Jeremy Hunt reveals the haircut that cost the country £10 billion
It must rank as the most expensive haircut in history. Jeremy Hunt, in his new book Zero – an account of his six years as Health Secretary, the longest any occupant has held the post since the NHS was founded in 1948 – tells a story that exemplifies much that is wrong with the way our politicians genuflect before a totemic model of health care that they know to be broken, but refuse to reform in any meaningful way.
In the run up to the 2015 general election, Labour had threatened to “weaponise” the NHS against the Tories, so Hunt went to see George Osborne, the Chancellor, to ask for the money to back up a five-year plan unveiled by Simon Stevens, the chief NHS executive in England.
Hunt was ushered into Osborne’s office in 11 Downing Street for “a meeting I will never forget”. The Chancellor, far from giving the subject proper attention and with no officials present, was in the middle of a haircut. “My pitch to George, as the scissors snipped away, was political. Labour had not signed up to Simon Stevens’s £8bn request. If we signed up to it we could kill Ed Miliband’s attack and turn weakness into a strength.”
Osborne like the idea and it was announced two days later. However, he had apparently forgotten that the NHS had already received £2bn of the £8bn in his previous Autumn Statement so it got £10bn instead.
And that is the way our health service is financed. Money is splurged for political reasons, with no proper thought given as to why it should get more funding or what it would do with it, to the accompaniment of a hairdresser’s clippers.
You might have thought that, after his lengthy tenure in the post, Hunt would rail against the NHS’s inefficiencies, its incompetences, its bureaucratic sclerosis and its wastefulness, and ask himself whether the fault lies with the continuation of the 1948 model of nationalised health care paid for predominantly out of taxes, and free at the point of delivery.
Yet despite recounting a depressing list of horror stories that can be laid at the door of poor practice and a culture of cover-ups and buck-passing, he remains of the view that it is “the most accessible system in the world” and therefore to be extolled “because the values it stands for have become entwined with what it means to be British”.
The refusal of our political leaders to challenge this egalitarian foundation myth is arguably at the root of our health care crisis, one partly compounded by the pandemic but already in existence before the virus hit. By then Hunt had left his post to become chairman of the Commons health select committee after being defeated for the leadership.
He became a much-sought after expert on what was going wrong in the NHS. Although his new book is called Zero, it is not about the eradication of Covid but an assessment of how to reduce the avoidable harms inflicted on patients.
Of course people die in hospital because they are sick, but Hunt recounts a number of grisly tales of those who would be alive today were it not for mistakes made and then often covered up. Many of the stories he tells having met the families of those affected are hard to read. Even as Hunt’s book went to press, yet another inquiry exposed shocking shortcomings in maternity care at Shrewsbury and Telford hospital.
Among his prescriptions for improvement is greater openness, encouraging clinicians to be honest about what happened when a procedure went wrong by assuring them that they will not get blamed for it – a safety approach imported from the airline industry. He also calls for greater continuity of care, delivered more frequently at home, the expanded use of data and new technology and, above all, prevention – better health all round, so that we can avoid going anywhere near the NHS if possible.
Hunt’s difficulty is that he was in charge for six years and “some will understandably criticise the fact I did not solve [the problem] when I was in the job”. Indeed so.
He identifies much that is wrong with the NHS which he thinks can be repaired, though you have to wonder how, after 74 years, it still struggles to share practices and systems that work. But, along with most of his colleagues, Hunt refuses to concede that it might be the model itself at fault.
He calls for a “1948 moment” but this is not 1948. To most people today, outcomes are more important than accessibility, if all that means is a poor service for all. An analysis of what makes Europe’s private/public healthcare systems better than ours at keeping people alive would have been useful. But for a politician with leadership ambitions, it would also have been political suicide; and therein lies the tragedy of the NHS.