Theresa May completed the reshuffle of her cabinet this week, implementing a moderate shake-up of her senior team while promoting a number of younger, female and minority ethnic MPs to junior ministerial posts. The Prime Minister was expected by some to implement the most radical alteration of the Cabinet in her short tenure as Prime Minister, but the principal offices of state – including the Home Office, Foreign Office, and Treasury – were unchanged with Amber Rudd, Boris Johnson and Philip Hammond remaining in post.

The highest profile casualty of the reshuffle has been Justine Greening whose 3-hour meeting with Theresa May on Monday night easily surpassed protracted negotiations over the roles of Jeremy Hunt and the Business Secretary Greg Clark earlier that day. The Education Secretary resigned from government by refusing to take up an alternative role at the head of the Department for Work and Pensions. Greening is succeeded by Damian Hinds; with former DWP minister Esther McVey becoming Secretary of State for Work and Pensions.

The Prime Minister sought to elevate the importance of housing and social care in 2018 by bolstering the portfolios of Sajid Javid – now Secretary of State for Housing, Communities and Local Government – and Jeremy Hunt – now Secretary of State for Health and Social Care. Despite this, Theresa May has earned few plaudits for a reshuffle that was seen as a chance to shift the negative political narrative overshadowing the work of her government, and has been criticised even by generally supportive publications.

Jeremy Hunt stays on as Health and Social Care Secretary

Jeremy Hunt has remained in charge of the health service after being handed an enhanced portfolio by the Prime Minister in her Cabinet reshuffle. The Prime Minister met with Hunt for the best part of Monday afternoon before officially moving the Surrey West MP into a new post as “Secretary of State for Health and Social Care.” He was tipped by many commentators to be promoted into the vacant First Secretary of State post created by Damian Green’s resignation and, later on Monday afternoon, rumoured to be taking a sideways move to the Department for Business, Energy and Industrial Strategy. Hunt will soon become the longest tenured Health Secretary in the history of UK politics.

The addition of “and Social Care” to his job title is at least significant to the extent that Hunt will oversee the social care green paper, set to be published in 2018, a task previously in the hands of Damien Green at the Cabinet Office. Chair of the Commons Health Committee Sarah Wollaston tweeted her support for the ‘new’ post on Monday evening, saying it is, “really encouraging to see both health and care together”. Wollaston has been pushing for the creation of a cross-party summit on health and social care funding in recent months and added in her tweet, “now we need the long-term planning and sustainable funding for the scale of increased demand and costs.”

Norman Lamb claimed the change was simply “window dressing… unless (the Government) is proposing to change funding of social care.” No significant reshuffle of responsibilities is expected for junior ministers within the Department of Health following Hunt’s reappointment.

For at least the third time since the 2015 election, Jeremy Hunt has become the unlikely survivor of a
major government reshuffle. Both Hunt and Business Secretary Greg Clark remained at Number 10 for over an hour on Monday afternoon to learn of their fates, with BBC political editor Laura Kussenberg reporting that Hunt was due to take Clark’s post, before convincing the Prime Minister of the need to keep him in Health and Social Care.

Two ministers appointed as Phillip Dunne leaves DH

Two Conservative MPs have been promoted to take on ministerial roles at the renamed Department for Health and Social Care. Stephen Barclay, MP for North East Cambridgeshire, has moved from his position as Economic Secretary to the Treasury, while Caroline Dinenage, MP for Gosport, comes across from the Department for Work and Pensions, having previously held junior posts in Education and Justice.

Barclay has not previously held a health role, although in 2013 he held an adjournment debate on the regulation of health professionals after the scandal at Mid Staffordshire following the death of a young constituent whose condition was misdiagnosed. He has campaigned to make it easier to sack doctors for misconduct. Barclay was previously a whip, before being appointed City Minister in June 2017 with extensive experience in financial law, and is also a former member of the Public Accounts Committee. Dinenage also has limited experience in health, but has been a government minister across three departments since joining the Ministry of Justice in 2015 and has 20 years’ experience as a small business owner.

Both Barclay and Dinenage have consistently voted against restricting the provision of services to private patients by the NHS, in favour of smoking bans, and reforming the NHS so GPs buy services on behalf of their patients. Jackie Doyle-Price Steve Brine and Lord O’Shaugnessy have all remained as Parliamentary Under Secretary of States in the department, whist Health Minister Philip Dunne has been removed from his role as Health minister.

New Secretary of State and Children’s Minister appointed at DfE

Damian Hinds, MP for East Hampshire, has replaced Justine Greening as Secretary of State for Education. Ms Greening had been widely tipped to lose her place in the reshuffle having disagreed with the Prime Minister over the Government’s proposed grammar school programme. In the end, she was offered the role of Secretary of State for Work and Pensions but refused the post and resigned from the Cabinet. Ms Greening’s departure comes at a crucial time for many of the reforms initiated during her short tenure including the Opportunity Area policy and consultations on strengthening qualified teaching status and the formation of a new sex and relationship education curriculum.

Mr Hinds 48, was born in London, went to a Catholic grammar school in Cheshire and read politics, philosophy and economics at the University of Oxford (where he chaired the Oxford Union). He was previously employment minister in the Department for Work and Pensions, where he faced questions on the roll-out of Universal Credit. Prior to his appointment in July 2016 he was exchequer secretary to the Treasury, and before that, a whip. He sat on the Education Select Committee between 2010 and 2012 and chaired the All-Party Parliamentary Group on Social Mobility, an area of policy which he says he is passionate about. When a member of the group he noted that giving preschool children essential skills was the key to breaking Britain’s class system.

Children and Families’ Minister Robert Goodwill, has left the Government. Nadhim Zahawi, MP for Stratford-on-Avon, has been appointed Parliamentary Under Secretary of State for Education. While it has not been confirmed, he will likely take Mr Goodwill’s portfolio. He co-founded the influential polling company YouGov and is a former government apprenticeship tsar. He has not previously worked in the Department for Education or in the health or education spaces.

School Standards minister Nick Gibb MP, and Skills minister Anne Milton MP, and School System Minister Lord Agnew, have remained as ministers.

Evidence of ‘worst ever’ winter NHS crisis mounts

Sky News has reported on the worsening of the NHS winter crisis, as figures show that in December nearly 15 percent of England’s A&E patients had to wait over four hours to be seen, significantly under the aim of less than five percent. This is the joint worst figure on record, and one percent worse than the performance in January 2017. 95 percent of NHS hospital beds in acute wards in England were fully occupied, which is the highest level since 2010, and there was a significant increase in the number of beds that were closed because of norovirus, diarrhoea and vomiting, from 731 in the week before to 944.

The figures also showed that last week hospital admissions doubled on the week before, from 4.89 per 100,000 to 7.38 per 100,000; 11 trusts reported having no beds available on Sunday. 16,690 patients were also kept waiting in an ambulance for more than 30 minutes before they could be handed over to A&E, which represents a slight improvement on the week before. However, 5,082 patients were kept for over an hour, which is an increase from the 4,734 patients in the previous week.

A group of senior doctors wrote a letter to the Prime Minister outlining their experiences working in A&E over the past few weeks. In the letter, they said, “Some of our own personal experiences range from over 120 patients a day managed in corridors, some dying prematurely”.

An NHS England spokesperson noted that “despite the clear pressure on the NHS in December, with rising levels of flu and record numbers of 111 calls and hospital admission, we managed to hold A&E performance at the same level as last January.”

Public Health Budget faces five percent cuts over next two years

After the NHS was given £2.8bn extra money in the Autumn Budget last year, Pulse has reported that the Government still plans to implement the 2015 autumn budget decision by former Chancellor of the Exchequer George Osborne to reduce the public health budget by 9.6 per cent between 2016-17 and 2020-21. This plan will result in five percent less funding for public health at the end of the period compared with today, equating to £170m less cash for local authorities.

Cllr Izzi Seccombe, chair of Local Government Association’s community wellbeing board, called the cuts “extremely counterproductive” outlining that the funding helped to “prevent illness and the need for treatment later down the line and ease the pressure on the NHS.”

Dr Dominique Thompson, a GP in Bristol, likened the cuts to “reducing seat belt use” as “public health is by definition preventive medicine” and said that the likely consequence of the cuts is an increase in demand for GP services. She opined that funding cuts were targeted at “soft” services such as smoking cessation and sexual health services “because people tend not to take to the streets waving placards asking for chlamydia and gonorrhea screening.” A GP partner practicing in Nottinghamshire, Dr Steve Kell, had its smoking cessation services cut and noted that many other practices had already lost such services and that cuts have led to a “fragmented system” that resulted in the loss of having a holistic approach.

A Department of Health spokesperson said, “we also have a strong track record on public health. Cancer survival and dementia diagnosis are at a record high whilst smoking rates and teen pregnancies are at an all-time low. Over the current spending period we will invest more than £16bn in local government public health services.”