on the backbenches, Hunt has devoted more time to thinking about the future of health policy than of his own party. He has just released a book that he began writing while health secretary, Zero: Eliminating Unnecessary Deaths in a Post-pandemic NHS.

Rather than expressing typical conservative scepticism about the NHS’s funding model, the book is a thoughtful defence of it. Hunt dismissed the “rabbit hole” of considering different options to our tax-funded, universal service. “Other health systems have all got problems,” he said. “The truth is that as we all live longer and new medicines come on-stream, wherever you live, we’re going to pay more.”

“It’s a rabbit hole to try and change how the NHS is structured”

Hunt’s vision, instead, is for the NHS to become the most transparent of all health systems: shifting from a culture of cover-ups and individual blame to become an organisation that examines fatal errors rapidly and openly, thereby reducing unnecessary deaths. The book includes stories of patients who were failed by the health service.

“It does feel like a rogue system to families who are suffering a terrible loss and feel that the system is shutting them out and doesn’t want to tell the truth about what happened to their loved ones,” Hunt said. Changing that mentality could, he believes, bring about a higher quality of care.

However, as one Tory adviser told me recently, he risks sounding like “Captain Hindsight”. After all, he was health secretary for six years.

Hunt held office during the slowest period of NHS spending growth in history. NHS England hasn’t met its cancer care, hospital appointment or A&E waiting time targets since 2015, and on his watch, for the first time, strikes by doctors meant that even emergency care wasn’t covered. A chronic staffing shortage persisted, and local authority cuts led to a damaging squeeze on social care, both for vulnerable people and those suffering the knock-on effect in overcrowded hospitals.

“The cut that went too far was social care. It was a silent killer”

“I still get loads of tweets every time I appear on the media saying, ‘gosh, Jeremy Hunt’s absolutely right about the workforce shortage, he’d be so angry if he knew who the health secretary was between 2012 and 2018!’” he smiled.

Hunt insisted that by the end of his time in office three million more patients were going to “good” or “outstanding” hospitals (Ofsted-style categories he introduced), that he secured a £20bn rise in the NHS budget, and that he persuaded Theresa May to “increase the number of doctors we trained by 25 per cent” with five new medical schools. It was during his infamous confrontation with junior doctors over their contracts, which led to strikes in 2016, that Hunt said he began hearing about “rota gaps” that meant there wasn’t adequate cover throughout the week, let alone on weekends (which he was trying to have staffed on the same terms as weekdays). Now, however, there is still a huge shortage of doctors and nurses plaguing the NHS he left behind.

“The government is massively shooting ourselves in the foot over NHS staff shortages”

The government recently voted against Hunt’s plan to regularly publish the number of doctors and nurses that need to be recruited, which he described as “a massive shooting ourselves in the foot”. Yet his “biggest regret” is not addressing the crumbling social care system (which was added to his brief in January 2018). He blames this failure for the severe ambulance delays we see today.

“When you see people waiting an hour to get an ambulance for a stroke, one of the reasons that’s happening is because the ambulances are stuck at hospitals because they can’t get people out of A&E,” he said. “Because there aren’t enough beds because people can’t be discharged into the social care system.”

Although he defended austerity “in its entirety”, he admitted that there was nothing but “a lot of pain for the NHS” until 2018, the year he left for the Foreign Office, and that the cut that “went too far was social care”. “I think it was a silent killer, because what happened was when you cut the money for social care going to local authorities, no individual has their package cut, but the local authority just doesn’t provide new packages for as many people, or at as generous a level as it would otherwise have done.

“People don’t really notice that, but when I was health secretary and I was seeing our hospitals filling up because we couldn’t get people out into the community, I realised just how dangerous that was.”

“I hope it doesn’t take as long for the penny to drop on social care with Sajid Javid”

Now, his select committee is calling on the government to raise social care funding by £7bn a year by the end of the parliament (the increase will only be £2bn a year). “I’m afraid we’re a long way off what I think it needs,” he warned.

“I hope it doesn’t take as long for the penny to drop with Sajid Javid as it did for me, because if he’s battling to get flow through hospitals so that people can arrive at an A&E, be treated and sent home quickly, then social care is a really essential part of that mix. So I am disappointed we haven’t made further progress on social care.”

[See also: Why would anyone want to work for the NHS right now?]

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