Who do LMCs want as the next health secretary?

LMC representatives have no confidence in health secretary Patricia Hewitt, but who do they want to replace her? Henry Ellis seeks some opinions.

A deep-seated mistrust now exists between GPs and politicians with last week's LMCs conference passing a vote of no confidence in the government's handling of the NHS.

Whether health secretary Patricia Hewitt has steered the NHS in the wrong direction or not, it appears unlikely that she will survive the cabinet cull expected by prime minister in waiting Gordon Brown.

The political lull as Tony Blair conducts his lap of honour offers an opportunity to look at the impact that Ms Hewitt - one of his leading supporters - has had.

When Ms Hewitt took over from John Reid in May 2005, she bustled in on a wave of promise and immediately won over many GPs. But many have since become jaded by pay freezes and anti-GP spin, and the same optimism is unlikely to greet the next incumbent.

Norfolk LMC chairman Dr Ian Hume said: 'It isn't a matter of who takes over, it is what they are planning to do.

'Ms Hewitt came to Norfolk and gave a speech when she had just taken over as health secretary and she was very nice and personable. It also seemed that she wanted to listen to what GPs had to say. But two years on and it has all fallen apart really.

'She has done what she said she was going to do - she has pulled the NHS out of its financial crisis, but the morale of GPs has plummeted.'

'It is as if we are hearing two stories. They are spinning the financial situation as good, but on the ground we have seen vast amounts of cuts; at the practice level, there is a lot of stress.'

Expectations not met
Devon LMC chief executive Dr Peter Joliffe agreed.

'Off hand, I can think of nothing she has done. The major thing has been her ability to talk at one moment about how marvellous the achievement of GPs has been and in the next breath say we have been greedy, overpaid and duplicitous in negotiations. She cannot have her cake and eat it.

'She has done registrars a great disservice. How can such a farcical system as the Medical Training Application service, which has threatened the careers of some of our brightest young doctors, not be a resignation issue?'

'It is a shame Andrew Lansley is a member of the opposition party because he is the man I would like to see as the next secretary of state.'

Dr Joliffe's views are echoed by Derbyshire LMC chairman John Grenville, who said a strong leader was needed because Hewitt had not truly been in command.

'She has been very unpopular because she did not take any of the positive changes brought about by Milburn and Reid and build upon them. It has been quite clear that the main strategy for health is being set elsewhere.

'Ms Hewitt has been quite weak. There seems to be very little cohesion of policies.'

But Wessex LMC chief executive Dr Nigel Watson said it was easy to be too hard on politicians who took up the poisoned chalice of the NHS.

'I think to be fair to the politicians, they are trying to run a health department that is the largest employer in Europe with a limited supply of cash,' he said.

'I was having this same discussion with a couple of colleagues the other day and we were trying to think back to the last health secretary who was actually liked by GPs. We liked Frank Dobson because he was GP-friendly.'

Many GPs now think the NHS is a political football that has had the life kicked out of it in recent years.

Both the BMA and the King's Fund have said that the health service would be far better run by clinicians and managers without a political agenda to push.

Dr Mary McCarthy, Shropshire LMC chairman, said the time had come to wrest control of the NHS back from the government.

'I think the profession finds all these changes of mind demoralising and confusing,' she said.

'I would like not to see a new secretary of state for health at all.

I think an independent body like the King's Fund that is looking further ahead than the next election, not just looking for quick fix solutions, would do a far better job.

'The GP pay freeze was not necessary.'

Dr McCarthy added that GPs in her area had a regular meeting with the PCT which sought agreement on plans.

'Our PCT is critically underfunded - that has been a feature of Hewitt's time - and the government has tried to impose a very impractical model on us which does not take account of things like travel expenses for visits in a rural area,' she said.

'But after all the PCT's hard work to balance the books, it was hit with an £8 million top slice to bail out other worse-performing PCTs.'

Dr McCarthy was insistent: 'Whoever takes over as health secretary needs to engage more with clinicians.'

There does not seem to be a clear candidate to take over the reins. Hazel Blears, Harriet Harman and even Hilary Benn have all been mooted as possible successors by the media.

The GPs' choice
But the GPs' choice is health minister Andy Burnham - the only person to cause a ripple of interest among LMCs, it seems.

Dr Watson said: 'I am no reader of tea leaves but I would like to see Andy Burnham as the next health secretary. Certainly he is inexperienced, but I heard him speak in an interview a few weeks ago and he was very good.'

Dr Joliffe said that there was no excited buzz about the appointment, but he agreed that Mr Burnham might be the right man for the job.

'Andy Burnham talks the right way, and he did the right thing when he first arrived by getting out into the medical world and spending time in hospital A&E and GP surgeries to see first hand some of the difficulties involved in healthcare,' he said.

'Mr Burnham spent some time in Plymouth with one of our members and he was impressed. But I think he might be too young for the job and I do not know where he lies within the machinations of the party.

'The NHS is unfortunately one of the greatest toys in the cabinet toy box - one of the only ones they can play with without Brussels taking it away from them. But I agree with Dr McCarthy - it should be depoliticised.'

Three of the four leading candidates for the health secretary's job are involved in the race to be deputy prime minister. The results of that ballot will be announced on 24 June.

The leading candidates for health secretary
Hilary Benn - MP for Leeds Central and a Labour party deputy leadership candidate. International development secretary for the past three years.

Hazel Blears - MP for Salford and a deputy leadership candidate. Currently Labour party chairwoman and minister without portfolio at the Cabinet Office. Former public health minister.

Andy Burnham - MP for Greater Manchester constituency of Leigh. Appointed health minister responsible for GPs in May.

Harriet Harman - MP for Camberwell and Peckham in South London and a Labour party deputy leadership candidate. Currently minister for constitutional affairs.

Time line to a new prime minister

22 June: Deputy leadership ballot closes.

24 June: Deputy leadership result announced.

27 June: Tony Blair has an audience with the Queen and resigns as prime minister.

Gordon Brown is invited by the Queen to form a government and receive the seals of office, becoming prime minister.

What do you think? Comment below or email healthcare.republic@haymarket.com

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