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Longest-serving health secretary Jeremy Hunt completes five years in post

Jeremy Hunt this week completed five years as health secretary. GPonline looks back at half a decade that has seen MPIG scrapped, the start of revalidation and CQC inspections, junior doctor strikes and the emergence of a full-blown GP crisis.

Health secretary Jeremy Hunt (Photo: JH Lancy)
Health secretary Jeremy Hunt (Photo: JH Lancy)

Jeremy Hunt became health secretary on 4 September 2012 - five years ago this week. He moved past Labour health secretary Alan Milburn in early May 2016 to become the longest-serving of the 12 MPs who have held the post of secretary of state for health since 1988.

Only two people have held equivalent posts for longer since the NHS began, either as health minister - a role that existed from 1919 to 1968 - or as secretary of state for health and social services when the two were combined between 1968 and 1988.

Moving past the five-year milestone leaves Mr Hunt less than six months from achieving a longer spell as the top government health minister than Aneurin Bevan - the chief architect of the NHS.

Top 10 health secretaries by time spent in post since the NHS began
Rank Name and Years in office Party Length of tenure
1. Norman Fowler
14 Sept 1981 - 13 Jun 1987*
Conservative 5 yrs 272 days
2. Aneurin Bevan
3 Aug 1945 - 17 Jan 1951**
Labour 5 yrs 167 days
3. Jeremy Hunt
4 Sept 2012 - present
Conservative 5 yrs 1 day
4. Kenneth Robinson
18 Oct 1964 - 1 Nov 1968
Labour 4 yrs 14 days
5. Sir Keith Joseph
20 Jun 1970 - 4 Mar 1974*
Conservative 3 yrs 258 days
6. Alan Milburn
11 October 1999 - 13 June 2003
Labour 3 yrs 245 days
7. Iain Macleod
7 May 1952 - 20 Dec 1955
Conservative 3 yrs 227 days
8. Virginia Bottomley
10 Apr 1992 - 5 Jul 1995
Conservative 3 yrs 86 days
9. Enoch Powell
27 Jul 1960 - 20 Oct 1963
Conservative 3 yrs 85 days
10. David Ennals 
8 Apr 1976 - 4 May 1979*
Labour 3 yrs 27 days

*In post as Secretary of State for Social Services because health was part of the social care department between 1968 and 1988.

** NHS established in 1948 – halfway through Aneurin Bevan’s five-and-a-half-year tenure.

Looking back at Jeremy Hunt's record

GP contract

Mr Hunt took over from former health secretary Andrew Lansley in September 2012 after his predecessor faced growing criticism as the architect of an NHS reform programme described by then health service chief executive Sir David Nicholson as 'so big you can see it from outer space'.

Despite initial hopes that a change of leadership at the DH would improve relations with the profession, within months talks collapsed over a new GP contract for 2013/14, and the government pushed ahead with imposing a deal that would phase out MPIG by 2021 and equalise PMS and GMS funding. GP leaders said the move left the profession facing the 'biggest cuts in years'.

Mr Hunt followed up by imposing a 0.28% overall rise in GP contract funding for 2014/15 - condemned by GP leaders as a 'kick in the teeth'. In that same year Mr Hunt spelled out his vision to scrap QOF entirely - a move yet to be completed, despite the steady shift of funding into the core contract in recent years.

Rolling out revalidation

The rollout of revalidation for NHS doctors was also rubber-stamped by Mr Hunt in his first year as health secretary. Five years down the line, the vast majority of GPs are not convinced that the process has had a positive impact on their clinical practice - with many blaming the additional bureaucracy involved for driving doctors out of the profession.

The health secretary's relationship with GPs soured further in his first year in office when he blamed the 2004 GP contract for increasing pressure on A&E and threatened to hand back responsibility for out-of-hours care. This theme was revived in 2017 as Theresa May was heavily criticised by GP leaders for 'scapegoating' the profession for a severe NHS winter crisis by blaming problems with access to GP appointments for a health service meltdown that saw many major hospitals unable to maintain standard services.

Ofsted-style CQC ratings

report commissioned by the health secretary - published in early 2013 - backed Ofsted-style CQC ratings in primary care. By October 2014, practice inspections had begun and earlier this year the watchdog announced that every practice registered when CQC checks on GPs began had now been visited by its inspectors.

GPonline has mapped GP CQC ratings by CCG. Our investigations suggest that the best-performing practices are largely those that are better funded and larger.

Plans for CQC ratings emerged against the backdrop of the government's response to Sir Robert Francis' report on failings at Mid Staffordshire NHS Foundation Trust.

GP workforce

Just under a year ago, Mr Hunt admitted failing adequately to prioritise the GP workforce in his time as health secretary. Despite a string of increasingly desperate efforts to boost GP recruitment, the Conservative pledge ahead of the 2015 general election to boost the GP workforce by 5,000 by 2020 remains an uphill struggle.

Recent GP workforce data have shown a sharp dip in numbers, and acceptance that even if more medical graduates can be attracted to GP careers they will take far too long to train to fill the emerging gap has led to the pledge just last month that £100m will be invested to encourage recruiters to bring in up to 3,000 GPs from overseas.

Strikes

In 2016 the crisis facing the health service came to a head with the first strikes by junior doctors in 40 years, largely over concerns that plans for a seven-day NHS and changes to rotas would undermine patient safety.

GPs could yet be heading for industrial action in the coming months after a ballot of the profession earlier this year to gauge practices' willingness collectively to close their patient lists in protest over unmanageable workload. Polling by GPonline suggested the vote could be on a knife-edge.

What next for Jeremy Hunt?

Despite profound problems facing the NHS and warnings from GP leaders that the next winter crisis looks set to be far worse than the last, Mr Hunt looks odds-on to surpass Bevan's period in office.

Few politicians would relish taking on the role of health secretary as NHS England continues to drive through a shift to accountable care organisations and general practice at scale amid continuing austerity. Writing for GPonline earlier this year Mr Hunt spelled out his vision for a health service with GPs at its heart. The NHS, he said, was 'turning a corner'.

What lies around that corner for general practice will be determined by how prepared the government and its health secretary are to deliver the 11% share of NHS funding GP leaders believe is needed for the profession to begin to operate on all cylinders. Mr Hunt's ability to find that money urgently and successfully to oversee reforms that can turn around the NHS crisis will determine whether he can reverse what to date has been a long but unpopular stay at Richmond House.

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