Attempts to discuss the expansion of medical training crashed into scepticism of how this could happen post-Brexit

During the new parliamentary term’s October session of health questions there was a sharp little spat typical of frayed nerves in post-Brexit Britain, the kind we could sensibly do without.

Philip Dunne, now Jeremy Hunt’s deputy, was discussing agency nursing bills and government plans to expand the UK’s medical training programme – from 6,000 a year to 7,500 – when things turned nasty.

Dr Philippa Whitford, SNP member for Central Ayrshire and the party’s health spokeswoman, intervened to complain that, with 10 per cent of medical posts already unfilled, expanding numbers must be welcome. But linking it with a wish to replace the 25 per cent of NHS doctors who come from abroad is a recipe for “unrealistic expectations and conflict”.

Since Dr Whitford is an experienced NHS Scotland breast cancer surgeon (she volunteered as a medic in Gaza in her youth), she knows what she’s talking about. In the days following the Tory party conference it had all got mixed up with Amber Rudd’s confusing briefing about identifying foreign workers in private firms.

Fuel to the flames

The home secretary didn’t actually say the words in her conference speech and the gaffe was later “clarified” away, not for the first time in Rudd’s brief Cabinet career.

But the prime minister’s own remarks about making the NHS “more self sufficient” in the context of Brexit’s promised curb in immigration added fuel to the flames. There was talk of Theresa May’s own “Le Pen moment”, itself an unjustified and inflammatory comparison. But that’s what happens when ugly passions are stirred. Just look at Donald Trump’s America.

Even the habitually moderate Dr Sarah Wollaston, Tory chair of the Commons health select committee, felt obliged to Tweet the need for May to embrace the NHS’s foreign staff, though it is untrue that France’s Marine le Pen tweeted support for May. A fake account did: that’s a mechanism for ugly passion, too.

So it was scarcely surprising that minister Dunne grabbed the chance to “set the record straight” against what he called “scaremongering” in the wake of his party’s Birmingham jamboree.

“We are not changing any of the present arrangements for international students being trained here, or doctors and nurses working here,” he assured MPs, praising the “vital services” provided by non Brits in the NHS.

This is all true. I am told that Jeremy Hunt has often spoken privately of the need to expand UK medical training. So well done, ministers. Up to a point.

As home secretary herself for six years, May deployed those “Go home or face arrest” billboards on vans which patrolled areas suspected of housing high numbers of illegal immigrants

But in the wake of  the Other Jeremy’s confirmation as opposition leader, Labour is finally back in the business of doing what it says on the tin: oppose. Up popped Jon Ashworth, who has emerged from the shadow Cabinet musical chairs as his party’s health spokesman. An MP since 2011, 38 this month, and evidently keen to play the tough guy on his first outing (a party backroom boy, he has no background in this field), Ashworth quoted Mrs May’s precise words: “There will be staff here in the interim period until the further number of British doctors are trained…”

“Interim” sounds a bit ominous and clearly May didn’t mean it. How could she? It’s nonsense and she’s supposed to be the Keep Calm candidate. Except, as Jon Ashworth was quick to point out, as home secretary herself for six years, May deployed those “Go home or face arrest” billboards on vans which patrolled areas suspected of housing high numbers of illegal immigrants. What next, ambulances plastered with “Go Home” slogans,” Ashworth quipped.

Good eggs

All right, I know May later admitted that the vans pilot scheme failed, a small win for evidence based policy making. But I wish I could be more optimistic at this point. Tory friends tell me that Hunt’s new health team (his old team all got promotion, except veteran Alistair Burt, who chose to stand down) are all thoughtful and decent people – “good eggs,” as one moderate MP puts it.

He singles out Oxford music graduate and human rights campaigner Nicola Blackwood, who is in the mental health hotspot, as a warm and empathetic person. In her teens she suffered from chronic fatigue syndrome, which must provide insights. But the May regime seems to have taken some odd turns since the summer.

The much delayed obesity strategy was a disappointment (again), hard to square with Mrs May’s declared concern for society’s poorest (and fattest?). Her grammar school strategy is nostalgia, albeit helpful to the thin but sharp elbowed middle class. Kiwi judge Lowell Goddard’s appointment to chair the abuse inquiry looks worse by the day. As for Brexit, oh dear.

There will be some Brexit upsides, though none I can detect for the NHS and its 55,000 EU staff or social care’s 80,000, except easier working time flexibility. But the downside risks are greater and anyone who says it is simple – “just leave” – is a fool or a liar. To retain the confidence of voters and all important markets the government must convey it knows what it’s doing.

Muddling up Jeremy Hunt’s earnest wish to train more medics with dog whistle stuff about keeping out migrants is sheer incompetence which horrified thoughtful Tories. Don’t civil servants and special advisers talk any more to iron out glitches? Apparently not. “When a government changes, collective memory suffers,” explains one pal.

In the encircling gloom I offer the embattled NHS family one micro sliver of comfort: neither Hunt nor any of his new team backed the Brexit panacea.

Michael White is a former political editor of the Guardian.