As Westminster grapples with the latest cabinet reshuffle, the pivotal role of Health and Social Care Secretary has been taken from Steve Barclay, who has been demoted to the Environment, Food and Rural Affairs portfolio, and given to Victoria Atkins, a rising star from the moderate wing of the Conservative Party.
Formerly the financial secretary to the Treasury, Atkins is a seasoned junior minister, having served in key roles within the Ministry of Justice and the Home Office. In these capacities, her focus was on issues related to violence against women and girls, domestic violence, and the prison population. Prior to taking office in 2015, Atkins was a criminal barrister specialising in serious organised crime.
Atkins has long been regarded as a new talent within the party. On the resignation of Dominic Raab as justice secretary amid bullying allegations, Atkins emerged as one of the rumoured successors. Officials who have worked closely with her praise her competence and hard work, as well as her positive attitude to her brief.
However, Atkins faces a challenging task ahead. Sir Julian Hartley, chief executive of NHS Providers, underscores that addressing industrial action by doctors is paramount for the new Health Secretary. “The cumulative impact of strikes on patients, staff and the NHS cannot be understated. Constructive dialogue between the government and unions is key to finding a sustainable solution.”
The British Medical Association, at odds with the government over pay, is also eager for Atkins to swiftly familiarise herself with the dispute. The repercussions of strike action thus far have included the cancellation of over a million NHS appointments and an estimated £1bn deficit in the NHS budget. Professor Philip Banfield, chair of the BMA council, said: “Time is almost up to get credible pay offers on the table – an opportunity to both end strikes and boost the recruitment and retention of doctors. This would not just get long-suffering patients the planned care they need, but give us some glimmer of hope, however slim, of getting through this winter more safely. It would be disastrous if the revolving door of health secretaries was responsible for the failure of talks and further strike action.”
Atkins’ experience as financial secretary to the Treasury may be both a blessing and a curse. She will be expected to address the Treasury’s decision to withhold funding to cover the £1bn deficit, and having overseen previous financial settlements in the healthcare sector may equip her to navigate difficult questions about public spending and assess the impact of lost time and earnings due to industrial action. But those on the other side of the negotiating table may fear that her involvement in the Treasury will have made her hostile to their demands, and that she may incline towards the penny-pinching “Treasury brain”.
Another critical focus for Atkins will be disease prevention. Steve Brine, chair of the Health and Social Care Committee, emphasises the importance of prioritising “preventing ill-health” to assist the NHS in resource management, calling for the new secretary of state to put prevention “high up” on her agenda. Despite Boris Johnson introducing a UK Obesity Strategy in 2020, delays in implementing restrictions on foods high in fat, sugar and salt persist due to a lack of political will. Health experts have long called for the government to address prevention and public health issues, particularly obesity, given its association with serious illnesses straining the NHS, such as cancer and diabetes.
Atkins is likely to face scrutiny in this area. She is married to Paul Kenward, the managing director of British Sugar, one of the world’s largest suppliers of sugar cane and sugar beet. Oversight of measures outlined in the framework for the government’s Major Conditions Strategy, published in August this year, aimed at curtailing lifestyle drivers of ill-health and disease, will be closely examined for any potential conflict of interest.
Publicly addressing her own experience with type one diabetes, Atkins has said that her commitment to the NHS is a driving force behind her public service. Her experience aligns with issues highlighted in the development of the Major Conditions Strategy, providing a personal connection to the work. But the strategy remains large and rather unruly, combining several health issues which may well require standalone strategies. The challenge for Atkins will be giving her time and commitment to all the issues raised in equal measure.
Atkins’ role is arguably one of most important ahead of the next general election. The NHS consistently places in the top three voter priorities, yet remains hampered by industrial action, underfunding and staff shortages. Not only will the Health Secretary be presented with immediate crises, such as an expected winter flu outbreak, pay disputes and crumbling buildings, but will also be responsible for spear-heading manifesto commitments to future-proof the NHS and deal with an ageing population. Atkins is an experienced and popular junior minister, but in her first role as a secretary of state she has been thrown in at the deep end. Without a large funding pot at hand, Atkins has a complex set of challenges ahead of her.
[See also: Restoration of a loser]