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LONDON, ENGLAND – MAY 01: Health Secretary Matt Hancock leaves 10 Downing Street with aide Gina Coladangelo after the daily press briefing on May 01, 2020 in London, England. Mr Hancock announced that the government’s pledge to conduct 100,000 Covid-19 tests per day had been successful. British Prime Minister Boris Johnson, who returned to Downing Street this week after recovering from Covid-19, said the country needed to continue its lockdown measures to avoid a second spike in infections. (Photo by Dan Kitwood/Getty Images)
Schrodinger’s Matt

Schrodinger’s Matt

LONDON, ENGLAND – MAY 01: Health Secretary Matt Hancock leaves 10 Downing Street with aide Gina Coladangelo after the daily press briefing on May 01, 2020 in London, England. Mr Hancock announced that the government’s pledge to conduct 100,000 Covid-19 tests per day had been successful. British Prime Minister Boris Johnson, who returned to Downing Street this week after recovering from Covid-19, said the country needed to continue its lockdown measures to avoid a second spike in infections. (Photo by Dan Kitwood/Getty Images)

The health secretary’s alleged misconduct is, at the very least, stupid. It has come to light at a crucial moment for NHS policy – but Hancock has no more control over his fate than he has over quantum physics

As a journalist who has written about the politics and management of the NHS for the past 21 years, I would not, in normal times, pitch a shagging story to Tortoise.

These are, of course, very far from normal times, and this is not just a shagging story: it’s about politics and government. However, it has to begin somewhere. And to begin at the beginning of the end for Matt Hancock’s tenure as health secretary is as good a point as any. 

Today’s Sun alleged that Hancock has been having an affair with his communications advisor and close university friend, Gina Coladangelo. It was revealed last November that Hancock had appointed Coladangelo in secret, and put her on the Department for Health and Social Care’s board.

At the time, the Sunday Times quoted sources saying that “before Matt does anything big, he’ll speak to Gina. She knows everything… she has access to lots of confidential information”.

When the health department’s CCTV footage reproduced on the front page of today’s Sun was reportedly taken, on 6 May, hugging anyone outside your household or bubble was not allowed by the then-prevailing Step 2 of the Government’s “roadmap” rules.

These regulations stated that “no person may participate in a gathering in the Step 2 area which (a) consists of two or more people, and (b) takes place indoors.” 

In normal times, one would reasonably expect the health secretary to know and abide by such rules. Failure to do so would be a resigning or sacking event. Clearly, not-normal is the “new normal”.

Fresh attention will now be paid to Hancock’s comments at a Downing Street briefing in February, at which he was asked: “Why has the Government removed guidance from last summer, allowing couples in established relationships not to socially distance from each other?”

To that question, he replied: “We made the change that we did because as we went into the lockdown over the autumn, in November, and then again at the start of January, we wanted to make sure that we did everything we possibly could to stop this from spreading. I’m absolutely sure that the actions that everybody has taken and the sacrifices people have made have had that very positive impact”.

Hancock’s initial strategy today was to offer “no comment” to the Sun’s story: an adorable effort (given additional, piquant irony by the fact that Coldrangelo is a communications specialist). Inevitably, his Plan A didn’t last long.

Next, he issued a statement, accepting “that I breached the social distancing guidance in these circumstances”. Frankly, this is no more than a recognition that there is such a thing as empirical reality, and that he has been caught out by published evidence.

Such a minor philosophical observation certainly won’t see off the story, but it will probably end Hancock’s three-year tenure in the job. Let’s face it: his strong “Alan Partridge” energy is unlikely to save him. 

And if this indeed marks the downfall of the health secretary – a member of the “Covid quad” that has managed the government’s response to the pandemic – it will be quite a moment: one that tells us a lot about the political age we’re living through, and, as we shall see, will also materially impact the health and care system.

The senior ranks of the NHS were today accelerating their long standing preparations for Michael Gove to take over at health: his transfer to this department has been long-rumoured; and was a prospect explicitly mentioned in Dominic Cummings’ recently leaked WhatsApp messages with Boris Johnson about Hancock’s poor performance early in the pandemic. The prime minister wrote to his then-chief advisor: “[O]n PPE it’s a disaster. I can’t think of anything except taking Hancock off and putting Gove on”.

As it happens, I don’t believe that Hancock should resign for having an affair with his close friend. Even if Johnson were in a moral position where he could plausibly dismiss Hancock on these grounds without appearing monstrously hypocritical, he shouldn’t. 

The French tradition that politicians’ personal lives are, broadly, not of public concern has always felt like a sensible one to borrow. Individuals’ personal lives are just that: personal. In reality, they can be messy and complicated. Politicians should be able to lead such lives.

Yet that is not the end of the matter. Unfortunately for him, Hancock has given some high-net-worth hostages to fortune, in the shape (for example) of a 2018 speech on faith and values in public life, in which he said: “I believe very strongly in the value of public service. I believe politics, done right, is a public service”. This jars, to say the least, coming from a man who apparently went on to conduct a relationship with an advisor (whom he put in the DHSC board) in his government office.

And try this: “In my office in the Commons I have a ‘board of love’… none of this can be done alone. Public service is mostly a team activity – another reason it’s so rewarding. I work with other public servants every day.” Yes, indeed.

Hancock’s hypocrisy problem is compounded by the comments he made when the epidemiologist Professor Neil Ferguson broke lockdown rules last year to visit his married lover. At the time, the health secretary told Sky News: “It’s a matter for the police, as a government minister I’m not allowed to get involved in the operational decisions of police matters. But I think the social distancing rules are very important and people should follow them.” This, from the politician subsequently filmed breaching his own government’s explicit ban on two people from different households hugging.

In fact, the Johnson administration torched its credibility over lockdown rules last summer, in order to keep Dominic Cummings in his job during the Barnard Castle “eye test” fiasco. In those days, the PM’s principal guru was still regarded as an asset – in exactly the way that Hancock is not. 

The low esteem in which he is held is obvious from what his cabinet colleagues say – and also what they do not say. Last week, the leader of the house, Jacob Rees-Mogg, described him in the Commons, with unmistakable sarcasm, as a “successful genius”. Not even Alex Bourne, Hancock’s pub landlord friend who ended up with a nice Covid contract despite his lack of any discernibly relevant experience, would go that far.

Also last week: the health secretary’s Covid update and the Commons debate that followed showed us something significant: namely, how muted the Conservative backbenches were throughout.

After the full-throated, upbeat support Tory MPs offered him in the wake of Cummings’ attacks in his select committee testimony on 26 May, this marked draining of support will have worried Hancock – and was clearly noticed by Rees-Mogg. 

Which brings us to the reasons why Hancock should be removed: boiling down to various forms of stupidity. It’s not the affair: it’s the fact that the alleged affair was with somebody who works for him; whom he appointed to the DHSC board; and the alleged affair being apparently conducted in his office and in work time.

This morning, the transport secretary, Grant Shapps, attempted to defend Hancock’s nomination of Gina Coladangelo, claiming that “anyone who’s been appointed has to go through an incredibly rigorous process in government. Whatever the rules are, the rules will have to be followed”. “Whatever the rules are” may turn out to be a pithy epitaph for the Johnson government.

To which point: this controversy appears, prima facie, to involve a series of breaches of the ministerial code, which enshrines “integrity, objectivity, accountability, transparency, honesty and leadership in the public interest”. One of its first lines declares that “working relationships, including with civil servants, ministerial and parliamentary colleagues and parliamentary staff should be proper and appropriate”. The code also states: “Ministers must ensure that no conflict arises, or appears to arise, between their public duties and their private interests”. 

How did this footage get to The Sun? It’s not too mysterious. The health secretary’s alleged personal rudeness to junior staff at the Department for Health And Social Care is an open secret in Westminster. He is generally, it is alleged, ruder to women than to men. Revenge is a dish best served on the front page of the Sun on a Friday, it seems. (Hancock has always denied such rumours as Westminster scuttlebutt.)

Very pointedly, the former Conservative MP Nick Boles tweeted this afternoon: “In every political career comes a moment when the politician discovers how well he treated people on the way up (it’s usually a he). How many colleagues rush to his defence on air? How hard do journalists put the boot in? How many people urge a sense of proportion on Twitter?”

For obvious reasons, Boris Johnson won’t want to fire Hancock for adultery. But the optics of keeping him in the job after such an apparently flagrant breach of the Covid rules are terrible – the more so as the Batley and Spen by-election is just a few days away. 

In terms of political toxicity, Hancock’s “R” value has now risen well above one – and will soar even higher if the Sun, or another paper, has further incriminating images to publish over the weekend. Inescapably, he has become the story.

The timing of Hancock’s likely exit and probable replacement by Gove is also what Whitehall officials call “interesting”, given that the government plans to bring its new health bill to the Commons shortly. Back in February, I obtained and published the text of its white paper. Many of its proposals would simply enact a series of legislative changes requested by Simon Stevens, NHS England’s departing chief executive – effectively euthanising the “competition” aspects of Andrew Lansley’s controversial NHS reforms (that became the 2012 Health And Social Care Act). 

But – crucially – Hancock made his own dramatic additions, which would greatly increase the health secretary’s power over the NHS, Specifically, the incumbent would gain new rights to intervene at any point of an NHS reconfiguration process; to transfer functions to and from specified arms-length bodies (ALBs), and the ability to abolish ALBs as a result of doing so. The secretary of state’s revived powers of direction would also include the ability to mandate NHS England to take on public health functions (previously transferred to local government by the 2012 Act). And these dirigiste ambitions have caused serious concern among smarter Conservative MPs.

After the high-profile chaos of the Lansley reforms, the Conservative Party itself stayed far clear of health reform and policy, gladly outsourcing it wholesale to Stevens. He was recruited as NHS England’s second chief executive specifically to put at least some political distance between ministers and health policy. This, he achieved largely by ignoring the market mechanisms of choice, competition and clinical commissioning enshrined in the 2012 Act.

Not only did he accomplish these objectives – and mostly under the radar. Stevens also twice won multi-year increases in NHS funding during the period of public sector austerity, in 2014 and 2019. His political acumen and understanding of Whitehall were central to those achievements. They helped to keep the NHS – mostly – out of the headlines, or to limit the damage when controversy arose.

But things are about to change. The penny is beginning to drop that there are now more than five million people on the NHS’s waiting list: the highest ever figure. In which context, the new health bill’s blueprint for the health secretary to “take back control” may have unintended consequences. And people in Number 10 are starting to notice the risks inherent in this power grab. To name only a few:

  • The NHS has an underlying deficit.
  • There is still a workforce crisis in many areas.
  • The current estates backlog maintenance bill runs to £9 billion.
  • Social care is in a mess, causing delayed discharge of frail older people from NHS hospitals.
  • The pensions taper tax creates large tax liabilities which are discouraging senior clinicians from doing extra “waiting list initiative” work at evenings and weekends to help clear the huge NHS backlog.

All of these problems were enormous before the pandemic. Now, they are appreciably worse, compounding the challenges that face exhausted and potentially traumatised NHS staff. 

Fixing all this will cost serious money, and take many years. And we do not live in patient times. This is, after all, supposed to be the “People’s Government”, an engine of instant gratification. The stakes are very high.

Meanwhile, Hancock’s fate will be decided by perception, political volatility and cruelly unpredictable forces. If you recall: Schrödinger’s cat is a quantum physics thought-experiment in which the hypothetical cat may be considered simultaneously both alive and dead, its fate dependent upon a random sub-atomic event that may or may not occur. Schrodinger’s Matt, perhaps?

Andy Cowper is the Editor of Health Policy Insight