Better the devil you know? This new Health Secretary is definitely one to watch

Steve Barclay is the new Health and Social Care Secretary in the Johnson Cabinet. NHS managers were quick to respond:

A real nightmare, vindictive, arrogant, a bully, hostile to the NHS and all its works, a micro-manager of the wrong things, views NHS management as bloated and profligate.

In the dying moments of his premiership, Boris Johnson appointed his arch-supporter Steve Barclay to replace Sajid Javid, who resigned as secretary of State for Health and Social Care in order to get Johnson out of Downing St. Barclay says ‘It is an honour to take up the position of Health and Social Care Secretary. Our NHS and social care staff have showed us time and again – throughout the pandemic and beyond – what it means to work with compassion and dedication to transform lives.’

But the above views of NHS managers, quoted in the HSJ and the known views of Barclay are sounding alarm bells for the NHS services and already exhausted and hard-pressed staff. NHS managers have long been a popular scapegoat for the real problems of government underfunding, neglect and reform, with non-clinical employees providing an easy target in Conservative opposition to a ‘socialist service’. It would seem sadly, that Steve Barclay is certainly no different in his attitude towards them and may well therefore neglect the chance to actually reassess what the service really needs.

More of the same or even worse

In his acceptance speech, Barclay repeats government claims that it ‘is investing more than ever before in our NHS and care services to beat the COVID-19 backlogs, recruit 50,000 more nurses, reform social care and ensure patients across the country can access the care they need.’

Parroting out the same baseless assertions will mean little to NHS staff and campaigners. Steve Barclay may well prove to be the shortest serving Health Secretary in history (depending on how the leadership election goes and what choices are made) but worryingly this may well make him even more determined to leave his mark.

A Cambridgeshire MP, a former Treasury minister and Brexit secretary, Steve Barclay is something of a new kid on the block when it comes to health. He had a brief stint as a junior health minister (between January and November 2018) but this former solicitor and banking director’s appointment has already been ringing alarm bells amongst NHS managers and those who work for and care about the NHS.

Money Man

Steve Barclay first joined the government in 2015 as assistant Chief whip at the Treasury. The Prime Minister appointed him Chancellor of the Duchy of Lancaster and chief Secretary of the Treasury in February 2020, a role he retained until September 2021. Here he was responsible for controlling government spending as well as public sector pay and pensions. It will be interesting to see what this former Treasury chief will do in a couple of weeks’ time when faced with the decision of what pay to award NHS staff following the review bodies recommendation…

When Barclay worked under the now former Chancellor Rishi Sunak he was apparently known for favouring efficiency (historically NHS language for cuts) and referring to the NHS as (in the words of one of the Health Service Journal’s (HSJ) senior sources) as “a bottomless pit, resistant to change and unaccountable”.

Dangerous mistrust of NHS at beginning of pandemic

Dangerous mistrust of NHS at beginning of pandemic
During his tenure at the Treasury managing government finances, Barclay’s distrust of the way the NHS operates nearly led to disaster in late 2020 when he decided to block the start of the Covid vaccination programme. Apparently, Barclay argued over authorising the funding on the basis of ‘value for money’. NHS England chief executive at the time, Sir Simon Stevens thankfully disregarded this action, and the green light was given around 4 weeks later, by which time almost a million people had benefited from a first vaccination.

More cuts to come?

The very last thing a massively run-down NHS on the brink can cope with is yet more funding cuts, and yet that is a genuine concern with this new appointment. A senior minister at the Treasury has been known to have said “Steve is quite hardcore around ‘do you really need 60 people doing that job, why haven’t we got 50, or 30 or 20?” He has been known to go into government spending with a fine-tooth comb. Nothing wrong with that, until you consider the very likely motives of this government, the direction towards NHS reform and ‘efficiency savings’, and what this means in practice.

Questionable choices

As well as being someone seemingly committed to cuts and reform, Barclay is known for being one of Johnson’s closest allies, having defended him over the partygate scandal and being involved in operation ‘Save Big Dog’. He was made Chief of Staff in February 2022 for his efforts.

The new health secretary perhaps unsurprisingly, also sides with the party on the vast majority of issues, and was one of those who voted in favour of controversial revisions to the recent Health and Care Bill. On a crucial vote to improve workforce planning in the NHS (amendment 29 to the Health and Social Care Bill) he did not vote.

In a move that will greatly concern NHS campaigners and those desiring the reinstatement of a fully public health service, Barclay has voted against restricting the amount of income that trusts can earn from private patient care, showing exactly where his loyalties lie.

Not a “nice bloke”

Barclay showed his true colours at the Treasury. Just how that will play out in this instance, and what repercussions it will have for our NHS, is a genuine concern. Notably, one NHS leader summed him up by saying he had: “all the bombast and unfounded assumption of expertise of Hancock but without being a nice bloke”. Keep Our NHS Public has a different memory of Matt Hancock and we expect a similar experience from Barclay.

We’ll have to wait and see.

Samantha Wathen is the Press and Media Officer for Keep Our NHS Public