Extended web version: ‘We need to be ready for two years of recession’

Opposite Alan Johnson’s desk is a plaque from the Chinese health ministry — a gift that must, at times, seem like a taunt. The Health Secretary controls 1.3 million staff, more than anyone bar the commander of the Red Army. His £120 billion budget is greater than any government department in Beijing. The Chinese economy and the NHS were both subjected to limited market-based reform — yet there the similarities end. Deng Xiaoping succeeded. Tony Blair was ousted. And now Mr Johnson stands in charge of the largest bureaucracy on the
planet.

We have heard strikingly little about health since he took over, which he regards as a success. The Blairite health reform agenda had led to the most bitter feuding in government — at one stage, a Gordon Brown doll was dangling from a noose at one desk in the health department. His predecessor, Patricia Hewitt, latterly needed bodyguards when she went to speak to nurses.