Editorial Thursday 14 July 2016: New PM Theresa May retains Jeremy Hunt as Health Secretary

2016 is a year of surprises: I got a couple of political predictions right.

Both were on Twitter: first up, I replied to former Guardian leader writer and new Prospect editor Tom Clarke's tweeted assertion that "the great revolt of the people of England prepares the way for the smooth transition of power from one Etonian to the next", with the query "did Theresa May really attend Eton?"

A few days ago, I went on a long (and to some, annoying) tweeted disquisition about who would be the next Health Secretary in PM May's reshuffle, which I reproduce below:

I am justifiably not famous for getting predictions who'll be health secretary in a couple of days' time right, but what the hell: here goes.

(And I blow a loud, long raspberry to anyone who says 'Andy, you could have stopped after the first five words there', obvs.)

Health Secretary is not considered one of the Great Offices Of State (Home, Foreign and Chancellor are). Indeed, it's only been more than a ministerial job since 1968.

And DH has a reputation for being the last big Whitehall political job most people do, a rule whose only real exception to date was Kenneth Clarke, who went on to be (a fairy good) Chancellor. And before you reply 'Alan Johnson went from DH to the Home Office', well, yes he did. But that was part of The Brown Descent, and not really much good.

(Hereupon Victoria Macdonald of Channel Four News rightly reminded me that Dr John Reid also did the same, and I countered that a Cabinet minister who calls his own department "not fit for purpose" didn't quite ride the tiger successfully.)

So most NHS watchers are pretty confident that the NHS just about to encounter a significant financial 'shit-fan interface'. Theresa May or may not know this.

The Treasury do, which is behind this week's planned financial reset. HMT are going Full Simon Stevens (ignoring the legislation), but I'lll do that more fully in a future HPI piece.

As I was saying, the NHS finances will blow up, and no amount of Alan Johnson skills will get it reported as a 'News In Brief' on page 12. This will be headlines, and lead the 10.

Begging this question: who can you get to sort out knackered funding; strong-arm/sweet-talk HM Treasury and sort out huge cultural and morale issues, while also navigating the public/electoral unpopularity of changing care provision (i.e. making cuts to beloved local hospitals & services, even if that is the right thing to do).

Being the next Health Secretary might not sound like a wildly attractive job, phrased in those terms.

If Theresa May has an anhydrously dry sense of humour, she may give it to Boris Johnson. Except for, you know, the financial recovery and Treasury bit.

Then there's incumbent Jeremy Hunt, who has fallen out big-time with the BMA. Theresa May's attitude to Police Federation suggests she wouldn't give a monkeys about that.

The question is more whether Mrs May thinks broader cross-professional morale would on the whole benefit more from a fresh face than would be lost from the ending of continuity that Jeremy Hunt brings as the longest incumbent in the job, and from his sincere, sustained, impressive commitment to patient safety and transparency.

That could be a finely balanced judgment.

The need for Tory Party reconciliation over the EU advisory referendum may feature, as Jeremy Hunt was Team Remain.

Inevitably, I have little insight into who Theresa May likes or rates, but if she understands the severity of NHS & social care's oncoming financial storm, she may on balance ask Jeremy Hunt if he wants to stay.

The question that would then arise for Jeremy Hunt is whether NHS financial recovery inevitably unpicks the good work on patient safety. That is what many people think is likely to happen.

The Conservative Party's lack of appetite for a policy fresh start or new legislation due to Andrew Lansley Trauma points towards continuity.

On balance, I think that the Prime Minister may ask Jeremy Hunt to stay.

But I don't know whether he would be wise to do so.