How exactly does the new health secretary propose to ‘fix’ the NHS?

Thérèse Coffey has no personal experience or expertise in health or social care – she will have to learn fast, writes Ian Hamilton

Coffey has already identified her priorities using the acronym of ABCD: Ambulances, Backlog, Care and Doctors/Dentists (Reuters)

As with prime ministers, there have only been three female health secretaries – and the latest appointment made by new PM Liz Truss is her long-standing friend Thérèse Coffey. There has been considerable churn in the leadership of this large department with five health secretaries in as many years. This is clearly a department that needs some stability at the top.

Having stable leadership is crucial, as each newly appointed secretary cannot seemingly resist making their mark on the NHS – something that the late health economist Alan Maynard referred to as the “re-disorganisation” of the NHS. His criticism was that most changes lacked any evidence and were rarely evaluated. This seems remarkable, given the £13bn annual budget and the scale of the organisational upheaval involved. The reorganisation of the NHS in 2013 was judged to be so vast it could be viewed from space.

The recent inclusion of social care in the job description of health secretary makes this responsibility not only important but demanding. As if this wasn’t enough, Coffey has also taken on the role of deputy prime minister – not an insignificant job in itself.

So, given both these senior political positions it is worth reflecting on who Coffey is – and worth looking at her ambitions for the department with the largest budget.

Coffey has represented Suffolk Coastal as an MP since 2010 and has held senior positions within government. Prior to entering politics, she was employed in finance, experience that could serve her well in a department which spends such a significant amount of taxpayers’ money. However, she has no personal experience or expertise in health or social care – she will have to learn fast.

Coffey has already identified her priorities using the acronym of ABCD: Ambulances, Backlog, Care and Doctors/Dentists. At the root of all four areas is the issue of staffing (or, to be more precise, a lack of staff). Total shortages in the NHS stand at around 132,000 – and for social care, it is 165,000.

What is absolutely criminal is the absence of a workforce plan in an organisation that employs millions of people across the UK. It’s perhaps easy to see why there is no plan: publishing it would force the government to commit to spending on training, recruitment and retention. This would require significant sums of money to be realised.

But politics is not about making comfortable or convenient decisions – we elect our representatives to take on these challenges. The absence of a workforce plan is not just a Tory failing – Labour only appears to be evangelical about the idea when they are in opposition. Successive government and health secretaries have ducked out of committing to this important strategy.

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Every month, millions are spent on agency workers who are called on to ensure the bare minimum of staff on a ward or in a community team. Not only is this poor use of public money, it is also inefficient as permanent staff are left constantly orientating unfamiliar personnel. It is perhaps little wonder that staff feel demoralised and burnt out.

Care should not be about just managing – good quality care takes time, and patients should not feel they are a burden by speaking to staff or asking questions about their health.

There is little doubt that there have been incredible technological advances in health care in recent years, and that there will continue to be, over time. The basics of health care – compassion, listening, empathy and warmth – have not changed and never will. Yet these very human components can only be delivered by trained staff who are given the time to provide them.

The new health secretary should start by employing some of these skills and listening to health and social care staff – they not only know what the problems are, but they are clear about the solutions.

This should not involve yet another re-disorganisation of the NHS, no matter how seductive that may seem. The question for Coffey is whether she will have the time or the inclination to listen (and then commit) to a long-term NHS workforce plan. We should find out very soon.