'Sir Ara keeping one foot in the operating theatre should encourage clinicians to have confidence that their views are listened to'
Winning back public support for Labour's stewardship of the NHS is central to Gordon Brown's campaign to win his first general election as prime minister. He has exhibited a deft touch in choosing the ministerial team tasked with delivering it (see 'Johnson and Darzi lead Brown's campaign to woo back voters', 'Cabinet reshuffle: private sector fights to stay on agenda', 'Brief to ministers: calm NHS waters',.and news analysis).
Everyone from Unison to the British Medical Association has been up in arms over the permanent revolution visited upon the NHS under Tony Blair, and feel that the past two health secretaries have either bullied or patronised staff but rarely listened. So the first requirement was a secretary of state who would be seen to take staff concerns on board, be a good communicator and be someone to whom frontline staff could relate. Former union general secretary Alan Johnson is the ideal choice. That does not mean he will do the unions' bidding, but he will be skilled in selling the message.
He was all ears during his first hospital visit, to Kingston on Saturday, talking long after the cameras had gone. The fact that Mr Brown accompanied him despite his preoccupation with the terrorist attacks gives a measure of the prime minister's determination to be seen making personal contact with staff.
From left field
Former left winger Dawn Primarolo finally gets a public profile after working in the heart of Mr Brown's Treasury for a decade. The health brief is not entirely new to her, as she was a shadow health minister in the early 1990s.
She is joined by Ben Bradshaw, whose adoration of Tony Blair is such that he may well have needed bereavement counselling last week, and ex-nurse Anne Keen, who was briefly a bag carrier for then health secretary Frank Dobson in 1999. Ivan Lewis is left to provide the corporate memory from the outgoing ministerial team.
But the most intriguing appointment is Professor Sir (soon to be Lord) Ara Darzi. As a clinician of impeccable reputation, he has been given the job of rebuilding relations between the NHS and its staff and patients. The media operation surrounding his appointment reveals how important the government views his arrival at the Department of Health; a lengthy personal statement was published setting out his clinical credentials and even promising to be the advocate for all staff, from ancillary workers to fellow surgeons, in the heart of government.
Just in case anyone had failed to grasp the 'we're on your side' message, the new minister then banged home the government's determination to get staff back on board by citing his appointment as a signal of Mr Brown's personal commitment to listen to clinicians.
One foot in the theatre
In a Gordon Brown touch, Sir Ara professed humility in taking up his new role. But, anxious to distance himself from the grubby world of politics, he stressed that his career will remain focused on patient care, and he looks set to continue surgery.
Retaining that clinical link is politically important as well as professionally desirable. Keeping one foot in the operating theatre neatly wrong-foots any attempt by the British Medical Association or royal colleges to play the 'doctors know better than politicians' card when grandstanding to the public. More positively, it should encourage new BMA chairman Dr Hamish Meldrum and others to have confidence that their views are being listened to and understood.
But the generally warm welcome for the new ministerial team will need to be bolstered by changes in more than presentation. One of Patricia Hewitt's final acts as health secretary was to advise Gordon Brown by letter to avoid too much policy innovation and allow the existing wave of reforms to bed down. Mr Johnson needs to demonstrate that he has heeded her advice, although he will also have to improve access, a pledge Mr Brown made during his leadership campaign.
Mr Johnson's first big challenge, however, is to diffuse the row over nurses' pay, which is threatening to spill over into industrial action. The money to reverse the decision to stagger the pay award is in the health system, but the knock-on implications for other public sector pay deals would not be so easily managed.
Such a U-turn would go a long way to improving relations with the unions. Will Mr Johnson deliver?