Boris Johnson asked the people for a working majority and they gave him a landslide. In legislative terms, he will have more room for manoeuvre than any Conservative Prime Minister since John Major replaced Margaret Thatcher.
For health, this means that legislative change is now a certainty. The Conservative manifesto promises action within three months to “enshrine in law our fully funded, long-term NHS plan.” NHS England will hope this means that its own proposals will now be acted upon. Whether it is given a free hand remains to be seen.
There will also be legislation on patient safety and life sciences. Officials in the Department of Health and Social Care, although of course politically neutral, are likely to breathe a sigh of relief that highly technical legislation will not be prone to the uncertainties of a hung parliament.
Changing policy in a landslide Parliament will feel very different for the next Conservative Government. For years, ministers have had to tread carefully around coalition or confidence and supply partners, or rebellious backbenchers. No more.
Of course, with these barriers having disappeared, so will the excuses for failing to deliver. The Manifesto is no longer just an interesting text. It is the guiding document which voters will expect the Government to deliver in its entirety.
Make no mistake, expectations on health will be high. Ministers will need to make rapid progress on more staff, more nurses, more GP appointments and more money, not to mention changes to hospital car parking charges, action on cancer screening and a new Innovative Medicines Fund.
Then we come to social care. The result means that commentators will judge the Conservatives’ decision to avoid a detailed policy on social care as an electorally wise one, but it means it will be challenging to claim a mandate to move forward quickly on this. Cross-party talks are promised, but with Labour and the Liberal Democrats facing leadership elections, who exactly will they talk to?
Our focus is naturally on health, but it is important to remember that pent-up need for legislation exists across the public sector. The competition for legislative slots and political time and attention will be fierce. Not to mention, the Prime Minister will be focused on getting Brexit done (spoiler alert: it won’t be ‘done’ with the Withdrawal Act), as well as grappling with growing nationalist pressure in Scotland and potentially Northern Ireland.
The Parliamentary arithmetic may have got simpler, but the politics of health will still be challenging.