Working to make government more effective


Jeremy Hunt

Jeremy Hunt reflects on his nine years in the cabinet, including serving as the longest-serving health secretary, and his role in the Leveson Inquiry.

Jeremy Hunt
Jeremy Hunt, former health secretary

Jeremy Hunt served in cabinet between 2010 and 2019, including six years as health secretary (2012–18). He has been the Conservative MP for South West Surrey since 2005.

Since this interview took place, Hunt returned to government as chancellor of the exchequer.

Jeremy Hunt reflects on his nine years in the cabinet, including his time as the longest-serving health secretary ever. He talks about the Leveson Inquiry, relations with junior doctors and the impact of Brexit on the UK’s foreign policy.

Tim Durrant (TD): Can we start by talking about when you entered government after the 2010 election – you became secretary of state at the Department for Culture, Media and Sport (DCMS). What was your first day like? How did you find out about that job?

Jeremy Hunt (JH): Well, my very first day I remember sitting in a café in Pimlico with my wife waiting to see if I got a telephone call, and that it was glorious sunshine. Probably the happiest moment in your entire ministerial career is when you’re walking into Downing Street for the very first time because you’ve been appointed as a cabinet minister, because nothing is going wrong, and it’s all downside after that. But it was not a surprise, because I’d been shadow DCMS secretary. My biggest preoccupation was probably the fact that I was responsible for the [London 2012] Olympics and knew next to nothing about sport. Although I became a great sports enthusiast, I was very worried about the potential media pitfalls of being asked who the England cricket captain was or who won the FA cup final and not being able to give an instant answer.

"Probably the happiest moment in your entire ministerial career is when you’re walking into Downing Street for the very first time because you’ve been appointed as a cabinet minister…it’s all downside after that"

But I was then obviously taken to the department and had a very warm introduction. I think it was a period where it felt like the civil service, which I always found to be genuinely apolitical, did nonetheless want a change of government. The Brown government was sort of on its knees and I think the civil service were looking forward to a fresh approach and were incredibly helpful.

TD: Did David Cameron give you any guidance on what he wanted you to focus on? Or what his priorities were in that portfolio?

JH: None whatsoever, but bear in mind I’d been working with him as shadow culture secretary for two and a half years and I’d kept him in very close touch with what I was doing, so he knew what I was doing and the approach I was taking. So I had a pretty good idea of what his priorities were and I made it my job to make sure I knew exactly what it was that he wanted. But his approach was very hands-off and it was very much a case of asking for forgiveness not permission with him. He let us get on with it.

TD: You mentioned the London Olympics, which were obviously one of the big issues for that department. What was your view of how the Olympics were delivered?

JH: My view was that it was an exceptionally well-run project. It had been set up by Tessa Jowell [Labour culture secretary when London was awarded the Olympic games]. She had appointed outstanding people like John Armitt [chairman of the Olympic Delivery Authority], Paul Deighton [chief executive of the London Organising Committee of the Olympic and Paralympic Games (LOCOG)], Seb Coe [chairman of the London bid team], David Higgins [chief executive of the Olympic Delivery Authority]. A fantastic team of people. Paid enormous salaries but they took the decision that the Olympics just needed absolutely top people. And so, my job really was to keep out of their way and make sure they had the money they needed and to try and predict and head off any problems that they hadn’t thought of. And in fairness, they had thought about most of the problems, but there were things where the government had to get involved, the security of the Olympic park, for example. But, you know, Seb Coe and Paul Deighton ran a very tight ship at LOCOG, so I never felt the need to really get terribly involved in the way that I think I did when I was running the NHS.

TD: Let’s come onto the NHS in a bit. The Olympics was a big delivery programme that the government oversaw. Do you think there are things that can be learned from London 2012 for other big government projects?

JH: Yes, I mean, I think it was successful because the unique thing about the Olympics is that there is a hard deadline that can’t be moved and that creates a discipline. And when it comes to other big infrastructure projects, you don’t have that discipline and somehow you need to recreate it. But that was why we managed to deliver the project within budget, which was really an extraordinary achievement, but that was partly because we didn’t have the huge time delays which end up costing a lot of money. And they made sure that they had extremely competent people right from the very start which was very important. And the thing genuinely happened at arm’s length from ministers, which de-politicised it. But there was at the same time cross-party support because we won the right to host the Olympics under a Labour government, so they were as committed to it as we were. Those things came together and you can’t replicate all of those things, but I have to say, I think it was a very well-run project.

TD: I want to ask about media as well, because obviously one of the other big things that you did at DCMS was the decision on the BSkyB takeover and then the Leveson Inquiry [into press regulation]. On BSkyB, what was your impression of whether the department was able to adapt to taking that on? Because previously it had been expected to go into the business department.

JH: Well, we… I think it adapted pretty well. I had a very good media team at DCMS. We made one mistake which came out in the Leveson Inquiry which is that we should have told my special adviser, Adam Smith, to cease all contact with BSkyB, instead of which he just carried on with the contact that he’d previously had. That was a perfectly proper contact to have when they are just an ordinary stakeholder. But when you are adjudicating impartially on the decision, we should have told him that contact should cease. It wasn’t his fault that he carried on. He was just carrying on doing what he had always done and that was an oversight for which, ultimately, I have to take responsibility as secretary of state, but also the civil service has to take some responsibility.

But it was a decision that, you know, it looked like a scandal but in the end it wasn’t. And the reason was because I made a judgement, the moment I was given the decision, that no-one would ever believe that a Conservative secretary of state had made a decision in favour of Rupert Murdoch for non-political reasons. And so, I decided right from the outset that although legally the decision was mine, I needed to sub-contract some of the thinking to Ofcom [the media and telecommunications regulator], and the way I did that was I said I would get a recommendation from Ofcom, even though it’s not Ofcom’s decision, and I will publish that recommendation before I make my decision.

And that meant that if Ofcom decided in favour of the Murdochs, there would be independent justification. If Ofcom decided against the Murdochs then I would make my own decision, but it would obviously be much harder to then make a decision in favour of the Murdoch takeover. So, the fact that I took that decision at the beginning, in the end meant that Lord Justice Leveson realised that DCMS had behaved totally properly, but the process to get there, undoubtedly there was a huge amount of learning.

TD: And then the Leveson Inquiry came along. What’s it like being so involved in an inquiry like that?

JH: It was the most terrifying experience of my life, actually. It was, you know… I had the press camped outside my front door. On the day of the inquiry, I had a helicopter following me all the way to the inquiry. There was huge pressure on my family. The thing that I remember thinking clearly at the time is, how on earth would I feel if I had been guilty! But the fact that I hadn’t done anything wrong kind of kept me going, it made me feel this is a charade. But I remember thinking if I had done something wrong, this would be like the most dramatic form of punishment, your own death in slow motion as it went on over days and weeks and months.

" [Giving evidence to the Leveson Inquiry] was the most terrifying experience of my life"

So, it was a terrifying experience and the truth is that even though I hadn’t done anything wrong, I might not have survived if it hadn’t been for the fact that there was a public inquiry. The parliamentary pressure was huge, but David Cameron said, “I’m not going to make a decision on Jeremy Hunt until he’s given evidence to the inquiry,” and that was five weeks away. And those five weeks gave me the time I needed to put my case together and get my argument straight and for things to calm down sufficiently. So that probably was the reason why I ended up surviving.

TD: You moved on from DCMS before the Leveson report was published, but did you oversee any preparation for getting ready for those recommendations?

JH: Well, I didn’t have any involvement at all because that was all done by Maria Miller who was my successor. So, I just remember feeling a tremendous sense of relief when I was… I think the day it was published or maybe the day before I was summoned to the Cabinet Office and allowed to read the report in full, in private, because I was one of the affected parties. But so… yes, a tremendous sense of relief.

ND: You mentioned that before being appointed as secretary of state for DCMS, you shadowed the role for a number of years. To what extent do you think shadowing helped you prepare for doing the role properly as a minister?

JH: Enormously. And DCMS is an odd department because I was effectively responsible for five very distinct things which weren’t really related: culture, media, sport, technology and the Olympics. So, the Olympics was a kind of huge operational thing, but for the other four… I remember meeting the permanent secretary, Jonathan Stephens, who I have an excellent relationship with, during the 2010 election campaign as his job was to find out what it was we wanted to do. And I said to him: “Jonathan, I can make this terribly easy for you because I’ve got a piece of paper here, these are my priorities for each of the four areas.”

And I gave them to him, and in technology it was the roll-out of super-fast broadband. Up to that point, the Labour government’s focus had entirely been on universal access to broadband without any targets on speed, and I said: “We’ve got to have super-fast broadband.” And in fact we adopted a policy of getting it to 90% of the country by 2015, which we hit. It’s probably the single most important thing that happened in that department for our economic wellbeing.

On media, my priority was nothing to do with media mergers, it was all to do with creating a network of local TV stations. That was moderately successful but has probably been slightly superseded by the internet and the YouTube generation. On the arts, it was to boost philanthropy because we knew the arts were going to be facing a series of heavy cuts, and so we wanted to boost fundraising for the arts. On sport, my priority was school sport to be a legacy from the Olympics. And you know, to this day now, I think we’ve got 20,000 schools in the country who take part in the School Games annually, which is a fantastic programme, which started in that period.

So, I was able to give him my objectives on a piece of paper and we had one meeting a week in each of those areas, each of those priority areas, which maintained a relentless focus. It was the first time the civil service had been asked to work that way and I think it was extremely effective. The civil servants were absolutely astonished to be asked to come to a weekly meeting with the secretary of state; it’s clearly not the way they had done things in the past. But coming from a business background, I couldn’t imagine any other way of trying to make sure that a priority happened, so we had a weekly meeting. It’s something I carried on at the Department of Health, and in fact I just had a coffee earlier this afternoon with my former principal private secretary and I told her about this interview and she said: “You must mention the fact that you were the only secretary of state I ever came across who set out his priorities early and then insisted on having weekly meetings.”

The only difference in the Department of Health was that because the parliamentary pressure and the operational pressure of running the NHS was so high, we soon discovered that if we wanted to have these strategic weekly meetings, you had to have them all on a Monday. Because basically you had to get them out of the way before you could be dragged to parliament for an urgent question or a statement. So, I became famous in the NHS, and indeed across Whitehall for my Monday meetings. In the Department of Health, over my time, they changed slightly, but essentially my four-weekly… I used to have a weekly meeting with the NHS on operational issues. I would have a meeting on general practice and primary care, a meeting on patient safety, a meeting on mental health, and I would do those every week, every Monday and they were… that was the way I made sure that we were running things strategically and not just tactically.

Because a great problem you have is that there is so much… you have to be so nimble with, you know, an operational crisis, whether it’s a Mid Staffs [Mid Staffordshire] or a winter crisis, or a mental health issue that might need you to be summoned to parliament, and then you have to clear your diary to prepare the statement, you might have to do a media round. All those things can happen any time from Monday lunchtime to Thursday lunchtime when parliament is sitting, and of course, as health secretary, you have the other big moment in the week which is PMQs [Prime Minister’s Questions]. Because it’s highly possible that the leader of the opposition will go on health, and then you’ve got to be there to help support the prime minister. So I found that actually it was very hard to have strategic meetings with that incoming. For that reason, we had all the meetings on Mondays, and I found that worked extremely well.

ND: How did you find the difference between being a shadow and being the minister?

JH: I mean, you know, on the one hand, and I think for me this showed the effectiveness of our system, because most countries don’t have shadow governments, the two-and-a-half years I had as shadow culture secretary gave me an awful lot of time to think about what my priorities were, to work out some sensible areas where I could make a difference and to get read into my brief, and so from that point of view, it was very helpful.

From another point of view, I really didn’t enjoy being a shadow minister because it’s so relentlessly negative, because essentially what you’re trying to do is to pick holes in what the government is doing. And I remember being asked by David Cameron’s team to get up on TV and say that James Purnell [then Labour culture secretary] should resign because he had doctored a picture to put himself in a hospital visit in his local constituency which he hadn’t actually been in and… I didn’t really feel it was a resignation issue but I was a new member of the shadow cabinet, so I sort of went along with it, but there’s a lot of politics in being a shadow minister, you have to create a big fuss about things. And truthfully DCMS is not terribly political, so it was very difficult to create a huge fuss about what either James Purnell or Andy Burnham or Ben Bradshaw [successive Labour culture secretaries] were getting up to. So that side I didn’t like.

ND: You then became secretary of state for health in September 2012. Were you expecting that appointment and how did the conversation with the prime minister go?

JH: No, I wasn’t expecting the appointment and I was very thrilled and honoured because it was a big promotion and I’d been through a very difficult patch with Leveson. It was a huge surprise to the media, but of course the media see what you do that is public facing, in my case it would have been the whole Leveson thing that was in their minds. Whereas No. 10 sees what you’re actually like as a minister and they get the reports from the civil servants, and what No. 10 wanted, I think, was someone to calm down DH [Department of Health] after the 2012 Health and Social Care Act. And so that… I knew that that was really the main reason that I was being asked to come there as a safe pair of hands to calm things down.

ND: You mentioned that obviously you’ve had a few years to develop your priorities for culture, media and sport. How did you go about developing your priorities when you moved to DH? And then how did you manage your team of ministers to deliver those?

JH: Well, when I arrived at DH I was very open with them that I’d like to select a few priorities, but it’s going to take me a few months to work out what they are because I’m not read into the brief and I need to understand it. The first major issue I had to deal with was Mid Staffs [the crisis in care quality at Stafford hospital], and I remember taking home to read the original Francis report [of the inquiry into the failures in Stafford] and I knew that the final Francis report was coming up fairly shortly, a few months later. And it was like a shadow hanging over the whole NHS, because they all knew that it was going to be very, very critical. And reading that report really made me think that I want to focus on… well, on the quality of care that’s delivered by the NHS, which really became the patient safety agenda.

So that started off as being one of my four [priorities], and that was a fairly natural one. I then adopted one or two others that went by the wayside as time went on, but I focused very hard on. But mental health became a very big one. General practice, I spent a lot of time thinking about, and technology was another one that I focused on very hard. So, I had those four priorities and I stuck with those pretty much throughout my whole time.

ND: Following the passage of the Health and Social Care Act 2012, which was taken through parliament by your predecessor Andrew Lansley, operational responsibility was largely given to NHS England. How do you play the role of secretary of state, given that operational responsibility lies outside your direct control?

JH: Well, I play it very differently to the way that Andrew Lansley had envisaged [laughs] because in the end, you know, like it or not, the health secretary is going to be held accountable for what happens in the NHS. And it was never going to fly in parliament to say: “I’m sorry but what happens in the NHS is nothing to do with me anymore!” So I realised that I had to build a team which included NHS leaders, the Department of Health and other important stakeholders like the Care Quality Commission (CQC), and make it a joint enterprise. So that’s what I did with my Monday meetings at DH, and I saw Simon Stevens [NHS England chief executive] every Monday and we would sit around and have an NHS operational meeting, and we didn’t ever really spend any time talking about what… who’s constitutionally responsible. You know, I was like the chairman of the board and we talked about operational pressures and the best way to resolve them. That way I was fully briefed for what was going on in parliament. I hope he felt that he always got the political support that he needed. So, we broke down barriers by ignoring the constitutional divisions between us and meeting each other every week. And I think that meant that we developed trust and an effective working relationship.

ND: One of the big issues that you had to deal with during your time was the junior doctors’ strike. How do you go about managing relationships with health professionals?

JH: Well, that was a very unfortunate incident. It was… you know, it was very important to me that we improve the seven-day cover in the NHS because people don’t just get ill Monday to Friday. But I recognise, with the benefit of hindsight, that my communication with junior doctors could have been better. I think that they thought that I wanted to take away the few weekends that they had, when that wasn’t my intention at all. But I was also unlucky to be up against BMA [British Medical Association] leadership at the time, who made a number of junior doctors think that their salary was going to be cut by between 30% and 50%, which was never going to happen. So, the battle lines got drawn very early on and they balloted strike action before having any discussions with me at all. They got 98% support for strikes and so they’d got themselves into a position where they couldn’t negotiate, but I was certainly not going to back down on a matter of patient safety. But I really do think that if we’d sat around the table early on, we could have found a better solution.

ND: During your time you also secured the NHS long-term funding plan. Can you talk us through the process of securing such a big funding commitment outside of the normal spending review process?

JH: I can, but just before we do that, I think it’s probably worth saying that the most significant decision that I took when I was health secretary was probably not that, but was the establishment of the CQC as it now operates, on the Ofsted-style system [Ofsted is the independent body that inspects schools]. And that, I think, was probably linked to getting that enormous funding increase, for reasons I’ll explain. But in the wake of Mid Staffs, my first question to my officials was: “Well, have we got any other hospitals like this?” And the response of the Department of Health was: “I’m afraid we can’t tell you secretary of state.” And I said: “Well, surely we’ve got to have a system?”

"I recognise, with the benefit of hindsight, that my communication with junior doctors could have been better"

And this is one of those examples where sometimes it can be a benefit that you come from outside without any prior knowledge. So I said: “Look, come on, surely you must be able to let me know that our hospitals are safe?” And they said: “Well, we can’t. How can we know that?” And the striking thing about what happened at Mid-Staffs was that it had gone on for four years before anyone blew the whistle on it, or before the system brought it to a halt. Four years. You can imagine, you know, unfortunately, but in a system as large as the NHS with 1.4 million people, unfortunately from time to time terrible things are going to happen, but you would expect the system to notice it and for it to be stopped and sorted out quickly, but this went on for four years.

So, I then, you know, I had some knowledge of how it worked in education. I’d always been interested in education and the Ofsted system seemed to me to be a fairly sensible way of identifying which organisations are well run and which ones need improvement. So I said: “Well, why can’t we have the Ofsted system in health?” And this was in my weekly meetings that I was having to discuss how to improve the quality of care, and they said: “Okay, we’ll go and have a look at that.” Basically, we had these discussions week in, week out, and I realised after about three months of these meetings that for some reason the Department of Health were really not keen on the Ofsted system. And I said: “Could someone just tell me what the problem is here?”

Eventually, it took the permanent secretary, Una O’Brien, the only civil servant who had the courage to say: “Well, the reason, secretary of state, is that we actually have tried this before and it didn’t work.” And I said: “Well, thank you, finally, someone’s told me why you didn’t like this system. So can you tell me why? Let’s discuss why it didn’t work.” Because I then discovered, which I hadn’t appreciated, that they had the star ranking system of hospitals under Labour, which I think Andrew Lansley had scrapped. So I said, “Well, why didn’t it work?” and they then said, “Well, the reason it didn’t work was because the star rankings were very closely tied to ministerial objectives,” which were things like whether you were hitting your targets, whether you were in financial balance. So, it didn’t really have credibility in the system.

And in fact Mid-Staffs had got one of the top ratings because it was meeting its A&E [accident and emergency] target and had got a good financial balance. And this of course meant that the system had lost huge credibility. So I then said: “Well, let’s learn from that.” And the two most important appointments I ever made were of Simon Stevens and Mike Richards who was the chief inspector of hospitals. And we gave Mike complete independence, as Ofsted has, to go around and tell it as it is. I think that the one thing that the system is confident about, and certainly we haven’t sorted out all our quality problems, although there are 3 million more patients using good or outstanding hospitals now compared to when I started. But because we learned from what went wrong before, we were able to set the system up in the right way.

But for me, I never had any problems with the civil service, with a lack of enthusiasm from the civil service to try and help me achieve my objectives or a sort of Sir Humphrey-like wiliness to try and frustrate me behind the scenes. But what I did have a problem with sometimes was civil servants not having the confidence to speak out when they thought that one of my ideas was barmy. So that’s why I always try really hard to encourage people to speak out, and that’s why it was very helpful meeting the same faces every week, because then people do gradually develop the confidence to help me hone ideas from what might be a very half-baked idea or frankly a nonsense idea, into something that was sensible and would stick. I built up that trust with my civil servants, often with very junior civil servants who were astonished to be coming to a meeting with the secretary of state every single week. But I could see that that were some who were really brilliant and really passionate about what they were doing, and they actually had some great insights and we made real progress.

Now, why do I mention that? It’s because, first of all, it was a very invaluable lesson about decision making, which is that I needed the civil servants to help me hone the ideas and turn bad ideas, or half-baked ideas into good ones. That was, for me, very, very important. But also, one of the things that transparency about the quality of care did, which we introduced in the NHS really for the first time, and [were] the first country in the world ever really to have done that, was that of course we increased financial pressures. Because if you’re being completely honest about where the care is poor, then that creates a backdrop where people start to recognise the real need for resources. So, by the time… so I lobbied George Osborne [then chancellor of the exchequer] very hard for the £8 billion extra that the NHS said that it needed by the time of the 2015 election, and he didn’t really dispute the fact that it needed the money.

And then when I went for the £20 billion extra that I believed it needed in 2018, again Whitehall didn’t dispute the fact that the NHS needed the money. In fact, I remember a big meeting with Theresa May and Philip Hammond [then prime minister and chancellor of the exchequer respectively] when we were having the negotiations for that moment, at one point the Treasury was being very resistant, as is their… I guess their constitutional duty. Theresa May said in an exasperated way to Philip: “Yes, but the NHS does need the extra money, let’s face it.” And I remember thinking, “I’ve won,” for the prime minister to take that view.

But I think that was set by a really, very quick decision, which was in fact on the day that David Cameron gave his response to the Francis Report, because he decided to give that response himself. And I’d obviously written his statement, and in it I put the need for independent inspections, and we had a sort of two-minute meeting in his office after cabinet, George Osborne was there. And George Osborne actually queried the need for independent inspections because I think the Treasury were worried [laughs] that this could create financial pressures. And David Cameron said: “Look, Jeremy’s thought about this a lot. I think we should go with it.” And so it stayed in. And just in those… in that very short sentence, I think probably the foundations were laid for a funding increase for the NHS which has ended up being an entire 1% of GDP [gross domestic product], I mean, it was a huge increase, that funding increase.

ND: Ahead of that funding being agreed, it was reported that during the January 2018 reshuffle, you told Theresa May that you wouldn’t move from the Department of Health. What was that conversation like?

JH: Incredibly difficult. You know, I’d never had a conversation before where I was basically saying: “No, prime minister.” I recognised that I was… I thought I was probably going to be ending my career in cabinet when I said that, because prime ministers have to choose who they want. I wasn’t trying to play a game, but I genuinely thought it would be dishonourable to stop being health secretary in the middle of the most appalling winter crisis where the flu situation was at near record levels, and so I just thought it was wrong to change the captain on the ship at that time, and I didn’t feel it was right to jump ship to another government department. I felt I needed to see the crisis through.

"I genuinely thought it would be dishonourable to stop being health secretary in the middle of the most appalling winter crisis"

She was visibly shocked. I mean, I had tried to send signals to No. 10 because I’d obviously thought they might be thinking of moving me. I tried to send signals ahead of that to No. 10, but they obviously thought I was persuadable. So, to my surprise, Theresa said: “Well, we wouldn’t want to lose you from the government, so would you mind just waiting outside for a few moments?” So I went outside and waited in an anteroom outside the cabinet room, and I think what happened then was that they then contacted, through Jeremy Heywood [then cabinet secretary], NHS top brass and said: “Look, do you actually agree it would make an awful lot more difficult?” And they said: “Yes.” [Laughs] So I think it then got reported back to No. 10 that actually I wasn’t joking, I was serious about it. And so then I came back and I said: “Look, I’m very happy to move later on in the year, but I just don’t think the moment’s now.” And Theresa said, “Well, I probably will want to come back to this later in the year,” as indeed she did.

ND: You ended up as the longest-serving health secretary ever. How did your views evolve over your time in office and how helpful was it to have been in the post for that long?

JH: Well, I think it was enormously helpful because you get a chance to learn on the job. I arrived knowing that there were big problems in the quality of care being delivered by the NHS. But I, unlike when I was running my business, where I thought it was very important to have the right culture, I thought, I don’t want to touch issues of culture in the NHS with a bargepole because it’s so nebulous. How can you possibly measure whether you’ve improved the culture in the fifth largest organisation in the world? And I might not be around very long. But I learned over my time as health secretary that there is never any real change without culture change. Everything is about culture.

So, I started thinking very hard about how you create a more open, transparent culture where people are comfortable admitting mistakes, and in healthcare that is more difficult than anywhere else. Because if someone’s died because of a mistake made by a doctor, that’s an incredibly difficult thing to admit to, and lawyers get involved and families are angry. And I spent a lot of my time thinking about those issues and trying to make the NHS more open and transparent when it comes to medical error.

TD: You then became the foreign secretary, in summer 2018. What was that conversation with Theresa May like? Did she approach reshuffles differently to David Cameron?

JH: I mean, the conversation… they sounded me out in advance through the chief whip, I think because they wanted to make sure I was really going to accept it this time. But I’ve been around long enough to know that reshuffles are actually very fraught processes for prime ministers. In that particular case, it was prompted by Boris [Johnson] and David Davis resigning, but you’re meeting a lot of people and so they don’t… prime ministers don’t tend to want to have long conversations when they’re doing reshuffles. They’ve got other people to see. But it was a perfectly friendly discussion.

What is very striking in British politics is how unlike in the private sector, when someone takes on a job they will spend a huge amount of time with their boss saying: “This is what  I want you to do, this is how I want you to approach it.” You really don’t spend any time doing that in politics and you just get thrown into things. In my case, on my first day as foreign secretary I had to attend a lunch at Lancaster House with Angela Merkel [German chancellor] and a whole bunch of other leaders for the Western Balkans Summit. And I remember the first day in the job, Sebastian Kurz, the chancellor of Austria, coming up to me and I said: “How do you do? Jeremy Hunt.” And he went: “How do you do? Sebastian Kurz.” And I thought: “Oops, that’s the chancellor of Austria.” [laughter] I hadn’t realised, he looked so young. And so that was another baptism of fire.

"in foreign policy, it is surprisingly difficult to be strategic, because a global crisis is happening every day somewhere in the world"

But I tried to take the same approach in the Foreign Office that I’d taken in my other two departments, which is to say, well, the secretary of state’s job is to make sure that we are taking a strategic approach to everything we do. To look above the parapet… but to do that you have to be willing to delegate a lot of fire-fighting. Because you can spend your whole time as a cabinet minister fire-fighting, but if you actually want your department to be strategic in the way it approaches big issues, then you have to delegate a lot of that, a lot of that decision making, so that you can focus on big picture approaches.

TD: And how did the Foreign Office differ to the other departments you led?

JH: The Foreign Office is a living, breathing institution in the way that few other government departments are. It’s been around for more than 200 years and the calibre of the people who work there is extraordinarily high, which is why it was a joy being foreign secretary. You know, my private secretary…. private secretaries are typically young, ambitious but junior civil servants, but one of my private secretaries was completely fluent in Arabic, another was completely fluent in Japanese. You know, they were amazingly talented people. But in foreign policy, it is surprisingly difficult to be strategic, because a global crisis is happening every day somewhere in the world. And Britain’s influence, whilst it’s greater than many countries, we’re still, at the end of the day, only one of 193 United Nations countries, and we don’t control things that are happening in other parts of the world. So, everything is about forming international alliances and coalitions and that takes time, it’s not always easy to do.

TD: How did Brexit affect your work as foreign secretary and the UK’s international role?

JH: Well, I think with Brexit there was a lot of sadness in Europe that we were leaving, but      I think the thing that affected our influence was the political weakness of the government, more than Brexit. It was the fact that there was a government that didn’t have a majority and therefore couldn’t guarantee that what it had signed up to it would be able to get through parliament, and that in the end made our voice weaker on the international stage.

TD: There’s a view that the Foreign Office was sidelined on Brexit, with the creation of the Department for Exiting the EU (DExEU) and the fact that obviously the prime minister took a lot of interest in Brexit. How do you think the foreign secretary and the Brexit secretary can work well together, or Foreign Office and DExEU officials?

JH: Well, you know, it was a deliberate decision to take Brexit out of the hands of the Foreign Office while Boris was foreign secretary, that was what No. 10 intended. When I became foreign secretary, we got a bit more involved, but obviously structurally it was the job of the DExEU secretary of state to do the negotiations with Brussels, but I was reasonably closely involved.

TD: On a broader topic, you were in government during the coalition (2010–15), then there was a period of majority government (2015–17), then there was a minority government after the 2017 election. How did those different parliamentary arrangements affect the government’s ability to get things done and affect your role?

JH: Well, I think the coalition government and the period of majority government were much more comfortable. I think the truth is that we don’t do hung parliaments very well in this country because the adversarial system is in our DNA, and MPs and opposition parties find it very difficult to make compromises that are necessary to get stuff done in a hung parliament, in a way that happens much more easily in countries that have a tradition of hung parliaments. So I think that made it extremely difficult for Theresa May and made that period very difficult for the government generally. So, I think that would be my main observation.

TD: Ahead of the referendum in 2016, David Cameron lifted collective cabinet responsibility so that everyone could campaign as they felt right. Did that affect how the government worked, and do you think there was a sort of hangover of that into the early days of Theresa May’s time as prime minister?

JH: No. I think it was essential to lift collective responsibility for reasons of party management, and essentially he intended to win the referendum and then move on, and he wanted to be able to keep the same team there. So, I think it was a perfectly sensible thing to do. No, I think the reason why it was much harder for Theresa May was because we had a hung parliament and when you have a hung parliament, everyone’s leverage against the prime minister is higher. Because everyone, whether you’re a cabinet minister, you realise that essentially you start to become unsackable, because the prime minister can’t afford big battles with her own cabinet. Whether you’re a government backbencher where you don’t need very many people to defeat the government in any a legislation. Or whether you’re an opposition member, where the government may be wanting to court you to get your support. So, everyone has more leverage against No. 10 in those situations and that meant that Theresa’s job was practically impossible.

TD: What were Theresa May and David Cameron like as prime ministers? How did they approach the role?

JH: They have very different styles. David Cameron enjoyed making lots of quick decisions and didn’t have a cabinet discussion until he’d actually worked out what he thought the right outcome was. Theresa May would often have a cabinet meeting where we didn’t know what she believed. In a way, that made the cabinet meetings more interesting because you thought that maybe what you were saying might have weight attached to it. Whereas in David Cameron’s cabinet meetings, after George Osborne had spoken, you basically knew what David Cameron and George Osborne thought and the matter was broadly over. But sometimes it was frustrating because you thought Theresa May had registered an important point that you had made, but subsequently you discovered that she hadn’t. She was much more Delphic.

ND: You left government during the July 2019 reshuffle. Can you describe that process?

JH: Yes, I think I had realised during the course of the [Conservative Party] leadership campaign that I’d been in the cabinet for every hour my three young children had been alive for, so although I would have loved to have stayed as foreign secretary, if it wasn’t going to be that, then I really wanted to spend some more time with my family after nine years in the cabinet. That doesn’t mean to say I wouldn’t like to go back to the front line at some stage, but for me, I’m very happy to spend a few years being a slightly better dad and husband. So, you know, Boris is entirely within his rights to choose who he wants doing all the jobs in his cabinet, but when it became clear that the foreign secretary wasn’t going to be offered, I knew that was the moment to stand down.

ND: What achievement are you most proud of from your time in office?

JH: Well, probably when I was health secretary, making patient safety a much bigger priority throughout the NHS. By the time I finished, three million more patients were using good or outstanding hospitals. I introduced the Ofsted-style system which created more transparency over the quality of care. There were lots of battles along the way and I’m sure I didn’t get everything right, but I do think the NHS pays much more attention to the safety and quality of care than before. And I’d be the first to say that that wasn’t just me, I think there were huge efforts made by NHS staff in the wake of Mid Staffs to change their approach to safety and quality. But the fact that we did is something I’m very proud of.

ND: And what advice would you give to a new minister on how to be effective in office?

JH: I think the most important thing you can do is work out what it is you would like people to say about your time in office after you’ve gone. And the best thing to do is to choose one big thing to change and really focus on that relentlessly, because you’re going to have to decide all sorts of issues that crop up left, right and centre. There’s going to be all sorts of firefighting, all sorts of controversies, media slip-ups, but all that will be forgotten five years hence. But how many ministers can point to one big thing they changed that they’re really proud of? The answer is surprisingly few, and I think my advice would be make sure that you’re one of the few that can.

TDIs there anything we should ask that we haven’t?

JH: Your work at the Institute for Government, I think it’s very important actually. When I was a shadow minister, the IfG organised some seminars for things you should think about before you were a minister and they got some former ministers to give us advice. And one of the best bits of advice was from Hezza [Lord Heseltine] actually, he said never take red boxes home. He said if the private office thinks it’s their job to build up a red box during the day, they will build it up and build it up and build it up. But if you say to them, “I’ll do any paperwork you like in the office, you just find a time in the diary and put it in,” then their incentive is to reduce your paperwork. [Laughs] And I did that, I stuck to that, and in my whole time, I never took a box home. Save occasionally in the Foreign Office if there was urgent stuff that had to be done, but yes, very rarely.

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