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Editorial Friday 28 February 2020: Weather and friction | Health Policy Insight
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Editorial Friday 28 February 2020: Weather and friction

Publish Date/Time: 
02/28/2020 - 09:48

I’m grateful to a friend for giving me the insight below into Dominic Cummings, the special advisor to Prime Minister Boris Johnson.

This dates back to an incident when Mr Cummings was the special advisor to Michael Gove, who was then the Coalition Government’s Secretary Of State For Education. A person creating a charity to provide breakfasts for children in state schools was seeking the Education Secretary’s support, and so got a meeting with Mr Cummings.

At this meeting, Mr Cummings asked two questions about the project: “what is your objective, and what is the most frictionless way of achieving it?”

Cummings and goings
Those are two good questions to get an overview of whether the person with whom you're talking knows what they want to do and understands what the problems might be. They are not rocket science, but they are a tool to measure something.

It is straightforward to see why Mr Cummings matters right now: he holds a great deal of power and is wielding it.

This has the potential to matter significantly to both the NHS and social care. As Mr Cummings briefed The Times’ reliable Whitehall editor Chris Smyth, Number 10 plans to act to curb the legal independence of NHS England: “Cummings … believes that at present the law gives Sir Simon Stevens, the head of NHS England, excessive freedom, making it hard for Downing Street to impose its will”.

(It is worth noting that in terms of the logistics of available Parliamentary time and competing legislative pressures mean that any new NHS legislation would be unlikely to pass Parliament before the end of this year, at the earliest.)

At the moment, Mr Cummings is making the political weather. He may not control the climate for long enough for health and social care policy to arrive on the 10 Downing Street agenda in meaningful depth, but likewise he might.

If Mr Cummings starts to ask those questions of health and social care policy leaders, the objectives are probably not mysterious.

That conversation would start to become interesting on the topics of healthcare and social care friction.