Jeremy Hunt remains Health Secretary but faces further tests

It was one of the last big Cabinet jobs to be announced but the Prime Minister has chosen to stick with Jeremy Hunt as Health Secretary.

After more than two and a half years in post, there is no doubt Hunt wanted to stay - he told me earlier this year its a job he loves.

Despite a three-day wait to hear if he'd got it, the Health Secretary might have been forgiven some optimism.

Throughout the election, the NHS regularly topped the polls as the issue at the forefront of voters' minds. With an independent inquiry already promised into how the pollsters got the overall result so wrong, perhaps we shouldn't read too much into that.

But Labour have long been seen as the party most trusted with the NHS. So either the electorate were telling porkies about their priorities or Hunt did enough to neutralise the issue Labour allegedly tried to "weaponise".

Certainly, the Conservative pledge of £8 billion pounds for the NHS will have helped. But Jeremy Hunt knows better than anyone that its a promise begging as many questions as it answers.

Firstly, can that money be guaranteed and will it arrive in time? When Simon Stevens, the Chief Executive of the NHS, delivered the organisations Five Year Forward View, he said £8 billion was essential just to keep the service standing still.

But unlike the Lib Dems, who made the same pledge, the Conservatives didn't say where the cash would come from. They are effectively relying on economic growth being strong enough to provide the money by 2020. The problem is more funding is needed now. A report into NHS finances by the Commons' spending watchdog has already warned four out of five foundation trusts were reporting a deficit by last Autumn. That raises serious questions about how the service will find the £22 billion of efficiency savings already factored in to balance the books.

And remember, the £30 billion total of funding and efficiencies won't deliver anything extra - so what about the pledges made in the Tory manifesto?

The Conservatives have guaranteed same-day appointments for the over-75s and seven-day access to GP's by 2020. With a deepening crisis in GP recruitment and given the time it takes to train new doctors, immediate investment will be needed for there to be any chance of that. Then there is the more nebulous promise of integrating health and social care. But precious little has been said about that and how the care of the elderly and the vulnerable will be paid for.

Yet if a reminder was needed of why freeing up beds in our hospitals is so critical, note that just as David Cameron was walking back into Number 10 on Friday, patients in Cambridge were being asked not to darken the doors of their local A and E Department. Cambridge University Hospitals NHS Foundation Trust tweeted that with 67 people waiting in Accident and Emergency, patients who weren't in immediate danger would do better calling 111. Right across England, the proportion of patients being seen within four hours in A and E yet again failed to meet the 95% target, for the 31st week in a row.

With demand continuing to grow, its enough to raise anyone's blood pressure - not that you'd guess it from the Health Secretary's broad smile as he left Downing Street earlier.

The Chief Executive of the King's Fund, Chris Ham believes Hunt's reappointment will deliver much needed continuity to the health service.

But he told ITV News, "Mounting deficits, worsening performance and declining staff morale mean the NHS is facing its biggest challenges for many years. The Secretary of State will need to strike a balance between addressing unprecedented short term pressures and initiating the long term changes needed to place the NHS and social care on a sustainable footing. The stakes could not be higher".