The Victoria Atkins interview: 'The NHS belongs to us all, not just the junior doctors committee'
Victoria Atkins in the House of Commons Library (photography: David Bebber)
12 min read
Born into a political family, Victoria Atkins was seemingly destined to end up in government. But, as the Health Secretary tells Tali Fraser, her journey has not been straightforward – and nor are the issues she’s attempting to tackle. Photography by David Bebber
Victoria Atkins was in the Treasury watching the reshuffle, shocked by “that amazing moment” David Cameron emerged from his Range Rover onto Downing Street, when she got the call asking her to come in – and take up her first secretary of state role in Health and Social Care.
“The NHS is genuinely one of the reasons I came to politics, so to be offered the chance to help shape the NHS, reform the NHS to make it faster, simpler and fairer, I just thought I was very, very lucky.”
Appointed in November and with an election expected in the second half of this year, Atkins, 48, doesn’t exactly have much time to set about reforming the National Health Service – and yet she speaks of ensuring the NHS is “prepared and shaped for the next 75 years of its history”.
Is that really possible under a short tenure? “I’ve been in office now for three months – well, just look at what we have done in those three months,” Atkins says, rattling off a long list of health strategies.
“Sorry, there is so much going on, I sound like that David Cameron video,” she jokes, referring to a viral video in which he runs through everything he’s done in his first 100 days as Foreign Secretary.
The daughter of Sir Robert Atkins, a former Conservative MP and minister, and Dulcie Atkins, a Tory councillor and mayor, Atkins’ childhood was steeped in politics. She has known former prime minister John Major since she was in nappies. She remembers as a teenager arguing with her father during his time as a transport minister about the environmental impact of some of his plans.
“Not arguing but enjoying a robust debate,” Atkins corrects. “It was a very famous stretch of land that was protected, and I felt very strongly about that.”
“I could see from my parents the good that politics can do,” she says, but she did not set out to go into politics. “I either wanted to become a criminal barrister or a fashion designer.”
Despite her keen interest in clothing – she especially likes Samantha Cameron’s brand Cefinn, and her special adviser wanted to know if we needed an outfit change for our photoshoot – she decided she lacked the creativity for the fashion world, instead pursuing the legal route.
In the wake of the expenses scandal, at a time when she was considering applying for silk, then-Conservative Party leader David Cameron reopened the candidates list, asking for people “who believe in public service”. Encouraged by her husband, Paul Kenward, now managing director of British Sugar, Atkins decided to put herself forward. “It was my husband who said, ‘Will you please stop shouting at the television every time Gordon Brown comes on and put your name forward?’.”
It is clear that her family background has helped shape her political outlook. What does Conservatism mean to the Health Secretary?
She offers an imaginative answer for someone who claims a lack of creativity stopped her from pursuing a fashion career: “To me, Conservatism is about offering a ladder to the stars for those who can climb the ladder but also a safety net underneath to support those who cannot.”
As the Conservative Party continues to fracture into sets of different pressure groups, like the PopCons and the NatCons, usually trying to take the party further to the right, she insists that the more moderate wing – of which she is a member – will have “a very important role” to play in the coming years.
My worry is that young people will start to question their relationship with, not just the NHS, but also wider parts of the state
One of the party’s fissures is around immigration, with the right taking succour in a plan to ban overseas care workers from bringing family members to the UK.
“We do have to acknowledge that with the visa system as it was set up, frankly, it had a level of demand from around the world that far exceeded our expectations,” the Health Secretary admits, claiming that more dependents have been entering the country than “actual workers”.
Although she says the desire to come to the UK is no bad thing: “For those declinists out there, that is actually a sign of how great our country is viewed by other countries around the world.”
But will overseas care workers still want to come here if these visa changes are brought forward? Atkins maintains they will.
“I’m confident that those changes will still mean we have the movement of people who are genuinely going to contribute to our social care system, our health healthcare system, but we will do so in a way that is controlled.”
As the MP for Louth and Horncastle in Lincolnshire, Atkins is defending a majority of 28,868, making her one of the Conservatives who can afford to breathe a little more easily than others ahead of the general election. She brands herself “a proud One Nationer” but does not deny the rights of colleagues to be “much drier economically and socially than I am”.
While once the different inclinations of those within the Tory Party were able to happily coexist and jostle along in a good enough manner under the big tent, it has now broken out into its constituent parts.
The week we meet, Lee Anderson, elected as Conservative MP for Ashfield, has left the party to join Reform after the Tory whip was suspended for refusing to apologise over his comments accusing “Islamists” of having “got control” of London mayor Sadiq Khan. It was the same week that the Conservative Party’s biggest donor Frank Hester was revealed to have made racist comments about Diane Abbott, allegedly saying that seeing the Labour MP on TV “made you want to hate all Black women” and that she “should be shot”.
Atkins doesn’t go as far as to say she was sad to see Anderson – “who I’ve always got on personally with” – go, but does brand it “a shame”. “It is his decision to go. I hope he doesn’t regret it, because my worry is with that political party that, in fact, they will achieve the very opposite of what Conservatives want. A vote for Reform will be a vote for Labour but I wish him well.”
On Hester, she says that his comments “don’t represent my politics”, but did not at the time condemn them as racist.
Hester’s company the Phoenix Partnership has made more than £400m in contracts from the NHS and other government bodies since 2016. Would she back the NHS if they decided to cut ties with him? “It’s for NHS England to make operational decisions. It would not be wise for me to comment further.”
Atkins tends to avoid direct answers to difficult questions. Even on matters of individual conscience, the Health Secretary refuses to be pulled into discussion, preferring instead to “tread a careful path” on whether she would support the decriminalisation of abortion or the legalisation of assisted dying; in both cases saying she would not wish to pre-empt a parliamentary vote.
However, Atkins is happy to talk about her wider vision for the NHS and wants to encourage “a national conversation about what we see as its future”.
Conservatism is about offering a ladder to the stars
She flags that in the years since the pandemic any prior productivity gains “have collapsed”.
“We have record amounts of investment in the NHS. We have more doctors in the NHS, we have more nurses in the NHS than ever before… and yet we know that productivity is not reflecting that extra investment and those extra people. That’s the Gordian knot, if you like, that we have to untie.”
The three key words that Atkins says sum up her vision for the NHS are “faster, simpler, fairer”.
“I look at it actually from a young person’s perspective. We talk, rightly, about the older person’s experiences with the NHS, we talk about living longer, we talk about living healthier lives, but actually I think we also need to look at this from a young person’s perspective because they are paying for the NHS today and they will be users of it in decades to come.”
Atkins would like to see young people “as perfectly at home as digital natives with Siri and Alexa and having their lives online as being able to use an [NHS] app to access services”. She fears that if the health service fails to keep up, it will be the root of a wider generational breaking with the state.
“The NHS cannot afford to lag behind with this because, if they do, my worry is that young people will start to question their relationship with, not just the NHS, but also wider parts of the state.”
When Rishi Sunak announced at the last Conservative Party Conference in Manchester phasing out the sale of cigarettes in England, meaning today’s 14-year-olds would never be able to purchase a cigarette, Atkins – Financial Secretary to the Treasury at the time – was in the conference hall thinking about her son, Monty, whose age means he fits within the policy.
“When I was listening to it, my reaction was not as a minister and a Member of Parliament; it was as a mum. I thought, ‘good on the Prime Minister’, because we modern day parents have a whole host of things to worry about, my goodness, [and] smoking will be one of those worries.”
The Health Secretary – who has never smoked – has faced critics of the forthcoming bill, including those from her own party, who branded the intervention ‘nanny state’. Is she comfortable with that phrase if it means the policy passes through Parliament?
“I do not accept that description,” Atkins hits back. “Having thought about this deeply, I am confident that, for example, the argument that it is somehow unconservative – there is nothing freeing about an addiction to nicotine.”
She emphasises that the Conservative Party has marked it a free vote, “so we will be able to debate these matters”, but to her there should be a “realistic” focus on “the only consumer product which, if you use them as the manufacturer recommends, will kill you”.
The second arm of the government’s plans is to ban the sale of disposable vapes, with a restriction on vape flavours, a requirement for plain packaging and changes to how they are displayed to make them less attractive to children.
Luckily for Atkins, even without legislation, it doesn’t sound like her son Monty will be taking up vaping anytime soon. “He is vehemently against vaping!” she exclaims, adding: “Obviously his teachers have done a very good job teaching him that vaping is not a good thing”.
There is nothing freeing about an addiction to nicotine
When the pair have seen adverts for vapes, Atkins says they have noticed they are “designed to attract young people” with their flavours and colours: “They’ve got flavours like gummy bears, watermelon fizz, and then they’re in rainbow colours, and pink and blue. I think that is a very, very cynical marketing exercise. It shows what we’re up against. There is a battle here to be fought.”
If Atkins is so comfortable with legislating against smoking and vaping for children, why is she not prepared to go to similar levels to tackle obesity? It costs the economy £100bn every year and sees almost a quarter of English children suffering from obesity by the end of primary school. Why not also ban junk food adverts targeted towards children?
“Of course obesity is an enormous issue for our society but what I want to do is address it as part of an overall prevention strategy,” Atkins says, flagging the upcoming major conditions plan “because we want to ensure that we are not siloing these issues”.
But surely obesity, as a cause of other health issues – which Atkins readily recognises – should be dealt with at the root?
She replies: “We should, as the chief medical officer Chris Whitty puts it, be treating the person, not the conditions. That is part of my vision for the NHS.”
There are no plans, then, to do something like ban cartoons on food packaging such as Tony the Tiger on Frosties breakfast cereal?
“It would take some persuading for me to go down that route,” Atkins says. “Cigarettes sit in their own category because they are so very dangerous to us”.
“My experiences as a patient about this sort of finger-wagging attitude, whereby my opposite number, one day on breakfast media, called our children short and fat, is that doesn’t help me as a parent ensure that my child has a healthy diet. We need to be much more compassionate and understanding in how we talk about these things so that we’re working with people, not against them.”
Atkins found herself being accused of a finger-wagging attitude in her dealings with junior doctors, or “doctors in training” as she referred to them in December, but Atkins was taken aback by criticisms of her phraseology.
“I must confess I was surprised,” she says, citing the British Medical Association motion to stop referring to the group as junior doctors. “All I was trying to do was honour and reflect their wishes… but perhaps it shows that – well, it shows a range of opinions, if I can put it that way.”
Junior doctors are locked in an ongoing pay row with the government, leading to continuing strikes – 10 stoppages since this time last year.
The co-chairs of the BMA junior doctors committee say strikes could have been stopped by “a credible pay offer” from the government, but Atkins says the committee has overstepped.
“The NHS belongs to us all, it does not just belong to the junior doctors committee… Junior doctors should understand that the decisions of their committee have stopped them from receiving an additional pay increase on top of the up to 10.3 per cent pay increase they have already received this year,” the Health Secretary says.
“That, of course, will then have a knock on impact when looking at the pay review process for next year. It is for the junior doctors committee to explain to me what their reasonable expectations are. I want to do a deal.”
PoliticsHome Newsletters
Get the inside track on what MPs and Peers are talking about. Sign up to The House's morning email for the latest insight and reaction from Parliamentarians, policy-makers and organisations.
