Key appointments for the new Conservative leader (2)

We are now in the last fortnight of the election for leader of the Conservative Party, with Kemi Badenoch and Robert Jenrick head-to-head to take the job

In the first essay on this subject, I explored the roles of shadow chancellor and shadow home secretary as central ones to the recovery of the Conservative Party. Those are obvious choices: the economy is always at the heart of politics, while the intertwined issues of immigration, border security, nationality and law and order are consistently near the top of the public agenda at the moment and represent, at least in the short term, vital battlegrounds on which either Kemi Badenoch or Robert Jenrick will have to engage energetically with the government.

Now I want to look at two more roles, the first administratively and organisationally central, the second another key policy area in capturing the imagination and support of the electorate.

Party chairman

An unexpected twist in the leadership race recently was Robert Jenrick’s announcement that, if he were to win, he would appoint former cabinet minister Sir Jacob Rees-Mogg as chairman of the Conservative Party. Rees-Mogg was defeated in North East Somerset and Hanham at July’s general election after 14 years as an MP and three as a cabinet minister, but he retains a significant public profile with his nightly State of the Nation show on GB News and his recently launched Letters from an Englishman on Substack. Jenrick noted that “Jacob has been a tireless campaigner for the grassroots. He understands better than anyone the need for party reform.”

While the announcement was primarily a matter of courting the support of parts of the right within the Conservative Party, Jenrick is part of a broad consensus that the party structures and administrative leadership are in need of change. There are a number of pressing problems.

The most striking is the sheer small size of the membership. The Conservatives do not publish figures as a matter of course, but we know that at the last leadership election in July-September 2022 there were just under 172,500 members eligible to cast a ballot. It seems inconceivable that this number will not have declined, especially since the majority of party members are believed to be older, though we will know for certain when the result of the current contest is announced on Saturday 2 November. What should we expect? As I say, I cannot believe it will be higher than in 2022, and, having spoken to candidates and activists who went through the general election about their experiences, I think the party would be doing well if the total is anywhere over about 160,000; I fear it might be nearer 150,000, which would be a cause for significant anxiety.

It is true that fewer people join political parties now than they did 30, 40 or more years ago, and that it is increasingly a niche pursuit. Nevertheless, even in comparative terms a total membership of, say, 160,000 is disappointing: figures for last year showed the Labour Party has 370,450 members, and the Liberal Democrats could muster 86,599, though they also claim, perfectly plausibly, that they have recruited considerable numbers of new members during and since their successful general election campaign. Reform UK did not publish any figures, while the Green Party of England and Wales reported around 53,000 members, and the Scottish National Party 64,525.

It is obvious but worth saying that a political party without members will fail and disappear. Members provide income, votes and the tireless volunteers who do the hard work of canvassing and campaigning on the ground, as well as being the pool from which candidates emerge for elected office, from local councils to the House of Commons. So a major task facing the next leader will be increasing the Conservative Party membership, and doing so by significant numbers. Incrementalism will not be enough. A key figure in carrying out that task will be the party chairman. (I wrote about this issue a few months ago.)

The Conservative Party is generally held to have been established in 1834, when Sir Robert Peel wrote an appeal to the electors of his constituency of Tamworth in Staffordshire. The Tamworth Manifesto essentially turned a page for the old Tory Party, accepting the major reforms of the Representation of the People Act 1832 (the so-called Great Reform Act), offering a “careful review” of the institutions of the state, including the Church of England and promising that change would be embraced where it was proven necessary. No longer would the Tory response to any reform be a reflexive “no”.

It was not until 1911, however, that there was an identifiable head of the Conservative Party machine, Central Office (set up in 1870) previously having been the responsibility of a principal agent who was supervised by the party’s chief whip in the House of Commons. After the Conservatives and their Liberal Unionist allies lost both general elections in 1910, there was a review of how the party worked, once of the recommendations of which was the creation of the offices of chairman and treasurer. It was also anticipated that the former should be of “cabinet rank”, which has not invariably been the case since then. The first chairman appointed was the recently elected MP for East Birmingham, Arthur Steel-Maitland, a brilliant classicist and legal scholar in his mid-30s who had won the Eldon Law Scholarship at Balliol College, Oxford, before becoming a fellow of All Souls.

In the intervening 113 years, some of the Conservative Party’s most eminent figures, including two future premiers, have held the role of chairman: Neville Chamberlain (1930-31), Lord Woolton (1946-55), Lord Hailsham (1957-59), Rab Butler (1959-61), Iain Macleod (1961-63), Lord Carrington (1972-74), Willie Whitelaw (1974-75), Cecil Parkinson (1981-83, 1997-98), Norman Tebbit (1985-87) and Theresa May (2002-03). In a manner characteristic of the Conservatives, the position is enormously flexible and adaptable: appointed solely at the discretion of the party leader, it has sometimes been held jointly, as in 1961, 2003-05, 2010-15 and 2019-22. There have frequently been multiple deputy chairmen and vice-chairman to assist with the work, dealing with women, young people, ethnic minorities, local government, business and other specific sectors. Like the chairman, these are all appointed by the leader. When the party is in government, the chairman is often included in the cabinet, usually in a sinecure like chancellor of the Duchy of Lancaster or minister without portfolio (though Rab Butler combined it with home secretary and Lord Carrington with defence secretary); at the same time, like Norman Fowler in 1992-94, the chairman need not hold any ministerial role at all.

When Nadhim Zahawi was forced to resign over his tax affairs in January 2023, I wrote about the post of chairman of the Conservative Party and examined some of the candidates to replace him (the job eventually went to Chelsea and Fulham MP Greg Hands). I suggested that the chairman had to fulfil or delegate to someone else under his supervision a number of separate functions: efficient and effective management of the party administration, from Conservative Campaign Headquarters (CCHQ) in Matthew Parker Street downwards; representing the party in the media confidently and fluently on almost any subject as required; acting as a sharp-eyed and sensitive political adviser to the party leader; maintaining good relations between CCHQ and local constituency associations; supervising the party’s finances and fundraising; and chairing the Conservative Party Board.

The chairman need not take on each of these roles and aim to excel, but he or she must do some of them and seek to delegate others to colleagues while keeping an overview of the operation of every part of the party. In addition, he or she must achieve this while balancing personal popularity and authority with the avoidance of any suggestion of being a rival to the leader. Norman Tebbit’s relationship with Margaret Thatcher deteriorated badly during his period as chairman in 1985-87 because she came to suspect, almost entirely without foundation, that he had designs to supplant her as prime minister. At the same time, any candidate for the post of chairman will be aware that to perform well and deliver successful election campaigns is an important route to promotion and the fulfilment of ambition: Quintin Hailsham oversaw the winning campaign in October 1959, developed a base of support within the party and was, for a short time, Harold Macmillan’s preferred successor as prime minister in 1963; Cecil Parkinson’s able media handling and party management first during the Falklands conflict in 1982 and then in the 1983 general election campaign made him for a while Thatcher’s anointed successor for the future, before he was forced to resign from the cabinet over an extramarital affair.

It feels to me, though perhaps this is merely a function of age and nostalgia, that party chairmen over the past 20 or 25 years have been rather less impressive and consequential figures than was once the case. This is partly a function of an absurdly high turnover, with 15 people holding or sharing the post in the past 14 years, Andrew Stephenson and Jake Berry each managing only a few weeks in post during the chaos of 2022. The last genuinely substantial and influential figure to serve a reasonable length of time was probably Francis Maude in 2005-07, though Lord Feldman of Elstree, who shared the job with a series of colleagues between 2010 and 2015 before. final year as sole chairman, worked diligently if unobtrusively in strengthening the voluntary party and membership. But when was the job last held by someone the public would recognise and who was a “big beast” in the Tory jungle? Zahawi had some of the qualities to be an effective, high-profile spokesman for the party but resigned after barely three months in post. Otherwise you are probably looking back more than 20 years.

We know that Robert Jenrick will appoint Sir Jacob Rees-Mogg, or at least has given that commitment. Rees-Mogg is at least a well-known personality, with a reach beyond the normal narrow political community, and he remains popular in certain sections of the Conservative Party. Arguably, of course, they are likely to vote Conservative anyway. Rees-Mogg is a conscious eccentric: as a child he wore a monocle and attended the annual general meeting of industrial conglomerate GEC, in which he had been given shares as a gift; as Conservative candidate for Central Fife at the general election of 1997, he canvassed the Labour-dominated constituency accompanied by his childhood nanny, Veronica Crook; once he became an MP for North East Somerset, he portrayed himself as a devotee of the history and importance of the House of Commons, spending his first nine years as a backbencher and cultivating an expertise in constitutional history.

If you had looked at Rees-Mogg 10 years ago, you would have seen a self-aware, socially conservative and religious devout reactionary, old-fashioned in speech and dress but impeccably polite and with an ability to inspire affection in unlikely counterparts. He formed an improbable but genuine connection with Labour MP Jess Phillips when she visited his constituency for Channel 4 News and developed a cult following, to the extent that by the late 2010s he was regarded, not wholly facetiously, as an outside candidate for the Conservative leadership if a vacancy were to occur. However, when Theresa May announced her resignation in May 2019, Rees-Mogg chose to support Boris Johnson, and was rewarded with promotion directly to the cabinet as leader of the House of Commons.

It was a role which suited him, partly as a representative of backbench MPs within the government and a custodian of the rights and privileges of the House, working with the business managers of other parties in a semi-non-partisan way. Early in 2022, however, he was moved to a new role as minister of state for Brexit opportunities and government efficiency, based in the Cabinet Office, before Liz Truss appointed him business, energy and industrial strategy secretary that September. He returned to the backbenches when Rishi Sunak became prime minister.

This is purely anecdotal but I would suggest that he has lost some of the affection previously extended to him. Because he became more strongly identified with Brexit, and in particular as he became a more fanatical defender of Boris Johnson as the former prime minister’s conduct was investigated and condemned by the House of Commons Committee of Privileges, he has become a sharper-edged figure, more divisive and partisan. It has been particularly disappointing that a man who once projected an image of rigorous constitutional propriety was found to have misled Her Majesty The Queen over the unlawful attempt to prorogue Parliament in August 2019, accused the Supreme Court of attempting a “constitutional coup” by ruling that prorogation had been unlawful and attempted to interfere in the Privileges Committee’s investigation of Boris Johnson.

Rees-Mogg and Jenrick wrote a joint article in The Daily Telegraph recently which stressed the importance of ordinary party members.

We need our membership to play a larger role in the life of our party. We must breathe life into our party with a renewed role and respect for members. That means revisiting the calls for greater party democracy that have been swirling around for decades, and taken forward in recent years by the Conservative Democratic Organisation.

They also argued that “candidates must be committed to the fundamental conservative principles and values that define our party”, by which of course, like any politician using that kind of rhetoric, means the interpretation of principles they hold.

Giving party members a more extensive role in the organisation of the party and making constituency associations more independent are not necessarily bad ideas. Rees-Mogg is an unapologetic Conservative who speaks his mind, and his right-wing views on immigration, Brexit, climate change and net zero would appeal to some voters who did not support the party in July, especially those who preferred Reform UK.

I said earlier, however, that an important role for the party chairman is to be an all-purpose media-friendly representative who can be trusted to speak with authority and effectiveness for Conservative policies across the board. Is that the kind of role the party should contemplate for Rees-Mogg? If he were to become a regular face and voice on television and radio, would he be an electoral asset for the party, would he persuade voters that Conservatives had rebuilt themselves and learned the lessons of 2024 and before? Would he help the party look like an organisation ready for the challenges of the 2030s? I am not at all sure that he would.

What about that other function I cited, the efficient management of the party machinery? Here it is harder to say. Rees-Mogg had a successful career in investment management before becoming a Member of Parliament, co-founding Somerset Capital Management in 2007 and becoming a multi-millionaire. In 2022, it was reported that he had left “passive-aggressive” notes on civil servants’ desks when they were working from home to encourage them to spend more time in the office, which does not indicate the surest of touches as a manager of people. The same could be said of the rather pernickety style guide he issued to his private office when he first became a minister in 2019. In essence, it is his judgement in general terms which is a potential weakness. In the interests of fairness, Harry Phibbs made the opposite case recently in CapX.

If Kemi Badenoch is the new leader, the field is open. The current chairman, Richard Fuller, is very much an interim appointment. He was elected MP for Bedford in 2010, lost his seat in 2017 and returned to the House in 2019 for North East Bedfordshire. He enjoyed a fleeting ministerial career, appointed economic secretary to the Treasury in July 2022 as Boris Johnson’s government crumbled and stayed in office only until Rishi Sunak became prime minister in October. A recent profile in The Spectator described him as “likeable, if low-profile”, and it seems likely he will be happy to return to the backbenches once the leadership election is over.

It would be an enormous asset to the leader and the party to find a chairman who is an effective communicator, someone who would reliably be sent on media rounds and deal with presentational crises and emergencies. James Cleverly has shown himself a deft performer, but has served as party chairman before from July 2019 to February 2020 (overseeing the successful general election campaign in December 2019), and may not relish a second stint (Jenrick recently offered to appoint him deputy leader of the party if he is victorious). Mel Stride, shadow work and pensions secretary, has a much lower public profile but is emollient and reliable, often the face of the Conservative Party in the last election campaign and regarded as a safe pair of hands. That amiability could be regarded as an effective foil to Badenoch’s reputation as prickly and combative.

Of course, as Jenrick’s promise to appoint Rees-Mogg reminds us, the chairman of the party need not be a current Member of Parliament or peer. If Badenoch were to pursue that line of thought, it would surely be sensible to consider Penny Mordaunt, narrowly defeated in Portsmouth North but a politician with a substantial public profile and who can point to polling evidence that she appeals to voters who usually support other parties as well as habitual Conservative supporters. She is a tireless campaigner who knows the voluntary side of the party well, and having held office in more than half a dozen government departments she has experience across a broad range of policies.

Among other defeated MPs, Greg Hands, party chairman for 10 months last year, has announced his support for Badenoch and has always been an energetic media performer. Grant Shapps, another former chairman, lost his Welwyn Hatfield seat and was a prominent supporter of James Cleverly, and is regarded (on slender evidence, in my view) as a good media performer. Yet another ex-chairman, Sir Jake Berry, was defeated in Rossendale and Darwen; his strong advocacy of the George Osborne-era Northern Powerhouse could be a opening towards a Conservative revival in the north of England (although he has just announced his appointment as chief operating officer of Fullbrook Strategies). Paul Scully, MP for Sutton and Cheam from 2015 to 2024, was vice-chairman at one point and is a steady, down-to-earth media presence, but stood down from Parliament at the general election.

This may sound prosaic, but one of the chief considerations should be getting the choice right and appointing someone on the assumption he or she will do the job through to the next election. Nothing can ever be guaranteed in politics, and every leader should reserve the right to remove those who underperform or simply turn out to have been the wrong fit for the role. But chairman of the Conservative Party is an absolutely central post in terms of organisational reform, fundraising, policy development and communications strategy. I often say, and believe, that many comparisons between politics and business are misleading and unhelpful, but in this case, it would not faze the private sector to say that such a key appointment was being made on the basis of a 4/5-year tenure, and that should be in the new leader’s calculations. If this doesn’t work, it will be a major obstacle to achieving any kind of significant recovery.

Shadow health and social care secretary

There is always something of a mismatch between what we think of as the most senior cabinet positions, like the so-called great offices of state—prime minister, chancellor of the Exchequer, foreign secretary, home secretary—and the policy areas which most directly and frequently affect voters’ everyday lives: education, healthcare, transport, housing. A poll conducted by YouGov in 2017 revealed that the public, while agreeing that the chancellorship was vital to how government works, rated the Department of Health (it acquired the “Social Care” title in January 2018) as the second most important role in cabinet, excepting the premiership. This is true both practically and symbolically.

The health and social care secretary has several limitations on his or her jurisdiction which we can sometimes forget. When we talk about “the health service”, we are essentially talking about NHS England, as healthcare (with a few exceptions) is a devolved matter for the Scottish Government, the Welsh Government and the Northern Ireland Executive. Equally, NHS England is an executive non-departmental body which oversees the budget, planning, delivery and day-to-day operations of the health service in England, with a chief executive, Amanda Pritchard, and a supervisory boards, currently chaired by Richard Meddings. It therefore has a high degree of independence and autonomy from the Department of Health, although in the run-up to the election, Wes Streeting, now secretary of state, indicated he was in favour of greater integration and a more direct degree of control by the DHSC.

On the other hand, the NHS is a hugely important organisation with which the electorate has a great deal of contact. In 2022/23, NHS England spent £155.1 billion on health services, the overwhelming majority of the DHSC’s budget of £181.7 billion. NHS hospital and community service staff are equivalent to 1,345,015 FTE posts, which is a small but significant proportion, for a single sector, of the total UK workforce of 33 million. You don’t need to assemble a very large group of people to make it statistically likely that at least one of them works for the NHS. Every year, primary care deals with more than 350 million appointments, while hospitals have more than 120 million outpatient appointments. The NHS touches us all frequently.

The symbolic importance is almost axiomatic now. Nigel Lawson remarked in his 1992 autobiography, The View From No. 11: Memoirs of a Tory Radical, that “the NHS is the closest thing the English have to a religion”, and although it was a slightly offhand witticism, it has much truth in it. You do not have to wait very long in any debate about the future of healthcare before there are accusations that right-wingers seek to privatise or abolish the NHS, wrangling over in whose hands it is “safe” and how long the electorate has to “save” the health service. That combines with the obvious practical importance of healthcare to make the portfolio especially demanding for a Conservative, because he and she will always have to work on two fronts which are almost equal in importance, practical ideas for reform and improvement, and how these ideas can be presented and their reception managed.

Social care was added to the Department of Health’s formal title by Theresa May as part of a cabinet reshuffle in January 2018. It represented no addition of responsibilities or funding, but the secretary of state at the time, Jeremy Hunt, was so enthusiastic about addressing health and social care in a more integrated way that he refused a move to the Department for Business, Energy and Industrial Strategy to remain at a rebranded organisation. At the same time, social care remains a neglected issue, partly because it is recognised as a financial burden so large that politicians are often wary of addressing it.

In 2010, Andrew Dilnot, then principal of St Hugh’s College, Oxford, was appointed to chair the Commission on Funding of Care and Support, which reported in July 2011. The commission’s conclusions included a £35,000 cap on individual lifetime contributions to social care and increasing the means-tested threshold for liability, with an estimated cost then of £1.7 billion. Many of these changes were included in the Care Act 2014, but the implementation of several provisions was delayed again and again. The Conservative manifesto in 2017 included a new and controversial proposal to include the value of people’s homes when assessing whether they should pay for their social care, with May reacting to a political backlash by promising an overall limit on contributions. The controversy was widely felt to have been a major part of the Conservatives’ unexpectedly poor electoral performance.

In 2021, Boris Johnson’s government issued Build Back Better: Our Plan for Health and Social Care, which, with a nod to the creation of the NSH, promised to “pursue the equivalent project of our era, supporting the NHS, reforming adult social care and creating a new integrated system between health and social care focussed on improving outcomes for our people”. Yet there are many unresolved questions over social care provision and little consensus on how to address them.

The Labour government knows that healthcare will be a significant test of its success or failure. Shortly after taking office, Streeting asked surgeon and former health minister Lord Darzi of Denham to undertake a swift investigation of the state of the NHS in England; Darzi published his report in September, with stark and damning conclusions. The prime minister addressed the King’s Fund the same day to respond to the report, warning that “it’s reform or die”.

The problem isn’t that the NHS is the wrong model. It’s the right model. It’s just not taking advantage of the opportunities in front of it. And that’s what needs to change. Second, reform does not mean just putting more money in. Of course, even in difficult financial circumstances. My government will always make the investments in our NHS that are needed. Always. But we have to fix the plumbing before turning on the taps. So hear me when I say this. No more money without reform.

I am wholeheartedly behind the idea that the NHS needs radical reform. On the other hand, I am less persuaded that either Starmer or Streeting fully grasps or is willing to commit to the scale of change which will be necessary to maintain a coherent delivery of healthcare free at the point of delivery. I explained my reservations in The Spectator, and argued in CapX that the political challenge of reform was vast, and that the government would need to devote a great deal of care and attention to creating a narrative which explained what it wanted to do and why to maintain public support. I also warned that we must not dismiss “institutional reform” as definitionally harmful or distracting: it is a bugbear of the health service for a reason, but to an extent it will be essential.

The Conservative Party has a difficult bat to play on healthcare. Darzi’s report contained a number of conclusions implicitly critical of the last government and many of those will have to be taken on the chin. It is unfortunate but true that Andrew Lansley’s tenure as health secretary from 2010 to 2012, which culminated in the Health and Social Care Act 2012, was an almost-unmitigated disaster; the reforms he introduced were unnecessarily complex, often ineffective and poorly handled and communicated, attracting opposition from the British Medical Association, the Royal College of Nursing, Unison and Unite the Union, among others. There is one factor, sometimes overlooked, which should be noted carefully here. Lansley was not ill-prepared or uninformed on healthcare policy. Quite the opposite: he served as shadow health secretary for six years (2004-10), comfortably the longest period in one post of any shadow cabinet minister who made the transition to government in 2010. Shortly after Lansley was replaced by Jeremy Hunt in 2012, the late Nigel Hawkes looked back at his period in office for the British Medical Journal, and it is a salutary assessment.

Whoever the new leader chooses to speak for the party on health and social care will need exceptional skills of communication, persuasion and reassurance. That is a given. But there is also serious policy work to be done. If I and others are unconvinced by the ability of the current government to reform the NHS with the thoroughness and radicalism which is essential, that does not obscure the fact that change is needed. While the opposition can, for the immediate future, focus on holding the government to account for its actions, it will not be long before the electorate is justified in asking what its own policies would be.

There are three elements the Conservative Party will have to manage in its approach to health and social care, and it is not for me in this context to determine them in detail. In broad brushstrokes, however, the first task will be to reach a credible and sustainable narrative on the 2010-24 government. Clearly the Darzi report made several very serious criticisms of health policy, many of which were accurate and justified. Yet it is also demonstrably true that the NHS overall has received increased funding year on year since 2010, and indeed before then, despite some suggestions to the contrary. That in itself demonstrates that money on its own is not the solution. So the shadow health and social care secretary will have to forge a rounded picture of the party’s legacy which stresses positive achievements, prays in aid external pressures like the Covid-19 pandemic but also acknowledges the strength of criticism and having made wrong decisions. Creating that kind of apologia is extremely difficult in a media environment which has a very short attention span, but it remains essential.

Secondly, and most importantly, there will have to a coherent plan for reform, both of the NHS and of social care. While I have predicted that the government will struggle, I am by no means suggesting that the Conservatives will find it easy. A considered approach will have to include a shift from treatment to prevention (and, as well as prevention, the encouragement of good general health); moving focus from from secondary to primary care; the integration and exploitation of technology, including artificial intelligence; managing workforce demands and workforce planning within a wider debate about immigration; political management of the various medical professions and disciplines; the perennial Cinderella which is the provision of mental healthcare; and responding to public expectations and demands. There will also need to be a great deal of thought on the interface between healthcare and social care. I don’t think it is yet clear to any leading politician what the NHS and the social care sector of 2030 or 2035 looks and feels like, but that cannot remain the case for very long.

The final element of policy must, of course, be financial. Healthcare spending, whether we like it or not, remains a powerful political totem and the Conservatives certainly cannot afford to fall behind. Sir Keir Starmer has the right idea when he says that reform and funding must go hand in hand, and some of the biggest changes in how we deliver healthcare are not necessarily the most significant financial costs. Equally, however, transforming a system as large as the NHS, and the provision of social care on top of that, will require investment in some areas.

The ability to master the detail of all of this, the acuity and agility to talk about it straightforwardly and in terms which voters will understand and relate to, and the media skills to maintain and defend policy day in, day out without mishap or gaffe is hugely demanding. But, quite simply, it is a policy area in which the Conservatives cannot fail. Even if the Labour Party maintains an electoral advantage in terms of health, the opposition will have to be a credible alternative and one whom the voters will at least grudgingly accept on the matter.

Who might be in the frame for this demanding portfolio? The current shadow health secretary, Victoria Atkins, has declared her support for Robert Jenrick. She was the last holder of the office in government, though was only at the Department of Health and Social Care for eight months and has retained the portfolio in Sunak’s interim shadow cabinet on that basis. A barrister specialising in fraud cases, she was elected in 2015 for Louth and Horncastle and was a junior minister at the Home Office (2017-22) then financial secretary to the Treasury (2022-23) before being appointed to cabinet. Often pleasant and down-to-earth, she has nonetheless suffered several challenging media encounters, and in July, as I examined at the time, was reprimanded by the deputy speaker in the House for barracking and interrupting the environment secretary, Steve Reed. It would be a bold assertion that she has the outstanding communication skills which the health and social care brief will require.

Apart from Atkins, nine current Conservative MPs have been health ministers, including Jeremy Hunt and Steve Barclay who were both secretary of state. Dame Caroline Dinenage, who was minister for social care from 2018 to 2020, is now chair of the Culture, Media and Sport Committee, is unlikely to be recalled to the front bench. Robert Jenrick himself was a minister of state at the DHSC but only for the short period of Liz Truss’s premiership. Of the remaining five, Edward Argar, a Jenrick supporter, is currently shadow justice secretary, and Helen Whately, who has declared her backing for Badenoch, is shadow transport secretary. Neither has a high profile outside (or arguably within) Westminster, which could be regarded as a lack of experience or a clean slate.

The other DHSC veterans are Neil O’Brien, a former special adviser and founder of think tank Onward who left the government in November 2023, and is backing Robert Jenrick; Dr Caroline Johnson, a shadow junior health minister but also newly appointed to the Education Committee and a Jenrick supporter; and George Freeman, who had supported James Cleverly and has just joined the Science, Innovation and Technology Committee.

One bold move for the new leader, reflecting the public feeling that secretary of state for health and social care is now one of the “great offices of state”, would be to offer the post to his or her defeated opponent. In practical terms, this would hardly be an insult or a dishonour: the shadow health secretary will get as much media exposure as almost any other figure on the opposition front bench, he or she shadows a department with huge responsibilities and budget, and the policy area is complex, multifaceted, demanding, potentially rewarding and immediately relevant to voters. But there would inevitably be a perception in some quarters that it was of inadequate seniority or, worse, represented a poisoned chalice, so I think the chances of that are slender. (Indeed, we don’t even know for certain, because one never can, if the losing candidate will serve in the shadow cabinet.)

There is often a desire for a professional, that is, a clinician of some sort, to be in charge of health policy. From time to time there have been ministers with medical backgrounds, but, almost counter-intuitively, a clinician has not run the department in any of its various guises since Walter Elliot, Unionist MP for Glasgow Kelvingrove and a qualified doctor, was minister of health from 1938 to 1940. (More recently, Sir Liam Fox, a general practitioner and Conservative MP for Woodspring 1992-2010 and North Somerset 2010-24, was shadow health secretary from 1999 to 2003.)

However, the shrunken cohort of 121 Conservative MPs currently serving is thin on medical practitioners. Dr Andrew Murrison (South West Wiltshire) was a Royal Navy medical officer and has worked as a locum general practitioner and a consultant in occupational health. Dr Caroline Johnson (Sleaford and North Hykeham) is a consultant paediatrician. Dr Luke Evans (Hinckley and Bosworth) was a hospital physician before training as a general practitioner. Dr Ben Spencer (Runnymede and Weybridge) is a psychiatrist. Dr Neil Shastri-Hurst (Solihull West and Shirley) served in the Royal Army Medical Corps before retraining as a barrister. So that represents a limited pool.

The new leader will therefore need to balance media handling, deep policy expertise and, perhaps, a clinical background. Shadow health and social care secretary is not a post for which there is a strikingly obvious candidate, but whoever takes the job will be a critical member of the party’s top team over the next few years.

Next time…

The role of deputy leader: what functions can and does it serve, and do you need one? I will also look at the area of foreign affairs and defence.