So Andrew Lansley has gone from health to be leader of the house. He always said that he would never do any other job in government but it appears he was persuaded otherwise.

It is reasonable to assume, though, that he is absolutely gutted. He always seemed to be a man who lived and breathed the health portfolio for nine years (seven as shadow and two in government).

Of course, he is also the man who has presided over – and devised – the controversial shake-up of the NHS, the biggest since the health service was formed. His critics would also say he is the man who devised the destruction and privatisation of the health service.

But for the moment, it is fair to say that is not why he has been shuffled. His major fault has always been his inability to say 10 words when he could think of another 90 to add on.

He is a man who loves detail and could be positively nerdy about the finer, and quite frankly, unsexy machinations of health service management. Like another Conservative Health Secretary, Virginia Bottomley, he had statistics and graphs ever ready at his finger tips. Yet he could never simply explain what it was he was doing with this beloved institution.

The joke (though not to some in the health department) was that when a Department of Health official went to Downing Street to say that winter planning was being delayed because of the shake-up, the aide to the prime minister told this official not worry. His words, indeed, were along the lines of “oh, don’t worry about these reforms. That is Andrew just being Andrew.”

This, of course, revealed that Downing Street had no idea whatsoever what Mr Lansley had in store for the NHS and by the time they had worked out that it was mammoth it was too late.  Even the so-called “pause” was never going to be able to undo what had been set in motion.

Now the new Health Secretary Jeremy Hunt will have a hard task ahead of him trying to work his way through enormously complex changes, some of which have already been put in place and others of which are imminent.

He will also be in charge of a health service which is facing increasingly hard times. The combination of the reforms and the demand for £20bn of savings, as well as a cut in the overall budget, means there is no room for manoeuvre. Times are hard for the NHS and the perceived wisdom is that they are only going to get harder.

But for all that, it is a likely bet that Mr Lansley will find it heartbreaking not to be there in Richmond House as all his changes are instituted.

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