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Should Boris Johnson Worry About The Departure Of NHS Chief Simon Stevens?

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With just a week to go before the May elections, there was no shortage of politics around today. We had Boris Johnson’s “nothing to see here” line about his flat refurb, a fresh row about overseas aid cuts and anger from leaseholders facing huge bills for removal of Grenfell-style cladding.

Yet perhaps the biggest political news was the resignation of a Cabinet minister. You mean you missed it? Well, to be fair, NHS chief executive Sir Simon Stevens isn’t actually in the Cabinet. But his huge budget, his unrivalled knowledge of Whitehall and his clout within government have meant he has had more power than many ministers could dream of.

Stevens announced he would be leaving the role at the end of July, a departure date that neatly allows him to leave office having overseen the vaccination of all adults across England. All political careers are famously said to end in failure, but the NHS chief will buck the trend and go out on a high that most MPs would envy.

Stevens has also been handed a peerage. Given his commitment to public service and experience in how real power works, it’s not surprising that his next stage will be as an independent crossbencher in the House of Lords. 

When he was appointed to the chief executive job at the age of 47, he had the perfect CV for the role. An NHS graduate trainee, he managed large hospitals and trusts in the north east and London before working for the New Labour government a health policy advisor to Frank Dobson, Alan Milburn and then Tony Blair himself. A long stint in a global US healthcare firm came after Blair left No.10.

Through his seven years in the chief executive job, a tenure that covered three different Tory prime ministers, Stevens certainly knew how to get his way. Or rather the NHS’s way. Under Cameron and Osborne, he helped persuade them to back a sugar tax to start tackling the UK’s endemic obesity crisis. 

He also knew that with rising demographic pressures, cash was king. In 2017, when Theresa May wrongly claimed the service was getting more money than it asked for, he produced a Daily Mail newspaper headline at a select committee to show EU countries were spending more on beds, doctors and scanners.

But perhaps his shrewdest political move came later that year when he delivered a speech in front of a poster of the Vote Leave battlebus and its pledge to spend ”£350m a week” on the NHS. “These clear Brexit funding commitments to NHS patients – promises entered into by Cabinet ministers and by MPs – the public want to see them honoured,” he declared. The move bounced May and chancellor Philip Hammond into delivering more cash.

Once Boris Johnson became PM, that Brexit-style emphasis on the NHS became even more of an asset and Stevens was smart enough to harness a £20bn real terms spending increase. The Tory manifesto of 2019 was then stuffed with pledges to build 50 more hospitals and employ 30,000 more nurses.

The Covid pandemic ensured the NHS was again centre stage of public life, though Stevens made sure it was insulated from the worst bits of government policy (he pointedly said Test and Trace was not part of the NHS) and rightly credited with the best bits (the vaccine rollout and the heroic way the service coped with the first and third waves). 

His student-days association with Johnson, with both men having been Oxford Union presidents in successive years (Stevens the comprehensive-educated Labour contrast to Johnson’s fogeyish Etonian), helped too.

Indeed, when Stevens was finally allowed to co-host a No.10 press Covid press conference with the PM in November last year, his impressive delivery and grasp of the detail contrasted with the man alongside him. It led some in Labour to whisper he was “the best prime minister we never had”.

Stevens undoubtedly could have gone down the route of many former advisers and become an MP. Instead, his passion for healthcare led him back to the NHS. On everything from a greater priority for mental health to the closer integration of health and social care, he has proved a pioneer who could do business across the political spectrum.

And he always stood up for his staff, most notably pointing out the NHS had been budgeting for a pay rise for nurses that was higher than the 1% offered by government.

As parliament on Thursday formally prorogued ahead of next month’s Queen’s Speech, there was an end of term feel in the Commons. Yet with government reforms set to take powers from the NHS chief executive and hand them to the Secretary of State, Stevens’ announcement of his departure feels more like the end of an era.

But this summer probably won’t be the last we see of Simon Stevens, or his candour. When he was asked in January whether there was too much household mixing in December (a reference to Johnson’s failure to lockdown the whole country that month), his reply was a masterpiece of political economy: “The facts as we see it in the health service are that on Christmas Day we had 18,000 coronavirus positive patients, and now we’ve got just under 33,000.”

That was a hint that, come the inevitable public inquiry into Covid, his could be the testimony to watch. Once he’s left the health service, he will be even freer to speak his mind.


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