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Hancock’s half hour

Still practising

Chris Preece

Tuesday, 31 July 2018

CYdnw3QK.jpgDear Matt Hancock,

First of all, congratulations on your new job. I appreciate starting anything new is a bit daunting at first, and becoming the new Health and Social Care Secretary at a time of NHS crisis is hardly the easiest role to pick up. On the other hand, there were many who would have accepted pretty much anyone in this post if it meant ousting your predecessor, so you’re arguably starting with an advantage. To be fair to Mr Hunt he had just managed to negotiate an extra £20.5 billion for the NHS by 2023/4, so that’s got to help too. It only took him five years to realise that money’s quite useful, but hopefully, having worked for the Bank of England as an economist, you’ve got that basic lesson under your belt already.

It’s in the spirit of getting those fundamentals right that I thought I would quickly pen this letter, and offer some advice. I promise to keep it brief, no more than 30 minutes at the maximum – it’s just, first impressions are really important aren’t they? You don’t want any embarrassing faux pas like Jeremy’s confusion about his wife in China

We’ve touched on the first obvious issue already – the money. The NHS has historically had a 4% a year uplift – up until, well, a certain Government came along. It doesn’t take your Masters in Economics to know that to get it back on track means a fairly major course correction back to that level, plus a bit to level out the deficit. You’re also going to need people – simply saying you’ll train another 5,000 GPs by 2020 isn’t really enough, you’re going to have to actually do it. You’re also going to need to find more nurses from somewhere, given that more are currently leaving the NHS than joining. Maybe it’s time to reinstate their bursary?

In fact, now would be the perfect opportunity to try and really win over the workforce. There’s a general consensus that your predecessor had managed to alienate much of the profession, but this is the perfect opportunity to earn back that trust. You just need a big conciliatory gesture to show you understand their value, and really boost morale at this critical time. How about a nice pay review, or…. No, hang on, I saw something about that, let me just go google it a moment…


Junior doctors are the only ones getting a rise that reflects that recommended by the Doctors and Dentists Review Body. More would have been a genuine boost, what they suggested would have at least been neutral, but less? Well, it’s a statement of sorts, I suppose…

Still. You’re new. You don’t yet understand the importance of doctors and nurses – I understand. You’re probably one of those people who’s lucky enough to have never actually been genuinely unwell and therefore thinks GP at Hand is a revolutionarily convenient breakthrough, rather than a sophisticated way of leaching money away from the genuinely sick to benefit the worried well.

Wait…There was something about that as well wasn’t there? Here it is:  “I no longer have a physical GP”. Oh dear. I was going to say that I hope you never develop any of the medical problems that would make you “less appropriate” for their service, but as that broadly seems to include “getting old” that might be a bit harsh.

Again - you’re new to the job. You’ll see the error of your ways in time, I’m sure. I’m like you, I’m a bit of an early adopter too, I love shiny new technology. (I even have a VR helmet, just so that I can experience the delights of motion sickness in the luxury of my own home). With time I’m sure you’ll find ways to use such technology in ways that support and enhance the NHS, rather than destabilising it. Of course you’ll need to invest a bit of time in making sure that any new NHS technology is secure, and doesn’t break any privacy rules. As the ex-Minister for Digital and Culture, the man who steered the country into adopting GDPR (twitches involuntarily), I imagine you’ll be a dab hand at this kind of thing.

Oh no – you’re that Matt Hancock aren’t you? The “Matt Hancock would like to access your photos” Matt Hancock. The first MP to have his own app – only it collected users personal information and accessed photos even when they explicitly denied it access. It was funny at the time, but that was before I realised you’d soon be heading up a digital revolution in the NHS. 

Sigh. Is there anything that isn’t a forgone conclusion? I know, social care! That’s your remit as well right? Surely you haven’t done anything to mess that up already? Still, before I get too carried away let’s just quickly view your voting record and make sure there’s nothing to derail me later on…

Matthew Hancock voted against making it unlawful for any provider of regulated social care to act in a manner incompatible with the European Convention on Human Rights.

That’s it, we’re doomed. I’m putting on the VR helmet and staying there.

Still, Matt, if you’re still out there in the real world, try not to destroy it too much. I know this is just another job for you, but these are real people, and real lives you’re playing with. We need a health service that is adequately funded, and properly staffed with real humans. A machine can make us better at some aspects of our job, but it can never meaningfully replace physical contact, never extract the subtext, never draw out the words we’re terrified to say. Prove me wrong, get this right, and erase the memories of that awful app.

Yours anxiously,


Image courtesy of UK Parliament, CC BY 3.0

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Chris Preece

Chris has worked as a GP Partner in North Yorkshire since 2004, and still relishes the peculiar challenge of never quite knowing what the next person through the door is going to present with. He was the chair of his local Practice Based Commissioning Group, and when this evolved into a CCG he joined the Governing Body, ultimately leaving in April 2015. He continues to work with the CCG in an advisory capacity. When not being consumed by all things medical, Chris occupies himself by writing, gaming, and indulging the whims of his children. He has previously written and performed in a number of pantomimes and occupied the fourth plinth in Trafalgar Square. Tragically, his patients no longer tell him he looks too young to be a doctor.
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