Thatcher creates key Cabinet job for health

Prime Minister Margaret Thatcher has given the task of reforming Britain's ailing National Health Service to one of her ablest younger ministers. The elevation of Industry Minister Kenneth Clarke to the new post of Secretary of State for Health involves splitting the Department of Health and Social Security (DHSS), the government's biggest-spending department. The division effectively demotes John Moore, until recently tipped as a possible successor to Mrs. Thatcher.

As Secretary of State for Social Services, Mr. Moore headed a combined DHSS. He has faced criticism recently in this post, and now, because of a surprise Cabinet shuffle, he has lost half of his department, leaving Mr. Clarke in charge of health.

The National Health Service (NHS), which is supposed to provide state-paid medicine to all citizens, is a hot political potato. Under Mrs. Thatcher, the government's opponents claim, health services have been cut back so that there is an acute shortage of hospital beds, nurses, and specialist services. It will be Clarke's task to carry through a review of the NHS, begun by Moore nine months ago, and to answer Labour opposition charges that the prime minister does not care about the NHS.

Key items likely to be contained in the review, which will be published this fall, are likely to be:

Much tighter management of local health authorities and more extensive use of privatized services in the medical field;

Tax incentives to people wishing to take out private health insurance, thus easing pressure on the NHS;

A tougher financial approach toward medical specialists who provide services within the NHS.

Interestingly, however, Clarke comes from the liberal wing of the Conservative Party and is not open to the charge, which Moore has had to suffer, that he is more Thatcherite than Thatcher herself. Clarke was a junior minister in the old DHSS some years ago, and is remembered as an energetic, forthright administrator lukewarm on the idea of privatization for its own sake.

His new appointment will make it harder for the Labour opposition to claim that the Thatcher government would like to dismantle state-paid medicine altogether.

Moore's demotion was one of many ministerial job changes, most of them non-Cabinet posts.