Health Policy July 25, 2019
Boris Johnson: Is it over before it begins?

By Ben Howlett - Accountable Care Journal

Boris Johnson entered Downing Street as the 77th Prime Minister on 24th July, the 55th person to hold the role. It is no understatement to remark that he faces an uphill struggle. Over the next 98 days, Mr Johnson takes on the challenge of withdrawing the UK from the European Union by delivering his self-proclaimed ‘do or die’ Brexit.

There are obvious constitutional difficulties for the new Prime Minister to proceed in withdrawing the UK without the support of Parliament. Mr Johnson will face his first electoral test next week at the Brecon and Radnorshire by-election. Should this go the wrong way, it could leave the government with a majority of just one.

For any Prime Minister, the first hundred days is a test that sets the tone for the rest of their premiership. However, for the first time in living memory, this Prime Minister has a high probability of failing to pass. As a former Conservative MP, you may think that I am being unfair to the new Prime Minister. However, Mr Johnson faces a test that has swallowed up and spat out many of his contemporaries, divided the major political parties to the point of splitting and caused a damaging rift in the very fabric of British society.

Strategically, Number 10 is clearly setting itself up for a General Election later in the year. Evidence being; the appointment of Dominic Cummings as Chief Executive at No.10 – the Vote Leave mastermind that David Cameron famously labelled “a career psychopath. ” With the political guillotine falling upon the remain wing of Theresa May’s cabinet over the past few days, there is a growing cabal of anti ‘no-deal’ heavyweights readying for a fight on the government backbenches. It seems that President (Lyndon) Johnson’s famous quote: “It’s probably better to have him inside the tent pissing out, than outside the tent pissing in,” was lost on this Prime Minister and his new team in Downing Street.

Therefore, my crystal ball predicts a General Election in the Autumn of 2019 with a likely coalition between the Brexit Party and Conservative Party forming to push a no-deal, and a remain coalition between the Liberal Democrats, Labour and the SNP moving to deliver the opposite. Who leads that coalition is anyone’s guess at this stage – 24 hours is a long time in politics.

On domestic policy, the reappointed Secretary of State for Health and Social Care, Matt Hancock, announced that Mr Johnson’s speech on the steps of Downing Street would be ‘surprisingly content-heavy. ’ He wasn’t wrong if he was referring to the broad spectrum of policy fields Johnson would go on to cover. The new Prime Minister announced that he wanted to solve the problem of not being able to see a GP within 3 weeks.

He also announced 20 new hospital upgrades and a new white paper on social care that would see a new national insurance scheme for workers over the age of 40. He further pledged that he wanted to give every older person the ‘dignity they deserve’ in later life. Call me cynical but given the repeated failed promises to publish the social care green paper over the past two years, it is highly doubtful that a white paper is imminent. On reflection, it is clear that this domestic shopping list of policies is both highly ambitious and disappointingly lightweight.

The more interesting announcement on the steps of Downing Street which received less coverage is the promise to change tax rules for research in the UK. As the new Prime Minister admitted that there would be “difficulties” as a result of no-deal Brexit, he believes that a change to tax rules will compensate for the difference.

For the healthcare and life sciences sectors, it is important for continued engagement with the Treasury and the Department for Business. The new business team, which includes Jo Johnson the PM’s brother, looks to be a splash of remain cold water in a sea of libertarian Cabinet leavers. Nevertheless, a focus on low-tax policy would be an advisable approach to take for industry government affairs teams.

Obviously, Mr Johnson will want to focus on his domestic agenda to show that he can do more for the country than just ‘deliver’ Brexit. However, the obvious fact is that Brexit trumps everything else and, therefore, the context for the government domestic agenda will be set by Brexit. Should there be a no-deal later in the year, the Chancellor’s ability to pay for hospital upgrades or new finance for social care will be squeezed even further. With a majority of one in the House of Commons, the question isn’t 'if' the government will collapse, it is 'when,' and it is likely to be before Halloween.

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