Incisive Health analysis of the election of Boris Johnson as Conservative Party leader, and therefore Prime Minister.
The day has finally arrived when Boris Johnson fulfils his lifetime ambition and becomes Conservative Party leader, and tomorrow he will officially become Prime Minister. But what kind of Prime Minister he will be, what he will focus on, and – frankly – how on earth he will do it, is all still uncertain.
Many column inches have been and will be devoted to these questions, and there is little point in adding to it all here. Amidst all the analysis, however, a simple truth bears repeating: Boris Johnson is better-placed than Theresa May to persuade the Conservative Party’s hardline Brexiteers to support a deal with Brussels.
What told for Theresa May was that, once she started compromising, there was no easy defence to the Brexiteers’ charge that it was all because she was a closet Remainer. Whilst some of the Brexiteers may hold the same view of Boris Johnson, his easy riposte is that he did lead the Leave campaign, actually. It may not convince them all, but it will convince many. And if he accelerates and intensifies no-deal preparations (yes, in defiance of Parliament), it will convince more still.
Whether this will convince enough Brexiteers, however, whilst not alienating the Rebel Alliance being forged somewhat-improbably by Philip Hammond, and also bag enough Labour Brexiteers to heave a deal over the line in the House of Commons… well, that is another question. Thankfully, this piece does not seek to answer it – but focuses instead on what our readers really want to know, which is what our new Prime Minister might do on health and care policy.
We can start with Boris Johnson’s pitch to the Conservative membership: to deliver Brexit; unite the country; and defeat Jeremy Corbyn. And we can assume the latter at some point requires a general election.
We know too how the Conservative Party fights its general elections on health: by trying to neutralise Labour’s lead – as far as it can – and by talking about anything other than the NHS.
And so the must-do for Boris Johnson is to avoid controversy on the NHS. In pursuit of this, he may well splash some cash to show the voters that, yes, the Tories can be trusted. He has talked throughout the campaign of his desire for more spending on infrastructure, after all, and the incompatibility of this with the Government’s current fiscal rule may unlock some kind of a solution for NHS capital investment. He has hinted at some fiscal fine-tuning too: in the midst of the leadership campaign hustings, on 8 July, he said of the problem of doctors’ pensions, “we will fix it, we’ll fix it”. Welcome news, doctors will hope.
Alongside spending, Boris Johnson may make warm noises about NHS England’s proposals for legislation – thus providing the “reform” he promised during the campaign – although he may then do nothing further to expose them meaningfully to Parliament.
More interestingly, Boris Johnson may make good on his promise – made in a recent Telegraph column – that his first Budget will contain preferential tax breaks for employers providing occupational health and mental health services. The idea has been kicking around Whitehall for months, years even. Will it finally see the light of day?
And then he might say something on social care. Perhaps surprisingly, he has said more on this subject than the NHS on the campaign trail. In early June, he said it was “probably” the biggest challenge facing the country. Later in June, he articulated the principles that should apply to reform: no one at risk of losing their home; and everyone being treated with dignity in old age. Earlier this month, he committed to publishing a Green Paper. The Sun even trails plans for a social care insurance scheme this morning.
We’ve heard a lot of fine words on social care before, of course, and so genuine long-term solutions might still be some way off – not least because Boris Johnson emphasised repeatedly throughout the hustings that such solutions were only possible on a cross-party basis. Put simply, he has been saying enough to offer hope of a fix, but giving himself the flexibility to avoid having to provide it.
Our readers will be forgiven for overlooking some of this finer detail in the blur of the leadership contest. If anything stands out, it will probably be the spat on sin taxes – when Boris Johnson famously dismissed leaked plans to extend the sugar tax.
That was back in early July, and it was depressing stuff then – but we recalled it late last night with the buried publication of the prevention green paper, shorn of the Department of Health and Social Care’s branding and without an accompanying press release. Whether this odd episode was due to Health Secretary Matt Hancock’s desire to align with the incoming Prime Minister’s anti-nanny state views, or more charitably to avoid binding the hands of Theresa May’s successor we do not know, but it reminded us that the pursuit of power is rarely an edifying spectacle.