Jeremy Hunt has a once an opportunity to mend the NHS

The new Health Secretary has the chance to make historic changes to the British health system.Jeremy Hunt has a once an opportunity to mend the NHSJeremy Hunt has just accepted one of the toughest jobs in British politics. Coming from the Department for Culture, Media and Sport to the Department of Health, he moves from a department with a total budget of £2 billion to one that spends £100 billion each year.

His new brief involves running one of the largest organisations on the planet, and being held personally responsible when anything goes wrong anywhere. It will make staging the Olympics feel like a walk in the park.

Some say that it is a truly terrible time to take charge of the health service, which has to make eye-watering and unprecedented efficiency savings, to the tune of tens of billions of pounds over the next decade. In fact, there is no better time.

Mr Hunt has an opportunity to make history. He must show real leadership, persuade people of the need for change, and inspire people with a vision of a better health service. Every day there are news stories of inadequate clinical care, the abuse of patients, or shameful waste.

In an act of political alchemy, he must use these as evidence in making a case for change, and demand medical excellence, dignity for patients and value for money.

If he is going to be a radical leader, he needs to be able to see the wood for the trees. He must avoid going native in his department and getting drawn into tinkering with the Heath Robinson wiring of the system. He should surround himself with brilliant advisors who know the detail and can ensure that the Lansley reforms are delivered, and he should use his power of appointment to put reforming allies into key leadership roles in the arms-length bodies and regulators.

This should create the space for him to think big, identify game-changing solutions, explain that necessity can be the mother of invention, and persuade people of the need for a better health service.

It is to his advantage that, despite its imperfections, the NHS Act gives him all the legal apparatus he needs to drive through change. For instance, it should be possible to allow the best providers of healthcare, from any sector and any country to treat British patients.

What he needs to do is explain why this matters. Huge studies by the OECD and IMF have shown that competition improves efficiency, quality, responsiveness to patients and value for money.

The Office of Health Economics in London has found that competition can improve quality and “be an important source of innovation”. Only by harnessing innovation can he hope to save the NHS.

A strong leader will not tolerate mediocrity, let alone failure, instead championing high-quality, compassionate care. Some 20 hospitals are bankrupt and many more are teetering on the edge.

The rationale of the new system is that the clinical commissioning groups – which buy care on behalf of patients – will dispassionately judge hospitals by performance, irrespective of whether they are public, private or charity. If commissioners conclude that some services should be shut down or sold off, then he should back them, not play to the gallery like many of his colleagues in the House of Commons who defend their local hospitals even when they are not very good.

As soon as Mr Hunt puts patients first he will put himself on a collision course with the professional interests. He must be diplomatic but unflinching in the face of resistance. Professional bodies like the Royal Colleges, as well as unions like the BMA and Unison, will doubtless mount campaigns to protect their members.

He must stand for progress against protectionism. Nobody, including the unions – as Tony Blair used to say – should have a veto on change. Clearly, none of this will be easy. But this is your chance to stand for change, Mr Hunt. Over to you.

Nick Seddon was the author and is the deputy director of Reform at:

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