Jeremy Hunt served as Secretary of State for Health, later Secretary of State for Health and Social Care, from 2012 to 2018. Appointed by David Cameron, Hunt served in the Cameron–Clegg coalition and Cameron majority government. He was reappointed by Theresa May and served in the majority and minority May governments. In January 2018, Hunt gained additional responsibility for social care in England and, in June, became the longest-serving Health Secretary in British political history. He left the role when he was promoted to Foreign Secretary following the resignation of Boris Johnson, and was succeeded by Matt Hancock.
Hunt pursued an ambitious agenda to address patient safety, regional variations in premature deaths, health tourism and A&E waiting times. He oversaw decreased spending as percentage of GDP on the National Health Service compared to the previous government and hugely increased waiting times for patients. Healthcare costs always increase faster than GDP. He was criticised for controversial reforms, manipulating figures and increased privatisation. He implemented policies working towards a seven-day NHS and oversaw the imposition of a controversial new junior doctors' contract in England, after the failure of negotiations during a dispute in which junior doctors undertook industrial action.
Appointment Hunt was appointed Secretary of State for Health by David Cameron in a cabinet reshuffle on 4 September 2012, succeeding Andrew Lansley. Hunt had previously co-authored a book calling for the NHS "to be replaced by a new system of health provision in which people would pay money into personal health accounts, which they could then use to shop around for care from public and private providers. Those who could not afford to save enough would be funded by the state." In an attempt to better understand the NHS, he shadowed workers which eventually established his keystone policy: patient safety.
Views The Daily Telegraph science correspondent Tom Chivers expressed concern in 2012 that Hunt was known to have supported homoeopathy. In 2014 Hunt asked the Chief Medical Officer to initiate expert reviews of three homoeopathic studies carried out by Boiron, a French manufacturer of homoeopathic products. Later that year, Hunt denied personally being a supporter, and blamed his inexperience as a new MP for previously signing a pro-homeopathy early day motion. However, he did support NHS funding for it if recommended by a doctor.
In 2012, Hunt said that he was in favour of reducing the abortion limit from 24 weeks to 12 weeks. In 2013, he said that the regional variations in premature deaths throughout the United Kingdom were "shocking".
In February 2018, Hunt attracted attention after defending the universal coverage provided by the NHS against US President Donald Trump, saying "I may disagree with claims made on that march but not ONE of them wants to live in a system where 28m people have no cover. NHS may have challenges but I'm proud to be from the country that invented universal coverage – where all get care no matter the size of their bank balance".
Health tourism
In 2013, Hunt announced plans to charge foreign nationals for using the NHS, claiming that the cost was up to £200 million though official figures put it at £33 million. However, £21 million of that £33 million was already recovered, putting the actual cost at £12 million – less than Hunt's crackdown could cost.
A&E waiting times
It was reported in December 2013 that Hunt was personally telephoning the Chairs of NHS hospital trusts where targets in Accident and Emergency (A&E) departments had been missed, a course of action which was described as "crazy" by David Prior, chairman of the Care Quality Commission and a former Conservative MP. Prior said that while Hunt, like his Labour predecessors, took responsibility, the result was money being diverted from primary and community care to A&E. However, Dr Clifford Mann, president of the Royal College of Emergency Medicine, blamed the problems on the Health and Social Care Act 2012 for causing "decision-making paralysis" and leaving the country short of around 375 emergency doctors.
In January 2018, Hunt apologised to patients in England affected by the decision to postpone tens of thousands of operations. Hunt made his comment as reports emerged of patients having to wait a long time to be treated, with ambulances left queuing outside A&E departments.
In March 2018, Hunt informed NHS trusts that they would not be required to meet waiting time targets for A&E patients in the following year. The decision was criticised by the Patients Association and National Voices.
NHS pay In March 2014, Hunt announced that the government would not give a recommended 1% pay rise to NHS non-medical staff receiving progression pay (around 55% of total non-medical staff). Later that year, he declared that patient choice was not key to improving NHS performance, in a major break from a policy favoured by Conservative and Labour governments over the previous 12 years. He stated that "there are natural monopolies in healthcare, where patient choice is never going to drive change". Following a pre-election report in April 2015 that hospital chiefs shared an average 6% pay rise totalling £35 million, Hunt promised to investigate if the Conservatives won the election.
Outsourcing In 2015, an undercover Daily Telegraph investigation showed that in some cases locum agencies, Medicare and Team24 owned by Capita were charging some hospitals higher fees than others and giving false company details. The agencies were charging up to 49% of the fee. Hunt criticised those who sought "big profits" at the expense of the NHS and taxpayers and promised to "reduce the margins rip-off agencies are able to generate."
NHS weekend cover In July 2015, Hunt indicated that he would be prepared to impose a new consultant contract on doctors in England which would remove the opt out for non-emergency work at weekends. He stated this was to prevent "about 6,000 avoidable deaths" resulting from a "Monday to Friday culture" in some areas of the NHS and to reintroduce "a sense of vocation" in consultants. The comments angered many doctors who responded by sharing photographs of themselves working at the weekends via social media using the hashtag #ImInWorkJeremy. It emerged in February 2016 that the "6,000 avoidable deaths" figure was based on Hunt's own understanding of an unpublished, unreviewed study by Freemantle et al. that he had access to before its publication in September 2015. The latter had been denied by NHS England's Freedom of Information Officer in October 2015. At the time NHS England also asked one of the authors to corroborate Hunt's figures who refused to do so, stating that it would interfere with the peer review of the unpublished paper; in response they reframed the figure as being based on earlier studies on its website in August 2015.
In October 2015, Hunt was accused by the editor of The BMJ Fiona Godlee of repeatedly misrepresenting a study published in the journal in the same year by Freemantle et al. on the weekend effect to parliament and the public. He had used the study as key evidence when stating in parliament and in interviews with the media that reduced staffing levels of doctors at weekends directly led to 11,000 excess deaths. Godlee asserted that the study's authors did not specify that the excess deaths were avoidable or that staffing levels were the cause. The lead author of the study Nick Freemantle, when asked about the study in February 2016, stated that they did not identify a cause for the excess deaths or establish the extent to which they were avoidable. Co-author NHS Medical Director Sir Bruce Keogh in response to Hunt's comments in October also stated "It is not possible to ascertain the extent to which these excess deaths may be preventable".
Hunt was also criticised for the fact that his claims about hospitals being more unsafe at weekends not merely misrepresented the facts but had potentially caused patients to delay going into hospitals and thus put them at risk. His critics described the Hunt Effect where patients who needed medical attention at a weekend had been deterred from doing so because they were persuaded that it would be better to wait until a Monday. Statisticians Professor David Spiegelhalter and David Craven, Dr Mark Porter, BMA council chair, Heidi Alexander, the shadow health secretary also denounced Hunt for making misleading statements about weekend hospital treatment after his assertion in parliament in the same month that "currently, across all key specialties, in only 10% of our hospitals are patients seen by a consultant within 14 hours of being admitted at the weekend." Speigelhalter stated that the data from NHS England showed that on average 79% of patients are seen within 14 hours by a consultant across all specialities and that this data is collected for the whole week so it would be flawed to state figures for the weekend as Hunt did. NHS England confirmed that it would not be possible to separate weekend and weekday performance from the data.
In January 2016, Hunt was criticised by top stroke doctors for using out-of-date data to try to show that stroke patients are more likely to die if they are admitted at weekends. They wrote that there had been significant improvements since 2004–12, when the data Hunt had referenced came from, and that new data showed there was "no longer any excess of hospital deaths in patients with stroke admitted at the weekend." Stroke specialist David Curtis said even the outdated statistics did not support Hunt's claims.
In February 2016, a mid-January internal report by the Department of Health was leaked. It stated the department was unable to find evidence to prove a link between increased consultant presence, availability of diagnostic tests, and reducing weekend mortality and length of stay. It also highlighted that the seven-day NHS could cost an additional £900 million each year, required the recruitment of 11,000 more staff including 4,000 doctors and 3,000 nurses, and that community and social services could struggle to handle more discharges at the weekend.
In May 2016, a report by the House of Commons public accounts committee criticised Hunt's plan for a seven-day NHS, saying "no coherent attempt" had made to understand staffing needs, the plan was "completely uncosted", and contained "serious flaws". Another study also concluded there was no evidence that people were more likely to die in hospitals at the weekend. In August, internal risk management documents produced by civil servants in the Department of Health in July were leaked. They described 13 major risks in delivering the "truly seven-day NHS" pledge promised by the Conservative party prior to the 2015 general election. These included a lack of staff and funding for the policy. The documents also discussed that no advance impact assessments had been made to show how the policy would affect the delivery of NHS services. Chris Hopson, chief executive of NHS Providers, the organisation that represents NHS services in England described the seven-day NHS plan as "impossible to deliver" due to a lack of funding and staffing. He also highlighted pressures on the NHS with 80% of acute hospitals in England in financial deficit compared to 5% in 2013 and an increase of missed A&E waiting time targets from 10% to 90% in the same time period.
No-confidence petition