Sajid Javid faces a huge challenge as health secretary – he has to rise up to meet it

Editorial: Beyond Covid-19, there is a need to deal with expanding NHS waiting lists and social care reforms

(Brian Adcock)

When Matt Hancock finally bowed to the inevitable and resigned, Sajid Javid, as a “minister for all seasons” who had already held five cabinet posts, was an obvious person for Boris Johnson to turn to.

It was a pity he overlooked another former minister also languishing on the backbenches in Jeremy Hunt, the UK’s longest-serving health secretary, who has provided sharp analysis of the Covid-19 pandemic as chair of the Commons Health and Social Care Select Committee.

Mr Johnson probably felt he owed Mr Javid more than Mr Hunt, given the manner of his surprise resignation as chancellor – after only six months – following a power struggle with the now departed but ubiquitous Dominic Cummings. While recruiting from the backbenchers allowed Mr Johnson a swift response to Mr Hancock’s exit, it is also a pity he did not take the opportunity to conduct a wider cabinet reshuffle. The prime minister, it seems, wants to ensure he is not outshone by his ministers, but it does not serve the country’s interests for people such as Gavin Williamson to limp on in important jobs that are patently beyond them.

Mr Javid has the most bulging and unenviable in-tray of any incoming minister for many years. He said on Sunday his immediate priority was to “ensure to see that we can return to normal as soon and as quickly as possible”. His libertarian instincts might make him more inclined to lift Covid restrictions more quickly than Mr Hancock, but his duty now is to put public health first.

His new post is bound to bring Mr Javid into conflict with Rishi Sunak, who was his Treasury deputy before succeeding him. The huge backlog of NHS treatment, with a record 5.1 million people waiting for hospital treatment (excluding about 20 million patients not seen in outpatient clinics last year), the potential timebomb of long Covid, and the need to tackle a potentially dangerous combination of Covid and flu next winter, will require extra resources in the government-wide spending review this autumn.

Mr Javid will have to tackle a staffing crisis by ensuring adequate long-term recruitment of doctors and nurses and that demoralised, exhausted staff are properly rewarded for their herculean efforts in the past 18 months. Resources will also be needed to ensure the UK is much better prepared for the next pandemic than the current one. Covid has made better provision of mental health services even more urgent.

There is one lesson Mr Javid must learn from Mr Hancock’s tenure; he must remember every day that he is secretary of state for health and social care. The shameful neglect of care homes at the start of the crisis must never be repeated. Social care can no longer be the poor relation of the NHS, a short-sighted approach which merely piles even more pressure on hospitals. That will require long overdue reform and a stable long-term funding settlement to be finally settled in the next few months.

Mr Javid should hit the pause button on Mr Hancock’s proposals to assume more power to direct NHS England’s operations. Although the NHS welcomes some of the reforms in the Health and Care Bill, the case for more top-down control has not been proved.

Mr Javid should also think very carefully about who should succeed the impressive Sir Simon Stevens as NHS England’s chief executive. Dido Harding, the Conservative peer who has applied for the job, is a close ally of Mr Hancock but her record when she headed NHS Test and Trace hardly commands confidence.

It is time this government started to award jobs on the basis of what people know rather than who they know.