Jeremy Hunt retains post as health secretary

Jeremy Hunt has retained his post as health secretary in the re-shuffle triggered by Theresa May’s appointment as Prime Minister, following the Brexit vote and David Cameron’s departure.

The news is likely to disappoint medics who took to Twitter to celebrate Hunt's departure from Richmond House following false reports that he had been sacked on Thursday morning. 

Staff took to the social media platform to claim there had been cheering in their hospitals when the news filtered through, and to post jokes about how he would now be able to enjoy his weekends.

Hunt’s reputation among medical staff was been badly damaged by his draining dispute with the BMA over new contract terms for junior doctors, which focused on weekend working.

He is on the brink of ‘imposing’ the contract on new junior doctors; following a vote to reject a deal agreed between the government and the union after unprecedented strikes this spring.

However, there would have concern about how might replace Hunt, who arguably stood up for the NHS in cabinet, and must have been at least partly responsible for its funding being ‘ring-fenced’ in the early years of Chancellor George Osborne’s austerity measures.

The NHS’s essentially flat funding was far from enough to cover rising demand linked to the ageing population and obesity – leading to the ‘Five Year Forward View’ plan to try and bridge a potential funding gap of £30 billion by 2020-21.

But it made it through the last Parliament in a better position than ‘non-protected’ departments, and then received an additional £8 billion in last year’s spending review.

A good chunk of this ‘frontloaded’ for ‘transformation’ projects, as demanded by NHS England chief executive Simon Stevens. 

However, the financial problems of the acute sector, which finished the last financial year £2.4 billion in deficit, have eaten up much of this money, and the financial 'reset' for the NHS and tightening the drive for 'efficiency' savings will now be top of Hunt's priorities.

Hunt has also had a significant impact on NHS IT. He was a vocal supporter of the transparency and patient information agendas put forward by NHS England’s former national director of patients and information, Tim Kelsey; although this associated him with the ultimately disastrous care.data project, cancelled last week.

And he has been a more surprising advocate of IT for NHS provider organisations; given that most politicians have run a mile from the electronic patient record agenda since the debacle of the National Programme for IT.

In 2013, he told the Policy Exchange think-tank that he wanted to see a ‘paperless’ NHS by 2018. And while this target has been refined and extended to 2020 at the earliest, it undoubtedly electrified the market.

It also came with some money. NHS England ran two rounds of ‘tech fund’ bidding for electronic patient record, e-prescribing, electronic document management and similar projects. 

Emphasising the importance of this money, it was the curtailing of ‘tech fund 2’ in the face of ‘winter pressures’ in 2014 that is now being blamed for a slow-down in these areas.

Further funding for major IT projects is now linked to the Digital Maturity Assessments that are being fed into the Local Digital Roadmaps and the wider Sustainability and Transformation Plans that are supposed to set out how the NHS will take forward the Five Year Forward View agenda.

This depends critically on IT, to support integrated care, shift some activity into digital patient channels, and support prevention.  

Hunt invited US ‘digital doctor’ Robert Wachter to the UK to review NHS IT. His review, which is expected in September, is likely to emphasise the importance of usability and clinical engagement to making these tech interventions succeed.

At last month’s NHS Confederation conference, Hunt gave a well-received speech acknowledging the NHS’ current financial woes, while insisting that it could still use this decade to become “the safest healthcare service in the world”. 

He also insisted that he remained not just committed to the paperless agenda, but that he would be "relentless" in pursuing it. Afterwards, he was asked if he would be around to do that, or whether had ambitions beyond being health secretary.

Hunt told his audience that health would be his “last big job” but that he hoped to be “doing it for a long time to come.” Having also survived the general election in post, it looks as if he is going to get his wish.