Oliver consultant in geriatrics and acute general medicine Politicians and their parties obviously embrace ideology, but problems as serious as preventable disease and health inequalities require proper solutions based on expertise and evidence, not on political biases. On 8 March the secretary of state for health and social care, Sajid Javid, set out his vision for NHS reform. 1 His three stated priorities were prevention, personalisation, and performance. In the same speech, however, he

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... that "public health and economic freedom are mutually reinforcing," called for "freedom from an overbearing state," and used the government's term "health disparities" to describe what the public health community has long called "health inequalities." 2 Despite his reincarnation as a champion of the NHS, Javid is on record as a devotee of the ultra-libertarian Ayn Rand. 3 Only last year, with the pandemic still raging, he voiced opposition to health protection measures by saying that the people should not be "cowering before covid" 4 -a phrase drawing on Rand's writing.