Published: 03/04/2003, Volume II3, No. 5849 Page 18
No one tells you how to resign. But come to think of it, no one tells you how to be a minister. On day one they throw the red boxes at you and expect you to know and defend every nuance of government health policy. It is sink or swim.
Resigning is an altogether different experience.Most people assume that you grieve for the offical car and the swanky office - not to mention the salary.
Actually, it is not so much the car as the driver. Peter Lewis was the only member of my private office to have been with me at the beginning and still be there at the end.He worked all hours, experienced most of my highs and lows. If you are to believe Yes, Minister, it is the drivers who know most about what is going on in government.Well, if they do they are not telling me.
But what really hits home is that there is no one to organise your life for you. From an 18-hour day stuffed full of meetings, briefings and parliamentary debates, There is nothing. Simply a void.
Your life is your own.My first task the day after leaving government was to buy a diary. I hadn't needed one for so long. It was all done for me - family birthdays included.
Next, I had to discover the whereabouts of my lap-top, last used five years ago.How times have changed. Everyone I speak to in the NHS now asks me for my e-mail address. I have great hopes of the IT revolution in the NHS - if not for the IT skills of the ex-minister responsible.
Time, of course, is what ministers never have enough of.
Certainly not to think strategically. But time is what a past minister has in spades.
Certainly, reflecting on what the government has achieved in health, there is a lot to be pleased about. The extra money is great and should bring us up to the level of French spending on health by 2008. But as important has been the setting of national standards, remarkably for the first time ever.
The National Institute for Clinical Excellence, the Commission for Health Improvement and the national service frameworks all have a critical role to play in defining what we mean by a national NHS. And although each has its critics, surely none can doubt their capacity to change the shape of what the NHS really means to the public.
The National Patient Safety Agency is also a potential worldbeater, despite a flaky start. Public health has seen a boost, too, with a clear strategy and inequality targets for the first time.How different from the last government.
I was forcefully reminded of it this week at the Royal College of Physicians when I attended a celebration of the life and work of Sir Douglas Black, inspired author of the health inequalities report that bears his name. It is to the everlasting shame of the Thatcher government that it suppressed its publication.
Indeed, the very word 'inequalities'was banned.
Regrets? Well, I am certainly sorry not to see the IT revolution through. It is desperately needed.
And the challenge is formidable.
But it is on the right track.More money, a centrally driven programme and the appointment of the splendid Richard Granger to spearhead delivery.
My greatest fear is that we will not get the doctors on board. The IT programme is a means to an end.
Nothing short of a major redesign in clinical process build around the patient's journey. And that will not happen unless we can engage the doctors and nurses who in the end will make or break it.
I am sorry that we never got to complete grips with 'targetitis' Some targets are essential. I am afraid that the history of the NHS shows that unless you set targets, it will go its own anarchic way at the expense of the taxpayer. But we set far too many, and the beleaguered NHS is still suffering under the weight of it all.
I also bear the scars of the twoyear battle to get rid of community health councils.They certainly put up a spirited fight. I am optimistic about the new patient forums and delighted that local government has at last been given a seat at the NHS table through overview and scrutiny committees.
The biggest wrench about giving up office is saying goodbye to the people I worked with - a highly committed ministerial team led by Alan Milburn, who was a joy to work for. I owe a lot of officials as well. Bureaucratbashing is a fine British sport, but I found the people I worked with at the Department of Health to be highly committed, hard working, and above all fun.
Sir Douglas Black was, for a time, a civil servant.He didn't altogether enjoy the experience as we were reminded by Lord Turnburg at Sir Douglas' memorial meeting.On leaving the DoH to take up the presidency of the Royal College of Physicians, he said 'It is a pleasure to return to the human race'.
Amen to that.
Lord Hunt of Kings Heath was junior health minister until he resigned last month over government policy on war in Iraq.
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