Following the resignation of Sajid javid, Steve Barclay was named the new health secretary. He had expressed dissatisfaction with Boris Johnson’s leadership and quit.
He takes up the role of secretary of state in a moment when both the NHS and English social care are under severe pressure.
Amanda Pritchard is the head of NHS England and has warned that the next two-years could prove even more difficult than the previous two years.
NHS Providers, which represents hospitals, and other NHS trusts described Mr Barclay’s first day as “big, pressing”.
The record-breaking backlog of planned operations is at the top of this list.
Nearly 6.5million people (or one in nine) are waiting to receive routine surgery such as hip or knee replacements or cataract extraction.
NHS England claims there are some signs of progress with fewer patients waiting for diagnostic tests and less time spent in the queue.
However, there is uncertainty regarding the future. Some projections show that waiting lists could grow to over 10 million by 2024.
Paramedics are often faced with long waits in order to load patients at English hospitals.
In May, the average time it took to respond to an ambulance for a Category 2 emergency (e.g., a stroke or heart attack) was nearly 40 minutes. This is more than twice the 18-minute target.
A&E doctors often say that the problem is caused by long delays in discharges from hospitals to residential care homes or arranging home care packages.
From October 2023, the amount that people must pay for social services in England will change.
It remains to be seen how the new system will actually work and whether it will suffice to address the “deep-rooted problems” that the King’s Fund, a health think tank, has identified in the care sector.
With 1.4 million employees, the NHS is the largest single employer in the world. Another 1.6 million people work for private companies in social services.
Barclay will need to respond to the demands for substantial pay increases this year at a time where inflation is at 9.1%. It is likely to rise further.
Two independent pay review bodies are expected to make recommendations to government regarding increases for NHS staff.
Ministers will make the final decision. Mr Barclay could be in for a rough ride with unions if the offer is lower than what they consider acceptable.
Mr Barclay was the chief of staff at No 10. This powerful position allowed him to advise the prime minister and manage the machinery of government.
He was previously chief secretary to Treasury and a Brexit minister. In 2018, he served as a brief time as a junior minister for health.
He will also be familiar with complicated public spending details and requests for more money from the health lobby groups.
The government must also plug the huge gap in the NHS workforce of 105,000. There is an acute shortage of GPs and nurses, as well as dentists and hospital doctors.
It is not easy to balance these demands in a period of constrained public spending.
All of this is happening in the shadows of the most severe public health crisis in recent history.
Now, the number of people admitted to hospital for testing positive for Covid is well below that at the peak of pandemic.
However, infections have been on the rise in many parts of the country recently, driven by Omicron’s BA.4/BA.5 variants. This is beginning to show up in the number of patients in hospitals and intensive care.
NHS Trusts warned that they are in for a bumpy ride over the next few weeks with a “very real danger” that Covid will throw off plans to reduce waiting lists.
Mr Barclay will also need to oversee the rollout and management of the autumn Covid booster and deal with a possible resurgence in seasonal flu and other winter pressures.
