27 July 2022: Hunt - A

It was considered by this writer to be quite important to get the elephant out of the room first. Why has the rumour about Jeremy Hunt and his familial connections been so persistent, and why has he done so little to squash these misinformation messages? It has long been asserted, mainly online, that Jeremy Hunt (a former Health Minister) is the nephew of Virginia Bottomley (an even more former Health Minister). Such alleged factoids give the so-called conspiracy theorists so much material to work with. Surely, if that was being said about you, and especially if you were being erroneously linked to VB of all people, you would make every effort to refute that untruth (… unless?)

In strode Mr Hunt, his wine coloured tie resembling a sliver of dried up blood. Unlike so many of his political peers with their penchant for high living, he appears to have generally maintained his physique, albeit under a suit. He certainly matched the idealised avatar for a political leader with his youthful looks, full head of hair, relatively tall stature, and lack of distinguishing tarnishes.

Mr Hunt has the accolade of being the longest serving Health Minister ever. He seems to have been one of the previous “ones to watch” as evidenced by his fairly meteoric rise to a Cabinet post. He took over from Andrew Lansley at Health after a re-shuffle, so he was part of an unplanned change which meant he did not benefit from a prepared handover or time in opposition with a chance to become familiar with the Health brief. The responsibility for blood policy, including support schemes fell to a series of Junior Ministers. He said his main personal aim was to make a difference on patient safety issues. The witnesses’ first Junior Minister for blood policy was Anna Soubry.

His arrival with the leading Health role came with no more experience of Health matters beyond himself being an NHS patient. He agreed he could have changed the responsibilities of his team of Junior Ministers, but it tended not to happen that way. He said the frequent changeover of Junior Ministers is the way it was done, but it shouldn’t be. “Government is poorer for it”, he suggested. Decisions on what Junior Ministers worked in what departments was a Number 10 decision. The Secretary of State had no control over that. You largely worked with the team you were given.

He came from a business background with no knowledge of Health matters. He therefore selected a few topics for him to focus on and delegating everything else to the Junior Ministers. From that and the Mid-Staff situation, (the Inquiry led by Sir Robert Francis QC), he realised the gap in someone having an eye on patient safety. He had weekly meetings with his team of Ministers where people raised any matters happening within their briefs. The witness tried to have most of his meetings on a Monday before 3:30pm. The Permanent Secretary attended most of the series of meetings on a Monday. His work with the Permanent Secretary was more ongoing and informal. He had less frequent contact with Chief Medical Officers (CMOs) unless there was a specific issue, such as e-bola. Mr Hunt recognised the reliance of Ministers, including himself, on officials and their briefings. There was always the possibility of Ministers thinking about disagreeing with an official briefing, but it was not a common occurrence. Mostly, the briefings were essential aspects which allowed Ministers to do their job effectively. He noted how sometimes there was “institutional inertia” against change.

After five months he realised he had not seen a single letter from an NHS patient. He discovered there were 150 officials dealing with correspondence to the Health Minister; which of course no one Minister could ever handle directly. He wanted that to change under his leadership, but initially nothing happened, he assumed because the officials considered his request as a bad idea and hoped he would forget about it. Nevertheless, he pushed it, and after getting to see letters praising the NHS, he insisted on seeing letters about problems. This strengthened his desire to understand the problem areas which were resulting in patients being harmed and the NHS not listening. He inherited a basic rule of never publicising or minimally responding to negative issues.

He discovered a “blame culture” throughout the NHS where there were repeating mistakes that are never addressed. The people who look like they are ignoring patients are often themselves scared of speaking out for fear of their own jobs. He tried to respond to one letter but got it back with a note saying, “Apologies not permitted”. The fear was that any such letter of apology for what happened to someone would turn into an admission of liability. He did not accept the advice and had the letter sent out as he had wanted. He did not seek to point out individual clinicians, but the denial and cover-up culture had to end. The Mid-Staffs situation taking four years to get fixed was just unacceptable. He saw the need for much more transparency, but it was a major cultural change, and initially it would expose people to accusations of neglect or mal-administration.

Mr Hunt had some communications directly with the Devolved nations, but since each of the four were run by different political parties, it was better to let the liaisons happen between officials. Health was too easy to be used as a “political football” and could turn into finger pointing about each other’s shortcomings, which was not helpful to anyone. With the Treasury, he experienced the big press to make cuts when at a different department, but it seemed the NHS was exempt, relatively. Any big spending decision required Treasury approval. Theoretically, a Minister could go to the Prime Minister, but with David Cameron and George Osborne being such good friends, you always knew what the outcome would be. Basically, there was never any extra money between funding rounds, unless for example, you were the Ministry of Defence and had a war to fight.

Prior to becoming Health Minister, one of his constituents (Mike Dorricott) had made it clear that there was a major injustice due to the administration of contaminated blood to patients of the NHS. Mr Hunt is the first Government witness this writer can recall making reference to the “Contaminated Blood Scandal”. When he became Health Minister, Mr Dorricott wrote to Mr Hunt on the issues related to the scandal. In the normal course of DH workings, the response was handled by Anna Soubry and gave the normal departmental response, but in the eyes of Mr Hunt it indicated how his Junior Minister was dealing with it. This was despite Counsel pointing out how much the reply did not address the matters raised in Mr Dorricott’s letter.

Counsel then displayed a general briefing on matters related to blood safety. The witness interjected by saying it was “wrong” and it was a “bad briefing”. It suggested that the matter was closed but it was not. It did not recognise the difficulties faced by people, rather it was more about protecting the Government. Mr Hunt referred to what he called a “memory illusion”, being an institutional desire to remember things in ways that suit their preferred recollection.

This writer noted the straightforwardness of the evidence session. The witness is not coming across as seeking to hide from or deny the relevant matters. In cricketing terms, he appears to be playing a straight bat. There were freely-made admissions of inadequacies within Government, with a candour in line with the stated hopes of the witness for being culturally adopted by the NHS. He referred to a thought process where, by and large, nobody is trying to do the wrong thing; apart from a very small number of rogue individuals. But it results in people suffering and dying. He referred to Andy Burnham being advised not to meet the victims of the Mid-Staffs and expects not doing so was a regret. Mr Hunt recalled a time when he was Foreign Secretary when he wanted to meet personally with Richard Ratcliffe, the husband of Nazanin Zighari-Ratcliffe who had been detained in Iran but he was advised against doing so due to fears about how Mr Radcliffe might use the meeting. The witness explained his view that, “Institutions close ranks around a lie, sometimes”. He noted how the response to the original communication had been handled by Norman Lamb, who the witness described as a great champion for unpopular causes.