As a beleaguered Matt Hancock finally steps down, calls are already being made for Sajid Javid the new Secretary of State for Health and Social Care to abandon the sizable NHS reorganisation that Hancock was expected to put before Parliament in the next few days.

Speaking ahead of the Secretary of State’s first statement in the Commons, Jonathan Ashworth, Labour’s Shadow Health Secretary, said: 

“This is not the moment to be rushing into a flawed top-down reorganisation. In recent weeks I’ve heard increasing worries from NHS and local government leaders that the plans are ill-thought through.” 

As the Lowdown this week explains, the planned legislation is already proving controversial within Tory circles with arguments raging over boundary changes. The Bill will transfer power back into the hands of the Secretary of State, which has also been questioned by Tory critics. Sajid Javid will want to check this direction of travel before strapping himself in for the bumpy ride this legislation could get through Parliament.

Meanwhile, his intray is already piled high with pressing issues: producing a long-overdue solution on social care, attending to record waiting lists, keeping staff onside after a demoralizing 1% pay offer, rescuing the health and social care from a staffing shortage of 220,000, rebuilding hospitals with repair bills estimated at £12bn plus, and that’s without mentioning the continued management of the pandemic.

A crux point will be the autumn spending review and the preceding discussions which must produce a new financial deal for the NHS that is capable of supporting the NHS to meet these huge challenges. Is Javid, a previous supporter of austerity and regarded as a more traditional Conservative willing to make the case?

NHS campaigners are already expressing fears that Mr Javid may follow in the tracks of Hancock. Unable or unwilling to release the chains of the Treasury to expand NHS capacity, he will lean heavily on the private sector.

Twitter was alive with speculation amid suggestions by Zara Sultana MP and others that Javid nets over £150,000 a year from a position with JP Morgan, and that this could translate into more backing for commercial involvement in the NHS. 

In the detail of the Bill there is likely to be some reassurance here, as after years of public campaigning the new NHS legislation plans a u-turn on the Lansley reforms of 2013, ending the need for competition around NHS contracts, a move which could keep more clinical work within the NHS. 

In a counter move though the government is already entering into a £10bn deal with independent providers to help out with the NHS surgery backlog – a move that is beginning to look less temporary and more like a replacement for the government’s current failure to invest in raising the capacity of NHS surgery.

In a similar vein, it remains to be seen whether Javid will stand by Hancock’s commitment that the new privately run mega-labs opened during the pandemic, that bi-passed the existing NHS laboratory network will go on as promised to be the foundation of the national diagnosis network, a straightforward privatisation move that will baffle many after the multiple critical failures of the outsourced test and trace contracts throughout the pandemic. 

As well-worn observers, we know that all politicians are declared supporters of the NHS and its staff, but a Health Secretary that consistently proved it, now that would really stand out.


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Co-editor of the Lowdown

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