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What’s the plan, Mr Hunt?

BMJ 2016; 354 doi: (Published 21 July 2016) Cite this as: BMJ 2016;354:i4036
  1. Fiona Godlee, editor in chief
  1. The BMJ
  1. fgodlee{at}

If Jeremy Hunt had hoped for a respite from being health secretary for England, he’s not letting on. He greeted his return to “the best job in government” with apparent delight (doi:10.1136/bmj.i3946), a sentiment not shared, though, by most of those working in the NHS (doi:10.1136/bmj.i3972). Nor does he have the confidence of fellow MPs. A highly critical report from the health select committee accuses him of misleading the public about how much money the NHS is getting (doi:10.1136/bmj.i3999): “less than would appear to be the case from official pronouncements,” it says.

Money earmarked for transformation projects is being used “almost entirely” to plug deficits in hospitals, and extra funds for mental health could meet the same fate. “We are concerned,” says the MPs’ report, “that these measures are masking the true scale of the underlying financial problems facing the NHS.” This and the largest aggregate deficit in the NHS’s history are a damning indictment of Hunt’s stewardship.

Cuts to social care have also played a part, exhausting opportunities for NHS efficiencies. Under these circumstances, Chris Ham says that now is the time for political realism about what the NHS is able to deliver (doi:10.1136/bmj.i3960). Meanwhile NHS England’s chief executive, Simon Stevens, writing in the Telegraph (, calls for “bold and broad reforms” to the service. General practice has repeatedly lost out to the ever hungry acute care sector, he says. He wants a strong focus on prevention and action to reduce health inequalities.

Few would disagree that these are crucial to tackling the growing burden of chronic disease. All the more worrying then that the government has delayed its long awaited obesity strategy in the wake of Brexit (doi:10.1136/bmj.i4011) and has cut spending on public health. The chair of the health select committee calls this “a false economy, creating avoidable additional costs in the future.”

Could it be that the government’s game plan is to run down rather than run the NHS? We must hope not. The new chancellor of the exchequer has indicated that he is willing to borrow more to spend more. And the House of Lords has embarked on a listening exercise, seeking ways to ensure a long term sustainable future for the NHS ( Public consultation runs till 23 September. Anyone with an interest in the NHS’s future should contribute.

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