We’ve seen several iterations of Matt Hancock since he became health secretary. There’s been the energetic Tigger enthusiast determined that everyone must have the best experience possible as they are kept on hold for 30 minutes on the NHS 111 helpline. There’s been the tetchy, defensive Hancock, who has just realised he’s been set up by Boris Johnson to take most of the blame for the government’s failings over its handling of the coronavirus pandemic and can’t understand why Labour aren’t more supportive of what he’s done. The clue might be in the word opposition. Today we saw a third Matt as he delivered his speech to an audience of a few dozen doctors at the Royal College of Physicians on the future of the health service. This was newly-qualified-management-consultant Hancock, who couldn’t wait to share his MBA thesis on why management consultants shouldn’t have anything to do with the NHS with the rest of the world. Irony has never been his strong point. But then it turns out that talking management bollocks is actually Matt’s happy place. Ask him – as several news reporters did that morning – how he knows if people are properly self-isolating on their return from Spain or whether the R rate is above 1 in some parts of the UK – and he becomes almost monosyllabic. His answers to the above questions were “I know because I know” and “I’m not going to tell you” respectively. Yet allowed 50 minutes to bore on uninterrupted about how “the important thing about a system is that it should work as a system”, Hancock is like a pig in shit. It doesn’t take much to imagine him driving down to Cornwall for his summer break and insisting that his kids use the time to write down their goals for their holiday, along with a 10-point strategy document outlining how they are going to achieve them. Hancock raised a few eyebrows by opening his speech with a section on the positives to be taken from the Great Fire of London in 1666. Given that the fire had been partially responsible for ending the plague of the year before, it initially sounded as though Matt’s solution to the coronavirus might be to burn the entire country and start again from scratch. Only it turned out that what he really meant was that the Great Fire had been the catalyst for great change, like the rebuilding of St Paul’s Cathedral and the establishment of the fire brigade. So the coronavirus hadn’t been all bad news. Apart for those who had died from it. Here Matt started to get animated. The coronavirus had revealed the possibility of a new type of health service: one where people could be stacked up in hastily constructed Nightingale field hospitals. One where patients could be shifted out of hospitals into care homes without being tested. One where dermatologists could get to try their hand at ICU procedures as outpatient demand for their services had rather dried up. One where innovation could be brought in at speed. “There are seven major cultural lessons to be learned,” Matt said earnestly. At this point, you could feel the energy being sucked out of the room. His new mantra of innovation at speed clearly didn’t apply to him. “The first is that we must value our people.” Something every health secretary over the past 10 years has said, before imposing a whole range of cost-cutting measures to systematically undermine the entire profession. On and on it went. There must be mission-based standards of bureaucracy with clear tramlines. Yeah, me neither. We needed better tech and better apps with more patients having phone or video consultations with their GPs. Oddly, he chose not to mention his “world-beating” test and trace coronavirus app that was supposed to make the entire country safe and which has been long binned as useless. Then he didn’t talk about the telephone track and trace system, which has also been a lot less effective than anyone imagined.
“Seventhly,” Matt said eventually, to a few sighs of relief from those still awake. Health needed to be more holistic, which is why the government had introduced its new obesity strategy. Had he quickly changed into his retro 70s Adidas tracksuit and squeezed out some one-handed press ups, he could have rescued the whole morning, but sadly he passed up the opportunity and let his speech drift remorselessly to its close. No one really had any serious questions for Hancock. Partly because the audience was too comatose, but mostly because there was nothing to say. The doctors would believe it when they saw it. It had been an OK speech as these things go, but had been delivered at the wrong time. Most people in the NHS aren’t worrying about long-term reform so much as getting through the next 12 months. Only that morning, the Office for National Statistics had reported that England had the most excess deaths in Europe and the self-isolation guidance had been extended from seven days to 10, while Boris Johnson had a couple of weeks ago suggested the UK would be back to normal by Christmas. It wasn’t the NHS that needed a reality health check. It was the government.