Smith entered the Government in July 1999, as a Parliamentary Under-Secretary of State at the Department for Education and Employment, working with the Minister for School Standards Estelle Morris. She then became a Minister of State at the Department of Health following the 2001 general election. She was appointed as the Government's deputy Minister for Women in 2003, working alongside Secretary of State Patricia Hewitt. In this role she published the Government's proposals for Civil Partnerships, a system designed to offer same-sex couples an opportunity to gain legal recognition for their relationship with an associated set of rights and responsibilities.