|Heidi Alexander, the Labour MP for Lewisham East, was a relative unknown, both at Westminster and with the public at large, when she became the new shadow health secretary last month. Two Jeremys now play key roles in her life: Corbyn, the party leader who handed her the politically important health brief; and Hunt, the health secretary who she has to match, expose and ideally help oust if she is to make her mark in frontline politics.
Sitting in her Westminster office, the 40-year-old daughter of an electrician father and school meals supervisor mother does not seem daunted by her elevation from whip to senior shadow minister. How does she rate Hunt, her political adversary? “He’s a very savvy operator, quite a polished politician. But sooner or later the polish comes off, and I think we might be starting to see that now. When he was first appointed [in September 2012] he quite rightly made a very big play of patient safety and transparency, and on both of those issues I think things are going backwards.”
Recent events seem neither intelligent nor particularly transparent, in my view
Alexander points to the Department of Health’s (DH) role in ensuring that both the regulator Monitor and the Trust Development Authority’s recent reports on NHS performance, including its increasingly grim finances, were kept secret until after the Conservative party’s annual conference, and in also burying Public Health England’s admirably independent report advocating a sugar tax – a policy David Cameron has rejected against the advice of the medical profession. There are also the murky dealings by the DH, NHS England and the National Institute for Health and Care Excellence (Nice) over safe staffing levels in hospitals, which have led to claims that saving money is being put before patient safety. “This is a man who used to talk about ‘intelligent transparency’. Well, recent events seem neither intelligent nor particularly transparent, in my view,” she says.
Asking Alexander how genuine Hunt’s commitment to the NHS is, given his always having an NHS badge in his left lapel and regular praise of its staff, draws a scornful response: “I was quite struck by Dr Clare Gerada’s tweet about the junior doctors dispute, where she said: ‘Jeremy Hunt wears his NHS badge on his lapel, but junior doctors wear the NHS in their hearts.’ ”
Plans to dissolve south London NHS trust anger neighbouring hospital
Hunt is one of the few senior figures in parliament who already knows what an effective opponent Alexander can be. The reason he will remember her is also one of the main reasons Corbyn gave her the job.
“When he [Corbyn] phoned me it was like a bolt out of the blue. I never thought I would be offered shadow secretary of state for health.” So why did he give her such a key post? “He’s been interested in subjects I’ve done a lot of work on, like the housing crisis in London and the realities of life for people who are refugees or recent migrants. But he also referred to all the work I did on the Save Lewisham Hospital campaign. He recognises that what the government is doing to the NHS worries people across the country, and [said] that he wanted me to bring some of the determination and fighting spirit I’ve learned from campaigners in Lewisham to the dispatch box in the House of Commons, and that’s what I will try and do.”
Lewisham hospital found its A&E and maternity unit in danger in 2013 when the trust’s special administrator trying to sort out and ultimately dissolve the financial basket case that was the South London healthcare trust decided to make downgrading Lewisham part of the solution. Protesters, who marched in their thousands and signed a petition Alexander organised at the unfairness involved, ultimately prevailed when they sought a judicial review of Hunt’s backing for clobbering Lewisham, won in the high court and then won again in the court of appeal.
No wonder the shadow health secretary drew such loud applause at the recent party conference when she told delegates: “Let me say this to Jeremy Hunt. You might have thought you’d seen the last of me with Lewisham, but you’re going to be seeing a darn sight more of me now.”
I'm sorry, I can't face being a doctor any more
What’s happening that might help her against Hunt? “The way he has handled the junior doctors’ dispute is utterly appalling. Junior doctors I’ve spoken to feel like they are the first line of defence in a battle for the future of the NHS. It’s their contracts today, but when will it be renegotiating terms and conditions for nurses and healthcare assistants?” She found shadowing a junior doctor at Lewisham hospital recently “deeply humbling. I observed the intricacies and humanity of the doctor/patient relationship, as well as the skills and knowledge the doctor had. I was quite blown away by what I saw.”
She also cites the NHS’s deepening workforce crisis, the sometimes chronic shortage of nurses, GPs and also trust chief executives and the “undeliverable” £22bn of efficiency savings. “We’ve got a very, very difficult couple of months coming in the winter,” she says. “Hospital bosses tell me it really is now a stark choice between balancing the books and delivering safe patient care, and I think that is going to start to bite in the next few months. The care system is on the verge of collapse, in terms of the rates paid to domiciliary care workers and nursing homes.”
One Conservative MP sums up the challenge facing Alexander: “Heidi has always struck me as being genuine, likeable, and an MP who is in politics for the right reasons,” he says. “She already has a successful NHS track record in campaigning for Lewisham hospital. The coming winter is likely to crystallise some of the challenges facing the English health and care system. So Heidi’s immediate challenge will be to rigorously hold the government to account for its record on the NHS. This will require a difficult balancing act between the impulse to criticise and the need to support the NHS and its hard-pressed staff during the busy winter period.”
So what are Labour’s own policies on these big, difficult issues? Alexander gives some hints about how that might develop under Corbyn, but no more than that. “The work [her predecessor] Andy Burnham did on the integration of health and social care, and providing whole person care, is something we would want to build on in this parliament. And clearly the importance that Jeremy [Corbyn] has given to mental health – Luciana Berger now sits in shadow cabinet as minister for mental health – fits very neatly with that.”
Alexander recalls her paternal grandmother, Peggy. “She worked in a betting shop most of her life, was very proud and very stubborn. When she got vascular dementia she had to move out of her modest semi in Swindon and ended up in a nursing home. She used up all her savings paying for that, including selling her house. My instinct is that it’s not fair [to have to sell a home for that reason].” She is deeply troubled by the growing inadequacy of social care services for older people, but acknowledges that fixing that would be “an expensive business, and we need to find a way that’s not only fair to individuals and their families but fair to the taxpayer as well.”
Another big challenge is how to fund the NHS properly. The £22bn of efficiencies cannot be achieved without affecting patient care and the £8bn extra the government has pledged by 2020 is billions short of what will actually be needed, she says. What would Labour do about this, and about the likely £2bn NHS overspend this year? She initially says that “the NHS should get every penny it needs”. But, pressed on how much and where from, admits: “I don’t know the answer to that, sat here today” and stresses: “I’m five weeks into this job and I need to talk to my colleagues in the shadow Treasury team and clearly we will need to review the requirements of the NHS and care system”.
Labour’s main election NHS policy, its poorly explained £2.5bn-a-year Time to Care fund, is clearly no longer fit for purpose. A new leader and a new shadow health secretary, but the same, familiar, difficult NHS issues. Who will triumph in Alexander v Hunt, round two?
Education Churchfields comprehensive and New College, Swindon; Durham University: geography BA, MA in urban and regional change
Career Sept 2015-present: shadow secretary of state for health; 2010-present: MP for Lewisham East; 2013-2015: opposition whip; 2011-2013: parliamentary private secretary to Mary Creagh MP; 2006-2010: deputy mayor and cabinet member for regeneration, Lewisham council; 2005-2006: campaigns manager, Clothes Aid; 2004: elected as Labour councillor in Lewisham; 1999-2005: parliamentary researcher for Joan Ruddock, MP; 1998: intern to Cherie Booth QC; 1996-1997: holiday rep
Public life 2007-2009: chair, Greater London Enterprise; 2007-2009: director, Lewisham’s local education partnership
Interests Keep fit; travel; rather too much reality TV