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Friday 25th May 2018

Patricia Hewitt 'in the dock'

22nd August 2007

Writing in Health Service Journal, King’s Fund chief executive Niall Dickson puts former health secretary Patricia Hewitt in the dock and assesses her record.


The immediate verdict on former health secretary Patricia Hewitt has not been favourable.

The public see the NHS as a service that is failing to deliver, the British Medical Association expressed no confidence in her and health managers and Labour politicians may also hold a damning view of her legacy.

Yet she left the health service in surplus after tackling failings in financial management, with high patient satisfaction rates, falling waiting times and a reform programme that is more coherent than when she arrived.

After her predecessor John Reid went to the Ministry of Defence there was underlying financial instability despite three years of unprecedented levels of funding but it was not until after she became health secretary in 2005 that the seriousness of the financial position was realised.

Commissioning a Patient-led NHS was unveiled, a document that abolished and reinvented the two main organisational tiers of the NHS but the timing and the manner of implementation were wrong and alienated thousands of nurses, midwives and allied health professionals into “organisational oblivion.?

She intervened in the Herceptin debate - arguably another example of diving in too quickly - and in the public’s mind the failure to deal with MRSA and Clostridium difficile was even more critical.

One of her biggest failures was the inability to take staff with her on the reform journey but perhaps her greatest weakness was one of style, not substance.

Many of the issues Ms Hewitt had to confront during her two years in office were inherited - she did not approve the large pay awards for doctors or reduced hours for GPs or devise Agenda for Change.

But her achievements are real.

The white paper Our Health, Our Care, Our Say may come to be regarded as a seminal document signalling the beginning of new understanding of how care out of hospital can be developed. She must take credit for sorting out the financial situation and fought hard for a better comprehensive spending review settlement in both health and social care.

Ms Hewitt lost the battle for hearts and minds in the NHS but cleared up messes not of her own making and persevered with reforms, which have the potential to deliver a better service.


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