‘I would like to be the person who safeguards Andrew Lansley’s legacy,’ says Jeremy Hunt, the Health Secretary, as he sits in his new office. Hunt is touchingly eager to praise his predecessor. He predicts that Lansley ‘will be seen as the architect of the modern NHS’ and stresses that he is in regular touch ‘to make sure that I learn as much as I can from him, because I don’t think there is anyone who knows more about the NHS than Andrew’.
But if Lansley was such a paragon, why was he moved? Hunt replies defensively: ‘You’d have to ask David Cameron about that.’ A few moments later, he is more forthcoming: ‘What has happened, because the reforms were so far reaching, we have had a big debate about structures and I think we need to move on from there and talk about why those structures are going to make a difference to patients.’ Hunt who (normally) speaks English, not just NHS, is perhaps better suited to this task than his technocratic predecessor.
Another striking difference between them is their views on the future of the NHS budget. When The Spectator interviewed Andrew Lansley at Christmas, he was clear that he believed that the health budget would have to carry on rising in real terms until, well, kingdom come — and that the next spending round and Tory manifesto would have to commit to that. Hunt is not prepared to guarantee this. ‘I don’t think it’s possible to make a prediction because there is so much uncertainty in the economic outlook and no one knows what is going to happen with the eurozone.’
When I push him on this apparent break with his predecessor, Hunt panics a little, and emphasises ‘how passionately committed David Cameron is to protecting the NHS budget for the very reasons that Andrew laid out’. He says: ‘I completely support that and I think that that would certainly be my instinct and David Cameron’s instinct coming to the next election.’ However, Hunt admits: ‘We would also have to have a look at the economic situation. It is something that is very, very difficult to predict.’ One thing at least, is easy to predict: given the centrality of the NHS to British politics and the Tory modernisation project, Hunt and the Chancellor will have to make their position clear pretty soon.
Another tricky cost issue on Hunt’s desk is social care. The coalition is committed to the Dilnot recommendations, which would see no individual having to spend more than £35,000 on social care. But it has not yet said how it would fund the £1.7 billion annual cost. The word in Whitehall is that George Osborne wants the money to come from the health budget. Hunt says: ‘I want to explore all options, but I think that would be extremely difficult, given the cost savings that we are already having to make.’
What seems to appeal is a cut-price version of Dilnot: ‘There are other versions that might not be quite so expensive.’ He says: ‘As we come to the next spending round, which we are going to have before the next election, we are looking very hard to see if there is any way at all that we could deliver on the core principles of Dilnot.’
Hunt has been portrayed as an NHS novice, but he is a product of a marriage between its two wings: his dad was an NHS bureaucrat who helped to introduce the first set of Tory health reforms and his mother is a nurse. To my surprise, Hunt doesn’t have private health insurance and waxes lyrical about the care he and his wife have received at Chelsea and Westminster hospital. But he does complain that ‘technologically, there were moments when it was in the dark ages’.
For such a senior minister, Hunt is relatively unknown. He describes himself as an ‘aspirational Tory’ who is ‘socially liberal, economically dry’. He says that at Oxford, where he was president of the Conservative Association, ‘I saw the world through very ideological hues and what you tend to want to do, particularly when you’re young, is find an ideology that can answer every question.’ But his business career made him ‘much more practical and much more pragmatic’.
Margaret Thatcher remains a lodestar. ‘I always remember Bernard Ingham saying that in all the time that he was working for her he never had to ask her what she thought on any issue, he was always able to guess what she thought. As a minister, it is very important that people know exactly what your priorities are.’ His priorities are care for the elderly, those with chronic conditions, dementia and ensuring that ‘we have the best cancer survival rates, heart and stroke survival rates in Europe’.
If there is a public perception of Hunt, it’s the image of him being hauled over the coals by the press and the Leveson inquiry’s QC for his handling of News Corporation’s bid for BSkyB. He likens the experience to ‘being accused of a murder that you hadn’t committed’. He says that this ‘gave me inner strength because I just thought I’m going to have a chance to make this case and when I make it people will see the truth’. He does concede that ‘I haven’t done everything absolutely right’ but stresses that ‘in the fundamentals of how I handled that very, very controversial bid, I think history will demonstrate that I did the right things at the right moments’.
The only time Hunt pauses before answering is when I ask him if he regrets how his special adviser was forced out during the Leveson firestorm. After a while, visibly pained, he replies: ‘I won’t go into that, if you don’t mind, because he’s an exceptionally able and honourable young man and he went through an incredibly difficult patch but he is now building a new life for himself and I think I’d rather let him get on with that, if you don’t mind.’ It is the answer of a decent man who knows he was hurried into doing the expedient thing.
Hunt says his ‘burning mission’ is to ‘demonstrate that we have as much to offer the NHS as Labour ever did’. He wants health to be central to the Tory campaign at the next election. ‘My job is to make sure… that people can see the benefits, can see that all the upheaval, the pain, the very agonised public debates were worth it because the NHS that has been delivered to them and their families has got measurably better.’ If he can do that, then he’ll be remembered for far more than the Leveson inquiry.
This article first appeared in the print edition of The Spectator magazine, dated 6 October 2012