Jeremy Hunt admits the state of the NHS is ‘completely unacceptable’. So how does he survive in his job?

The Health Secretary's long tenure is a mystery, but it isn’t the most important question for the future of the health service

Jeremy Hunt clung on as Culture Secretary despite the row over Rupert Murdoch's takeover bid for Sky, and has survived as Health Secretary long after others would have been sacked (PA)

How does Jeremy Hunt survive? Today he went on TV to say that the performance of parts of the service for which he has been responsible for four and a half years is “completely unacceptable”. That is, naturally, the rhetorical use of the phrase, meaning “not exactly acceptable but not yet damaging enough to require my resignation”.

Indeed, one of the reasons for Hunt’s survival is that he is more willing than most politicians to soak up and even to accept criticism. He survived as Culture Secretary despite a huge fuss about Rupert Murdoch’s last attempt to gain complete control of Sky. He stayed on as Health Secretary when Theresa May took over as Prime Minister last year, even though that would have been the obvious moment to move him after he had become a hate figure for junior doctors after their long-running dispute.

Yet he is still there, claiming that health is the only job he wants in Government, despite a moment’s thought about running for the Conservative leadership after the fall of David Cameron.

The junior doctors’ dispute has not been defeated so much as smothered. But instead of taking the NHS forward to a period of relative calm and stability, he seems to be leading it into a bigger and wider crisis. This is no longer about him, as the very idea of a tax-funded universal health service, free at the point of need, seems to have come up against some rather fundamental problems.

Most people accept that the NHS needs two things: more money and a social care system capable of looking after old people once they are discharged from medical care (which also needs more money). But how to pay for it? And, just as important, how to ensure that more public money produces results?

Only the NHS half of the second problem is Hunt’s responsibility, which may be why, paradoxically, some of the pressure on him has eased.

This week’s BBC opinion poll cast doubt on the prospects of raising more money from income tax for the NHS – a general principle opposed by more voters than supported it. Even when the question was worded in a way designed to maximise support, by specifying a rise in the basic rate of income tax of just 1p in the pound, it was supported by only 50 per cent (with 36 per cent opposed). Renaming it a rise in National Insurance pushed up support only to 53 per cent.

Labour managed to raise National Insurance contributions by 1p in the pound “for the NHS” in 2002, but those were different times. And that was supposed to be a one-off rise in rates that would “fix” the NHS. If Philip Hammond, the Chancellor, were to try to do that again in next month’s Budget, people would say: “But you’re still taking money from us from the last time you politicians put up taxes.”

Yet a promise to spend more on the NHS is a powerful message, as long as someone else is paying. During the EU referendum campaign that “someone else” was Brussels. So it would not be surprising if one of Hammond’s more theatrical announcements on 8 March will be along the lines of: “The Leave campaign promised to spend £350m a week more on the NHS – I can announce that we will fulfil that pledge.” Given that the plans are to spend about £250m a week more on the NHS in 2020 compared with 2015, it might be possible to hit the £350m side-of-the-bus figure by 2021 or 2022 – especially as Hammond is likely to add to planned NHS spending next year anyway to avoid a fall in NHS spending per head.

What is surprising about this week’s leak of terrible figures for A&E and cancer treatment waiting times is that levels of satisfaction with the NHS remain high. Last month a ComRes poll for The Independent found 71 per cent of respondents agreed that “overall, the NHS provides a high standard of care to patients”.

It cannot last. All the indicators are heading in the wrong direction. Much of the nation has watched the BBC documentary Hospital, which showed the escalating inefficiencies of a health service at the limit of its capacity. Patrick Carter, the Labour peer advising Hunt on NHS efficiency, spoke this week of the “nightmare” of non-urgent operations being cancelled to get the service through the winter crisis: “Idle theatres. Idle surgeons. Idle clinicians. Idle anaesthetists. I mean, it just isn’t right.”

In the end, the NHS needs the Prime Minister and the Chancellor to decide its future. But Theresa May is distracted by Brexit and the Chancellor is wedded to the Treasury view that more money will just disappear into the maw.

Hunt may have survived because at least he knows a lot about the NHS and can soak up the pressure. But who will fix the health service?