The Times Magazine 13Were I chairman of the Commons health
and social care committee (I’m not, but he
is), I would extend the session until I had
interrogated him on each point, but I limit
myself. I wonder, for instance, whether
his hatred of blame-and-shame might be
connected to the death of his baby sister.
This little girl drowned in the bath they were
sharing when he was two and she just ten
months, after their nanny left them alone for
a few minutes while she prepared supper. His
father, a navy admiral, refused to blame her.
“Well, much as we might try to pretend
otherwise, we are all creatures of our parents.
And my father definitely had a big influence
on me and he was a very generous-minded,
tolerant person.”
He forgave the nanny?
“It wasn’t just forgiveness. He actually told
the inquest that she shouldn’t be blamed, that
it was a terrible mistake, that she was a good
nanny. And again, I didn’t find that out until
the 2019 leadership campaign when, I think,
Robert Peston [of ITV News] found that out.
My father died in 2013, but when we heard
that story we thought, ‘That is so him.’
“And it wasn’t until after he died that I
came across the diaries he wrote when he was
a young officer and this extraordinary view
that officers should be trained to disobey and
shouldn’t be punished if they disobey. He had
a very romantic notion that the Royal Navy
at its greatest was Nelson turning a blind eye.
“You could say there is an equivalent risk in
the NHS today. People at the Department of
Health and NHS England try to micromanage
what GPs do and what hospitals do to such a
huge extent that we’ve ended up emasculating
the profession.”
He is convinced that the proliferation of
targets, which are useful in business, has in
the NHS become counterproductive. Meeting
targets has become more important than
treating patients, and there are so many of
these objectives – for A&E waiting times,
cancer treatment, vaccines, HIV transmission- that chasing them all makes hospital
administrators’ jobs impossible.
Didn’t his successor as health secretary,
Matt Hancock, demonstrate the fallacy of
the target culture? Labs were posting out
meaningless Covid tests that were counted
towards his infamous 100,000 daily target
even when they were not returned. Would
Hunt have done the job better?
“I think the truth is that I would have
done things differently and I would have made
different mistakes. I don’t think it’s possible for
anyone to do that job in a pandemic and not
make mistakes. I felt very strongly at the start
of the pandemic that we should be looking
closely at the approach they were taking in
South Korea, and that we could have avoided
a lockdown if we had adopted their test and
trace approach.”
Yet if the road to health hell is paved
with bright ideas, Hunt laid his share of shiny
slabs. Yes, we all supposedly have a named
GP assigned to us, but how often do we get
to see that person? A single consultant may
nominally oversee us during a hospital stay.
We may even know their name. They will
come to our inquest. Pre-mortem, however,
do we have their email address?
What must have frustrated Hunt most
was that having prised out Treasury money
to recruit more doctors and nurses, it hardly
made any difference. In 2015 he announced he
would train 5,000 more GPs by 2020. By the
time he left the job in 2018 there was a net
gain of just 300, because so many existing
GPs used the opportunity to go part-time
or retire early.
“But we have to understand why. I was
talking to a newly qualified GP in his late
twenties last week and he told me not one of
his colleagues or classmates was practising
as a GP full-time, having got their right to
practise as a GP. I said, ‘Is this a kind of
millennial thing, everyone wanting to work
part-time?’ He said, ‘Absolutely not. If you
spend a whole day as a GP and you see
40 patients in 10-minute slots and you
have to make a decision at the end of every
10 minutes, you get decision fatigue and
you get moral injury. You start to worry that
you’re making mistakes. It is impossible to do
that job five days a week.’ So people say, ‘I’ll
do it for three days and I’ll do training for two
days a week.’
“So we have to find a way of bringing that
magic back into that job.”
That must mean reducing the workload
by sharing it among more doctors. But what
is the point of pumping young GPs into the
system when the old ones just come out at the
other end?
“Well, you start by asking how many
GPs you really need and you make sure
that you’re training up those numbers for
the future,” he says, knowing that the very
day we meet the government will once again
defeat an amendment to the latest Health
and Care Bill that would legislate for just
those calculations.
Then there were nurse numbers. He
employed 11,000 more in his time, but they
came from community, district and mental
health services.
“The fundamental block in this is the
underfunding of the [local] council-funded
part of the care system,” he says.
And which political party, pray, was
responsible for reducing income to local
authorities? “My party, from 2010 on. I signed
up to the austerity regime because in the
end I believed then, and I believe now, that
we needed to go through that pain to put the
economy on its feet. If we hadn’t, we wouldn’t
have got the £20 billion increase in the NHS
budget. But if I look back on the cuts that went
too far, that had unintended consequences,
I think the cut to local authority funding for
social care was a silent cut that no one really
noticed at the time. I then started to notice
it as health secretary, because we couldn’t
discharge people from hospitals because there
weren’t the care packages.”
I say that it seems obvious that most of the
bad things that happen in the NHS would not
happen if it had more doctors and nurses and
their lives were less pressured. He counters
that I am right and wrong. Terrible things
happened in the first decade of the century
when staff levels were higher. “So I think
staffing is one of the central solutions.
I’d say it’s a necessary condition but not
a sufficient condition.”
He underplays it in the book.‘I WOULD HAVE DONE
THINGS DIFFERENTLY
IN THE PANDEMIC
- AND I’D HAVE MADE
DIFFERENT MISTAKES’