It is an understatement to say that there are many challenging and competing interests at the top of new Health Secretary Sajid Javid’s in tray. To paraphrase the Queen of Hearts’ advice to Alice in Wonderland, Javid may quickly come to feel that he must get used to making six impossible decisions before breakfast.
Immediate pressure points include the lifting of COVID restrictions; the long-term conundrum of social care; bolstering the shellshocked NHS workforce; and stewarding the increasingly politically contentious health legislation through Parliament. Some he will choose to embrace. Some he will try to ignore; to greater or lesser degrees of success.
As an additional challenge, he will only briefly have the support of longstanding NHS Chief Executive Simon Stevens, who is leaving his post in July. Playing a leading role in choosing Stevens’ replacement will be among the most critical decisions the new Health Secretary will have to work on. But coming in so late to the recruitment process gives more established figures, like Lord Prior, a stronger hand.
While Javid has wide ranging experience across Government – albeit with a brief tenure in each role – he has had little opportunity to make his mark in a high spending, high-profile, and heavily scrutinised department.
It is the tight scrutiny from all sides that may be the hardest to manage. During COVID, the model for the Health Secretary’s role has so far been to be communicator-in-chief as well as a leading driver of policy.
Matt Hancock was frequently mocked for his ‘tiggerish’ approach to his role. He was always up for the morning briefing round or the evening podium performance, telling the public over and over the latest rules to follow (although of course it is now clear he was not always following them himself).
Since the pandemic started, Hancock has been a stalwart in the small roster of spokespeople trusted to communicate core public health messages. Now he has gone, Javid will need to step up. How he chooses to do so could shape our perception of the next phase of the pandemic as much as the policies he advocates behind the scenes.
Javid’s initial comments as Health Secretary show he has different instincts to his predecessor. While he spent his first morning doing a hospital visit, enabling the press to capture him deep in conversation with frontline NHS staff, Javid’s first session at the Dispatch Box focused heavily on his desire to drive us towards ‘freedom’ from lockdown rather than messages around safety or caution.
He chose to stress that we cannot eliminate the risk from COVID and need ‘to learn to live with it’. Claiming that his role is about returning the ‘economic and cultural life’ of the country alongside protecting life and the NHS is a clear shift in emphasis.
For some, this new tone will be hugely welcome. Others questioned the logic in claiming that there is no reason not to expect a full and irreversible end of lockdown by mid-July on the day that the UK saw the highest case rate since January.
After years of relative stability in health policy leadership, we are clearly now entering a new era.