The must-read stories and debate in health policy and leadership

Jeremy Hunt’s place in the history books

Jeremy Hunt will imminently pass Norman Fowler’s record and become the longest serving political boss of the NHS. In a leader column, HSJ editor Alastair McLellan reflects on what a long, strange trip it has been.

Examining the health and social care secretary’s record, Mr McLellan finds if he were to be “inspected” today against the six Care Quality Commission domains, he would do relatively well on “caring”, “well-led”, “safety” and “effective”, but the inspectors might be less impressed when examining “responsive” and “use of resources”.

Whether that makes him “good” or “requires improvement” overall would depend on how much personal responsibility they decided he carried for Brexit and, especially, public sector austerity.

But such is the scale and nature of the challenges ahead of him that Mr Hunt could yet end his time judged either “outstanding” or “inadequate”, Alastair suggests.

One of our readers, commenting anonymously below the line, was a little less nuanced. The person wrote: ”I have been in many of his Monday [weekly meetings with senior policymakers and system leaders] myself.

“Hunt is personally responsible for many of the nastiest aspects of the way the NHS has been run in recent years. There is a vacuum where his strategic thinking should be. He treats people like dirt if they tell him something he doesn’t want to hear. I would never consider taking another job that carried a cat in hell’s chance of having to be in the same room as him again.”

Scrap the (visa) cap

The government’s tier two visa cap is “not logical” and is “threatening patient care and safety”, HSJ has been told, as the political pressure to scrap it continues to build within government.

Chief executives across the NHS are finding visa applications for overseas doctors are being rejected in greater numbers than before which they say is putting more pressure on existing staff.

In some cases, trusts are successful in just a handful of cases out of a hundred or more applications.

Manchester University Foundation Trust told HSJ it had 23 visas refused by the Home Office in the year to April 2018.

University College London Hospitals FT told HSJ between January and May they filed 19 applications for tier 2 visas for eight doctors from outside the EEA but none were accepted.

Tracy Dowling, chief executive of Cambridgeshire and Peterborough FT, told HSJ the trust’s “only option” was to recruit overseas doctors when they have not had any applicants from the UK, but they are “not allowed to recruit an appointable person” because of the visa cap.

More chief executives and senior medics trying to make appointments were lining up on social media to add their voice, too.