Editorial Wednesday 17 March 2021: Hancock's half-witted hopes to re-politicise top NHS appointments

There are only a limited number of new ideas in the world.

There are also only a certain number of good ideas in the world.

Yesterday, in the evidence given to the Commons Health Select Committee by The People's Partridge, Health But Social Care Secretary Matt 'Alan' Hancock, he revealed a few things, which I discussed yesterday.

I gave too little weight to his comments on chief executive and chair appointments (picked up by HSJ's Sharon Brennan),  which imply that The People's Partridge's 'more Matt Hancock' approach would go really quite far.

Alan told the committee "The proposed approach on appointments is that [NHS England] would make appointments but they would need to be signed off by the secretary of state. So it is effectively moving appointments to joint appointments, in which the secretary of state would have to be content an appointment was appropriate, rather than the secretary of state appointing directly ... it would be a power of veto, where NHSE is responsible for the appointment, and a power of veto for chairs for the secretary of state, essentially meaning that they will be joint appointments”.

This is, indeed, going really quite far.

Re-politicising NHS appointments to chair and chief executive roles is not a good idea, nor is it a new idea.

Remembrance of politicisations past
Those with very long memories will recall that once NHS directly managed units (DMUs, which later became NHS Trusts) were created following the Griffiths Report, the politicisation of appointments to chair roles under the Conservative governments of the 1980s and 90s was very much A Thing.

Ex-military people were also favoured during those times of political appointees. They were not regarded as being notably successful.

In the 20 November 1985 House Of Lords debate on 'NHS And Reform Of The Social Security System', Lord Ennals - the former Health And Social Services Secretary David Ennals - stated, "there have been many cases where appointments which have been properly made by health authorities have been overruled by Ministers, which I think is a very unsatisfactory situation".

Another David, former NHS chief executive and then inaugural NHS Commissioning Board chief executive Sir David Nicholson, found this proposal by The People's Partridge to re-politicise NHS appointments remarkable. He remarked on Alan's strategy, "I can’t begin to explain how bad this is: at a stroke, you bring party politics into the boardroom of every NHS organisation".

Much of Nicholson's NHS management career trajectory to the top of the system was throughout the time of politicised appointments: he really knows what he's talking about on this (as many other) issues.

Sir David also still has skin in the game: he now chairs Worcester Royal and Sandwell and West Birmingham trusts.

I am grateful to Michael Lambert for drawing my attention to the 1995 Nolan Report on standards in public life. On page 70, it states that "appointments to executive NDPBs (non-departmental public bodies) and NHS bodies are the subject of considerable political debate. We heard suggestions from many of our witnesses that a disproportionate number of posts are given to Conservative Party activists, ex-candidates, or those who have donated money to the party, both as a reward for loyalty and as a way of ensuring boards who will be supportive of Government policies and uncritical of Ministerial decisions".  

If The People's Partridge and his colleagues in the Johnson government wanted to stand any chance of getting their NHS legislation through Parliament without an utterly avoidable major row, this proposal torches that option.

Once people realise what's happening here, Hancock's half-witted time in charge will undoubtedly draw to a close sooner rather than later.