The Steve Hewlett I knew: a tough journalist, a fearless chronicler of the illness that killed him

Steve Hewlett became a household name over the past few months for talking about his cancer intimately and frankly to Eddie Mair on BBC Radio 4’s PM programme and for his diaries, which appeared in the Observer. At first I found it hard to reconcile how Steve was talking with the way he’d approached his life and work on Radio 4’s The Media Show, where I was his producer from 2009 to 2013.

It was an extraordinary time in media history, with stories of phone hacking and a BBC director general resigning. Steve Hewlett had always wanted to find the story, not be the story, and he was wary of “human interest”. But here he was on PM talking of himself with the same clarity and fascination as if he were a breaking story, with the scoop on his own condition. Suddenly it made sense. He was an utterly fearless interviewer and now he was turning that fearlessness on himself.

Steve made his name in investigative journalism on television and had been presenting The Media Show for a year when I first met him. We went for a pint and compared notes on what was going well and what might be changed. I had to get up to Steve’s speed on what he already knew, and find new subjects he didn’t know about, to test him, keep pushing him and show how wide the remit of this new programme could be.

Over the next few years, his scoops ranged from phone hacking and press regulation to who knew what, and when, about Jimmy Savile. On air he was dauntingly impartial, as hard on his friends, contacts and colleagues as on anyone else. It was gruelling at times, but Steve had the stamina of an ox.

The Media Show wasn’t Panorama, where he’d famously handled Martin Bashir’s interview with Princess Diana, and Steve was doubtful at first of radio and the impact it had, compared to television.

He was still developing his voice as a presenter of a live programme, rather than an expert answering someone else’s questions on his favourite subjects. But he hit his stride as we broke stories, and he enjoyed it even more when this rolled into appearances on Radio 4’s Today programme, which turned virtually into a residency during the phone-hacking scandals, the News of the World debacle and the Leveson inquiry.

I remember getting a call from Steve almost incoherent with excitement when he had just been phoned by someone at the News of the World, from the meeting where its closure was being announced. Steve made it to a studio to take part in the PM programme within the hour, exhilarated to be the one in the know, first with the inside story.

He was a great teacher. He impressed on me the importance of knowing the industry’s regulations, to see who was bending the rules, and of working out who had a strategy and who was being merely tactical. I often catch myself saying “causation or correlation?” and realise that’s a mantra from Steve, picked up when he snorted at a piece of research that claimed to show watching TV was bad for children, without demonstrating the link.

Steve pushed me and our assistant producer hard, but he always pushed himself harder. Especially in the first years of The Media Show, when it was live at lunchtime, I would arrive before 7.30am to find him already working on something in his office.

Often the door would stay closed for a confidential call. Later, as he came to trust me, it would be left open. Sometimes his tone would be intense, hushed, focused, and I’d not know who it was until after he hung up.

Sometimes it was altogether warmer, lighter and tinged with laughter, and I knew he was talking to one of his teenage sons, a holiday moment on a busy programme day. This would prompt him to tell stories about the other areas of his life, his weekends of refereeing rugby in Harpenden and his adventures in student politics, what he was doing at their age.

It was a glimpse of the side of him listeners eventually got to know much better in recent months. When I asked, he said it felt so natural to talk openly to Eddie Mair about his cancer, he couldn’t understand why anyone thought it was remarkable. Anyone who heard Steve, or read his diaries in the Observer, came to appreciate just how remarkable he was.

The Steve Hewlett I knew: a tough journalist, a fearless chronicler of the illness that killed him

Steve Hewlett’s legacy could be to save lives by raising cancer awareness | Letters

Everyone who heard Steve Hewlett’s moving account of his oesophageal cancer will be sad to know that, for him, there was no cure (Report, 21 February). But I write as the wife of a survivor of this disease. My husband, now 81, was diagnosed in November 2011.

After a course of chemo, he was operated on to remove the tumour just five years ago, one of thousands who are full of thanks to the oncologists and surgeons who saved their lives. The specialist nurse at the hospital where my husband was treated told us that this cancer is becoming more common, particularly for men, and the UK incidence is probably the highest in Europe.

I do want to point out that this month is oesophageal cancer awareness month, when pharmacists and GPs aim to make people realise that it is not normal to have to continually take over-the-counter remedies for stomach acid. In that case, people should see their GP so that further investigations can be put in train. As for all cancers, early diagnosis, before any cancer has spread, gives the best chance of a cure.
Susan Chesters
Winchester

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Steve Hewlett’s legacy could be to save lives by raising cancer awareness | Letters

Another referendum? Yes, but this time on the NHS | Steve Richards

Referendums resolve nothing. The campaigns that precede them are mendacious. A thousand factors determine the outcomes, many of them unrelated to the question on the ballot paper. Yet there is an overwhelming case for holding another one.

The next referendum should not be on Europe. We have had more than enough plebiscites on that unavoidably vague and highly charged issue. Instead the question that needs to be placed in front of the electorate is more focused and precise. As people live longer and medical technology develops, everyone agrees that, alongside structural reforms, higher investment in health and elderly care is essential.

Yet no party or leader can find a way to raise the money. The scale of the crisis is vast and the response of government is puny. Look at the current incumbents, still on a buoyant honeymoon with the electorate, but struggling to find a means of providing a tiny bit of extra cash for elderly care at the end of the year.

The referendum would not be about a prime minister, the government or the opposition. It would be about us, our priorities

The situation is perverse. Nearly all voters recognise that modern health provision is worth paying for and agonise separately about the possible future costs of elderly care. Will we have to sell our house? Will we lose our inheritance? Why can’t we get access to drugs available in other countries? Why are survival rates of some diseases higher in other countries? Why do I have to wait a week to see a GP?

Part of the answer to all these questions is obvious. The government needs to raise additional revenue. It will not be cheap but in the end – for selfish reasons and not altruistic ones – we need the only mediating agency available to address the challenge, and that is a government. There is no other institution available that can be held to account in the same way and that can respond to the sheer scale of demand.

Yet the obvious cannot be delivered. The government – any government – cannot deliver because it is too scared to raise taxation or is not trusted to do so. With the UK’s uniquely hysterical pre-election tax-and-spend debates no party can win a mandate to raise taxes in order to provide the necessary levels of investment. Before a general election there is pressure on parties to show how they will cut taxes and reduce public spending.

These debates have no relation to reality and yet constrain governments subsequently. The last election was typical, fought on the fantasy that George Osborne would wipe out the deficit by the end of this parliament. Moving nervily into this fantasy battleground, the Labour leadership wondered fleetingly whether it could argue that elderly care and a modern health service were worth paying for, and concluded that it could not. The priorities would get lost in a frenzy of headlines about tax bombshells.

Even without the headlines we live in a dangerous era of extreme mistrust. Some voters turn against those they elect and, most fundamentally, do not trust them with their money. But what if they had a direct stake in a decision as to how their money was spent? Suddenly the dynamic changes altogether.

The referendum I envisage would be far removed from the mad one on Brexit. A prime minister would offer to facilitate investment in the NHS equivalent to levels in similar countries and to provide a national care service for the elderly of the highest standards, as in Norway, where the wealthiest plead to live in state-run institutions because they are the best available. A government would explain the costs and the tax rise required to pay for them. But the referendum would not be about a prime minister, the government or the opposition. It would be about us, our priorities. The politicians would be ready to act, but equally they would be ready not to act. They would insist that it is up to us.

The referendum campaign would be as much a scrutiny of the providers. Are they efficient, will they spend every additional penny wisely? It would not be a highly charged campaign where political careers are at stake.

If the referendum were lost, the voters would have decided they prefer a lower level of taxation and poorer health provision, while being willing to busk it in terms of elderly care. Governments would have to start charging for more services, and private insurance schemes would flourish. If a majority backed a tax rise to pay for improvements, the entire electorate would have a stake in making sure that what follows delivers good value for money. The scrutiny would not just be on parliamentary committees, the media and the rest. The voters would be keeping a close eye on what happens next.

The drawbacks are many. The Treasury hates any form of earmarked taxation, let alone a tax rise based on the vagaries of a referendum. And why should voters back a tax rise in a referendum? But there is no easy way through the barriers towards civilised provision of health and elderly care services, and this provides a route. The tax-and-spend hysteria of a general election would not be repeated in a referendum because the stakes are less high. The campaign would not be about electing a government.

Indeed, some anti-state newspapers with relatively elderly readers would have to be careful about being too vehement in their opposition. The framing of the argument could be transformative. Instead of the state being regarded as a stifling, profligate monster, voters will be asking of it: what can you do for us? Lost connections between those who feel “left behind” and the ones they elect might be rediscovered. When as chancellor Gordon Brown announced a tax rise to pay for NHS funding, polls suggested the move was popular. Voters make the connections if given the chance to do so.

Referendums on Europe are bound to be preposterous. They are about nothing and everything. Some people have raised the possibility of a “second” referendum on Europe, but we have had two already, one in 1975 and the vote last year. If we have a third, we will have a fourth. The multi-layered complexities of Europe mean a binary referendum is doomed to generate further crises.

Most immediately, there is no obvious solution to Brexit. There is a solution to an underfunded NHS and elderly care service. Yet no government can act without the permission of the voters. So a government sometime soon must seek their permission. I loathe referendums, but in this era of mistrust, government is paralysed. We need one urgently.

Another referendum? Yes, but this time on the NHS | Steve Richards

Steve Hewlett: ‘People say I’m brave about cancer, but I’m realistic. I’m a storyteller’

Back in March, the broadcaster and journalist Steve Hewlett received the sort of mortal shock that frequently opens a newspaper article about how to deal with a serious illness: he was told by doctors, almost out of the blue, that he had an aggressive form of cancer that would be difficult to treat.

But Hewlett’s long experience as a journalist and media commentator for the BBC meant his story has followed a far less private path than most.

On hearing his diagnosis, Hewlett, 58, found himself, almost without missing a beat, wondering how best to communicate his situation and explain what he was learning along the way.

“My initial reaction, quite genuinely, was just to think ‘OK. My luck has finally run out.’ But there is something about journalism that is quite central to the person I am – a tendency to ask awkward questions. And I have realised over time that if I don’t understand something, it is quite possible that other people don’t either.”

So last month, Hewlett recorded the first of a series of candid radio interviews with Eddie Mair, the presenter of Radio 4’s PM news programme. Hewlett’s illness was not a secret among colleagues, but the impact of his decision to go public and talk on air about his medical journey was to give him the second big shock of his year, and this one was much more welcome.

“The size of the response has been amazing,” he told the Observer. “Hundreds of people are in touch. My social media followers went up by a thousand, for a start. People say I am brave about cancer, but I am just realistic. I have my moments, of course, when I well up.”

Hewlett suspects the strength of the public reaction is due to the rarity of hearing a couple of men just talking in a relaxed way about cancer. Hewlett’s analytical approach has always been no-nonsense, whether interrogating media executives on Radio 4, producing an award-winning 1991 BBC documentary from the Maze prison, or interviewing the late Libyan leader Colonel Gaddafi.

Now, in a chatty style, punctuated by his trademark phrase “to cut a long story short”, he has offered his listeners a down-to-earth assessment of his prospects, with honest reactions to his treatment, from details of his chapped hands and feet to his use of a cold cap to try to prevent major hair loss during chemotherapy.

The veteran radio critic Gillian Reynolds summed it up: Hewlett’s instinct for a strong story, she wrote in the Daily Telegraph, is what “makes him the best reporter on the unfolding story of his own physical change”.

For Hewlett though, Mair is at least half of the reason why the radio interviews work. “I have known Eddie for a long time, though not particularly well. When I was offered the chance to talk about the cancer on air, I suggested his show because it is a fairly free format. If he was willing – and warmed to the idea – I said, go ahead. But I have been amazed by the amount of time given to it. The first was almost a third of the programme. The second almost crashed the 6pm pips.”

Gwyneth Williams, controller of Radio 4, has also suggested that Hewlett record a diary for a separate documentary. “I have never had much trouble talking, after all,” Hewlett drily notes. “And so far I have had few side-effects from treatment.”

The scale of listener reaction is “enormously gratifying” to him and he says he has been especially pleased to hear from former colleagues, from his time as director of programmes at Carlton TV, where he produced the acclaimed Second World War in Colour, and right back to Panorama, where he was in charge when Princess Diana gave her famous “there were three of us in this marriage” interview to Martin Bashir in 1995.

Aside from replying to kind correspondence, Hewlett is persisting with research into potential treatments for his condition: advanced oesophageal cancer. Many of his doctors seem, he says, grateful to discuss possibilities with an informed patient. “I’ve looked up clinical trials and drug development programmes because I have the time. I don’t know how much anyone can do to alter the outcome, but you can make the journey better for yourself.”

The latest news on his condition is not great because the first round of chemotherapy failed two weeks ago, after a beguilingly positive start: “It gave me three or four months of improvement and without that I might not be here now. Now I have uncertainty again. I feel as if I have been given notice, that’s all, but can’t know yet if I will be one of those who respond well to the next kind of chemotherapy. There is only around a 4% chance of full remission in any case.”

There is a tendency to endow people who are confronting death with a superior brand of wisdom. Some deliver on these expectations, providing memorable music, in the case of David Bowie, or poetic visions, like the playwright Dennis Potter. Hewlett, however, is not of a contemplative or morbid bent. He is an enthusiast and, in his own phrase, “a question-asker”. So he has straightforward advice to offer, like the tip, passed on to him by his BBC colleague Nick Robinson, that chemotherapy can make you prone to sunburn.

“Most of us will end up in my position at some point, although it is not quite the same when an older person dies,” Hewlett says. “Then there is something almost orderly, or even natural, about gradually sloughing off this mortal coil. This is different.”

An avowed rationalist, he has now had to reconsider his easy dismissal of the “touchy feely” rhetoric of care. He now “listens to his body”, he says, and admits that the aromatherapy sessions set up by the Royal Marsden have helped him to relax: “It has challenged my attitudes.”

This week he is scheduled to rejoin Mair on PM alongside his three sons, Fred, 29, Bill, 24, and Bert, 19. His openness has helped them, he thinks.

“Some ill people feel an instinct to protect their family and say nothing, and that is common among men, apparently, as well as among mothers. But I found talking helps because it gives them a reason why I am behaving in a particular way. It seems important to tell people who might feel they can only see the same grumpy bastard.”

Hewlett’s long streak of luck, he recounts, started when he was taken from a children’s home in Birmingham as a baby and handed to his adoptive parents, Larry and Vera. “I did luck out there,” he says fondly, before listing a further series of fortunate incidents that shaped his career, starting with the moment he was on hand when the BBC needed a local Manchester journalist to find the identity of two men involved with a crime.

The fates nearly turned against him in the mid-1980s when his student activism was detected by the BBC’s covert vetting system and his contract was terminated. In 1985, his evidence to Observer journalists David Leigh and Paul Lashmar helped reveal the processes by which MI5 once controlled the hiring and firing of BBC staff.

Offered a job on the BBC1 consumer show That’s Life, Hewlett instead took a production role with independent company Diverse, making his name with The Friday Alternative and Brass Tacks, before joining Channel 4, then Carlton, then returning to the BBC.

He has, he says, a “tenacious” grip on a story and remains determined to tell this one. All the same, he is unsure whether to track down his birth parents. There is, he points out, now a genetic interest in finding out what happened to them. He would like to give his sons the information.

“It is a hard one,” he says. “It might be worth it, or it might bring someone a brief agony after a lifetime of emotional pain.”

Maybe caution will win out here. Or possibly Hewlett’s instinct is too strong. “I now realise that is really what I am about. I am a storyteller.”

Steve Hewlett: ‘People say I’m brave about cancer, but I’m realistic. I’m a storyteller’

A letter to Steve, a helpline Samaritan

I have been which means to write to you for a prolonged time. In reality, for much more than twelve many years. Way back in September 2001 my son somehow managed to get you on a helpline in the Uk. Not effortless, as you know, due to the fact I dwell in Hong Kong. My son spoke to you about my out-of-manage alcoholism and drug addiction and asked if you could support. You said you would attempt.

When you phoned me later on that day I was in my workplace, stoned out of my mind with a heap of white powder and a bottle of booze on my desk. It was late in the evening and I was alone. Your call came out of the blue.

You might not have realised it (I anticipate you did, though) but I was significantly considering of ending it all. I just could not cease my self-destruction. I could not deal with my shame, my fears, my resentments against family and colleagues and I saw no way out. When you explained: “Peter, you don’t know me, but I have just spoken to your son. Are you Ok? How are you?” I had to cease myself from weeping.

In that moment (I didn’t know at the time why) I knew you were the 1st person I would spoken to who understood my pain and helplessness.

You then telling me that you were a recovering addict/alcoholic and had when gone through the identical horrors registered with me like nothing at all else had ahead of. I know today that, rather than supply me sympathy, you have been giving me empathy: a single of the most essential factors recovered addicts can provide every single other. With out it my recovery might have been extremely hard.

At the time, I was amazed that you had known as me from 6,000 miles away and that you did not reverse the costs that you did not request me to get in touch with you back on my very own dime.

Following listening to you, speaking to you, identifying with you in excess of people 50 or so minutes, I knew I had to do something about my existence of addiction. I knew I had to quit the carnage the discomfort I was leading to my family members, my pals, myself. I also believed you when you stated it was attainable to end “employing” and drinking and remain stopped. But that I had to take action and have some faith and trust and courage for the first time for many years.

In quick you “reached out” and I received the message – if I took action (by way of a twelve-step fellowship) and had an sincere want to get “clean and sober”, my daily life would modify so positively that I would be totally surprised.

You have been correct. You did not exaggerate. As you mentioned, addiction is the only illness in the planet exactly where, when you are in recovery, you come to feel greater than you did just before you acquired the sickness.

Inside 10 days of our conversation, and with my son’s assist, I was in rehab. I have to admit I did not end using in the course of individuals ten days and I turned up at the remedy facility totally drunk. But because I checked into the clinic that day, I have not had a drink or a drug and my life has modified beyond my wildest dreams.

I believe in a increased power. I realized (as you informed me), that I was the difficulty, that the booze and the medication have been the signs and symptoms that abstinence was the answer but to obtain this my contemplating had to alter in a lot of techniques. So I did what I necessary to do. I worked tough. I received truthful. I started out to care.

Each and every year brought me a lot more stability and happiness and significantly less self-centred, obsessive behaviour. My need to use thoughts-altering substances has been removed. I’ve grown up. I have faced my demons. I have after far more a loved ones that loves me. In brief, I have a “daily life”.

I did phone the helpline variety on which my son had spoken to you on but you had been no longer there. I did not consider to track you down. Maybe I need to have, but I did not think which is what you necessarily wanted. You were “carrying the message” to me as you must have to a lot of other people. By this letter, I want you to know my gratitude to you for reaching out to me – a stranger – and, by undertaking so, affecting my existence so considerably for the much better.

I will be 13 years sober in a number of months. To you, and all individuals who have helped me on my journey, thank you sincerely.

Ideal wishes, Anonymous

A letter to Steve, a helpline Samaritan

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Steve Jobs Rejected The Initial Health care App In 1977

There’s been a good deal of speculation that long term Apple Apple merchandise will consist of wellness-associated apps and biometric sensors. Here’s the story of what might have been the initial Apple health care app, except for the truth that in 1977 Steve Jobs had absolutely no interest in going in that route.

George Diamond is now retired right after a lengthy and extremely distinguished career as a cardiologist at Cedars-Sinai Health-related Center in Los Angeles. But in 1977 he was just commencing his job at Cedars, where he was functioning on cutting-edge devices and statistical techniques to enhance the diagnosis of heart disease (a major issue that even nowadays is far from becoming solved).

Diamond’s operate concerned one particular of the 1st attempts to use Bayes’ theorem– a sophisticated and complex instrument for analyzing probability– and it involved a lot of computation. In 1977 there weren’t a lot of selections. Here’s his (lightly edited) story:

“I purchased 1 of the really initial programmable hand calculators– the TI 59. It had magnetic cards that stored 1k of memory, and I was capable to compose a plan that utilised Bayes’ theorem to determine the probability of ailment based on the test outcomes. It worked wonderfully, except that  I instantly exhausted the 1k of memory due to the fact there was so a lot information.

“Just about that time the Apple II was introduced. There was a personal computer keep in Santa Monica– one of the extremely first laptop stores,  called ‘The Laptop Retailer.’ So I went there to see an Apple II in action. I fell in adore with it right away and purchased it with my personal income. (And by the way, you know what it value? 48 k of memory and two floppy disk drives and a 9″ monochrome check: I shelled out $ 2700.)

“With the Apple II I wrote a fairly sophisticated plan that analyzed a number of diagnostic tests using Bayes’ theorem for the diagnosis of coronary illness. Now I considered it was really fantastic and should be marketed, but it required to be expanded with people who actually knew some thing far more about programming than I did. So I picked up the phone and referred to as Apple in Cupertino. I informed the secretary that I desired to communicate with someone about a health care application for the Apple II computer. The secretary linked me directly to Steve Jobs. (Of program I did not know who he was. I didn’t even understand the title as currently being one of the individuals who had actually invented the issue.)

“He listened to me for a couple of minutes on the phone. I said I’d love to come up and speak with him about my notion. He explained certain, any time, just choose a date. and so I did, and I got on a flight to Cupertino. When I got to his workplace he looked exactly like he constantly looked in the future– he was sporting jeans, a black t-shirt, and sandals. His desk was definitely cluttered with all varieties of things on it, which includes, of course, an Apple II.

“I described to him what I had been doing, and how impressed I was with his gadget. Other men and women imagined it was a toy but I noticed anything significant in it and imagined that sooner or later a pc like this should be on the desk of every medical doctor in the globe. I informed him that I imagined my system could be a implies towards that finish, and I would adore to get his thoughts about it, and if he would he be ready to do anything to assist us advance that thought.

“He stated he was extremely impressed with what I had accomplished, and that he agreed about the potential for the long term, but ‘frankly I’m not interested in operating with you on this.’ I asked why. He explained: ‘You have to realize. This is some thing that nobody in the planet nevertheless understands. I cannot be distracted. I’m trying to make the very best hammer I can make, the ideal hammer in the world. You can use my hammer to tear one thing down, or you can use it to construct anything up. I genuinely really do not care what you do with my hammer. I just want to make the very best feasible hammer. And what you are undertaking is a superb bit of development, but to me it is a distraction.’

“So that was pretty much the finish of our conversation. There was no exactly where else to go after that so I thanked him extremely much for his time and flew back to LA.”

Steve Jobs Rejected The Initial Health care App In 1977

On one issue about the NHS, Jeremy Hunt is proper | Steve Richards

‘Jeremy Hunt’s interventions had been wholly understandable and deserve support. If there is an A&ampE calamity this winter it is his neck on the line.’ Photograph: Neil Hall/PA

Picture the nerve-shredding shock for hospital bosses who failed to meet their targets for accident-and-emergency provision. One day in the direction of the end of final year their phones rang and it was the overall health secretary, Jeremy Hunt, asking them what had gone wrong. There is typically a mountain of mediating bodies separating hospital bosses from Hunt, but there he was on the telephone telling them diplomatically to raise their game. This act of hyper-active diplomacy marks the biggest U-turn of the coalition and explains the noisy eruption of NHS-related stories at the start of the new 12 months.

For decades governments have sought with a naive evangelism to move away from Aneurin Bevan’s principle that if a bedpan dropped in a hospital corridor the reverberations must echo in Whitehall. The Conservative wing of the coalition had meant to make a revolutionary leap away from the principle. Prior to the final election I attended meetings in which the then shadow cabinet and external professionals discussed how to devolve energy as far away as possible from Whitehall to personal customers of solutions. In fairness to Andrew Lansley, then the shadow health secretary, he was fairly open about his objectives. When some thing went wrong in an person hospital or a local location he must not be appearing on the Today programme due to the fact responsibility would lie elsewhere. Other frontbenchers were equally clear. They had been going to move the levers away from Whitehall. When a bedpan dropped it would not be a matter for them.

If at these genuinely exploratory and thoughtful meetings they had been advised that a Tory overall health secretary would be phoning personal hospital bosses from Whitehall they would have all necessary urgent medical consideration.

Hunt’s cellphone calls frame one of many clashes between the well being secretary and those who think they must be operating the NHS. Shortly ahead of Christmas, Sir Malcolm Grant, the chair of NHS England also complained that Hunt was striving to micro-control. Grant advised the Observer that politicians ought to end meddling in the NHS at a time when clinicians had been supposed to be in charge. From his division in Whitehall, Hunt was taking a keen curiosity, also keen according to the mighty quango, NHS England. In both circumstances Hunt’s interventions have been wholly understandable and deserve support. If there is an A&ampE calamity this winter it is his neck, along with David Cameron’s, that is on the line, much a lot more than those of the hospital bosses or the largely anonymous figures at NHS England.

If a huge services is presented cost-free at the stage of use, paid for completely by taxpayers’ income raised centrally with the degree of investing also determined centrally, there is no way close to it. The elected overall health secretary has at least a degree of accountability and a substantial degree of accountability when a bedpan rattles.

But, despite the fact that Hunt’s assiduous focus is reassuring, it heightens the level of chaotic confusion as to who is responsible for what in the NHS. The government can’t simultaneously create a framework in which it seeks no longer to be immediately responsible for provision, dismiss the so-referred to as “target culture” and then commence phoning individual hospitals demanding that they meet targets.

The messy ambiguity is at the heart of each debate on the NHS. This week the Guardian published a letter from ten NHS organisations asking for significantly less focus on the adverse aspects of the NHS, implying that Hunt has used scandals this kind of as these at Mid Staffordshire to paint an unnecessarily bleak picture. Again this is not honest on Hunt who had each and every lead to to react lengthily and extensively to scandals that raised wider issues. But the bewilderment from the army of NHS organisations is understandable in the sense that they have been informed repeatedly they would be allowed to get on with running the wellness service with out interference from ministers.

The exact same confusion applies a lot more overtly in an interview provided this week by Dr Clifford Mann, president of the School of Emergency Medication, complaining that ministers had ignored warnings about an A&ampE crisis as they were “tied in knots” implementing their original contradictoryNHS changes. Mann captures the inevitable chaos of the early attempts by coalition ministers to devolve power and now their desperate attempts to assert control.

In this column I refer to Hunt, NHS England, the Care High quality Commission and ten separate NHS organisations. I have hardly scratched the surface. There are as well many institutions accountable for the NHS, with no one particular realizing very who is accountable for what. But at least we have some clarity. Ultimately and rightly the elected health secretary is accountable. Hunt’s mobile phone calls symbolise the finish of the fantasy, begun by New Labour, that taxpayers ought to fund the NHS and then have no mechanism to hold the government to account for the subsequent delivery of healthcare.

On one issue about the NHS, Jeremy Hunt is proper | Steve Richards