After a turbulent few days at Westminster – sparked by some highly incriminating CCTV footage of Matt Hancock- we have begun the week with a brand new health secretary. 

The name is a familiar one. Sajid Javid is an old hand in a new job, having already worked for three different prime ministers, serving in high profile roles as business secretary, culture secretary and Chancellor. 

But as Javid returns to centre stage, many in Westminster and beyond are wondering what impact he will have on the balance of power in Johnson’s cabinet – and crucially, how his attitude on lockdown restrictions might differ from Hancock’s.

On Sunday, Javid insisted that it was his “most immediate priority to see that we can return to normal as soon and as quickly as possible”. 

His first task will be to address the Commons on Monday, and he is expected to confirm 19 July as the final reopening date. With Tory backbenchers hoping restrictions would be lifted sooner, on 5 July, this first announcement provides no evidence that Javid can be trusted to adopt a firmer approach to ending lockdown restrictions. But this difference will emerge in time. 

In May 2020, Javid said that he would favour “running the economy hot.” Most in Westminster are expecting Javid to show a greater concern for the economic damage of lockdown – and hence, adopt a more hawkish approach than his predecessor when it comes to Covid restrictions.

This switch-up may not have made a difference to this next round of unlocking, but it could have a big impact further down the line. Come winter, pleas from health officials to re-introduce lockdown measures may well emerge, and Javid is likely to be firmer than Hancock would have been in resisting such pressures. 

Lockdown aside, Javid will have some highly consequential decisions to make in the coming weeks and months about NHS funding. 

One looming challenge for him is the enormous backlog crisis created by the pandemic. Over five million patients are currently sat on waiting lists, excluding the 20 million who were not seen in outpatient clinics last year.

While Boris Johnson has also vowed to resolve social care funding by the end of the year, Rishi Sunak, the Chancellor, is struggling to find £10 billion a year to implement a cap on social care costs. 

Jeremy Hunt, a former health secretary, has warned that the PM breaking his pledge to fix social care would be equivalent to the Liberal Democrats’ disastrous broken promise to not hike up tuition fees. 

All this raises big questions about securing resources, and it will pile pressure on the new health secretary ahead of the autumn spending review.

Javid has made his name as a Thatcherite, small-state conservative. But sticking to those principles will be a challenge given the wads of extra money he’ll need to drum up in order to deal with waiting lists and social care. 

Javid will also need to decide what line to take on Hancock’s planned health reforms – policies aimed at “supporting recovery from the pandemic” – which have been described as the biggest shake-up of health law in a decade. Proposals for the Health and Social Care Bill would see the health secretary’s authority over the health service increase. The bill would make NHS England more accountable to ministers and it would grant Javid the powers to block changes to the configuration of local hospitals. 

But Hancock has departed before he was able to see the Bill come to fruition, and Sir Simon Stevens – the other man committed to the project – is stepping down as head of NHS England at the end of July. 

With both figures out of the picture, it’s unclear how far Javid will go to push these reforms. Number 10 has already expressed concern about overhauling the NHS when it is recovering from a pandemic, and the Bill is likely to be met with opposition in the House of Commons.

Another vital task for Javid will be deciding who replaces Sir Simon. Test and Trace boss Dido Harding has already raised eyebrows by throwing her hat in the ring. It’s highly unlikely that Harding will get the top job, as she may be seen as too close to Hancock’s regime. 

The favourite to replace Stevens is his deputy, Amanda Pritchard, who effectively runs the NHS on a day to day basis.