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28 October 2022

Back at the start of September, 20/20health reported that the incoming Truss government faced an unprecedented number of challenges, none more so than within the NHS. Seven weeks on, a new crisis has added to the pay disputes, escalating waiting times, low staffing records, and a £36bn funding blackhole to deal with the effects of covid; above average hospital admissions for seasonal flu.

Considering that the Truss government only lasted 7 weeks, it is perhaps understandable that the outgoing health secretary, Therese Coffee, failed to resolve any of these issues, and they must be considered priorities for the incoming Secretary of State Steve Barclay

Despite the short duration of her administration (the shortest in British history), there are important lessons to be learnt from the Truss administration. Firstly, the role of SoS for Health and Social Care is surely too big to be held in conjunction with another government position, in Therese Coffee’s case, Deputy Prime Minister? It is a sad inevitability that as the government collapsed around her, Ms Coffee would become more preoccupied with government business that she would her own departmental responsibilities, as demonstrated by the vote of no confidence that never was.

The Department of Health and Social Care is far too complex, important and large for the SoS to be distracted by other (potentially conflicting) priorities. The challenge of leading the DHSC is difficult enough without the added complications of leading the country in the Prime Minister’s absence or being the Prime Minister’s enforcer in Parliament.

The second lesson that must be learnt is the importance of ministerial consistency at the DHSC. The more successful ministers all have one thing in common; longevity in the post. Jeremy Hunt, Matt Hancock and Alan Milburn were SoS for between 3 to 5 years; allowing them to set the agenda. Any new SoS tasked with solving the numerous challenges must be given the time by the Prime Minister, parliament and the electorate to get on with his or her job.

Along with Prime Ministerial support, a successful SoS needs strong government and political stability. Without this support, any SoS is doomed to failure.

Complexity and size of the role, demands sole attention

20/20health consultant, Michael Ilsemann, says:

It is unsurprising, given the crises faced by Liz Truss, that the issues have not been addressed.

Despite the initial assurances that she would “hit the ground running”, the events of the last few weeks have demonstrated the futility of a minister and government attempting to grapple with the well-known problems facing the NHS at a time of extreme political crisis.

Regardless of political affiliation, it is a deep disappointment that a government which promised so much for the NHS, failed so spectacularly in such a short period of time. It is a sad fact that despite a few well-meaning soundbites and interviews, the same challenges facing the NHS remain for Steve Barclay

20/20health looks forward to engaging with Steve Barclay over the coming months and adding to debate over the future of healthcare provision in the UK.

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