As Minister of Health, English was responsible for continuing the reforms to the public health system that National had begun after the 1990 general election. The reforms were unpopular, and health was perceived as one of the government's weaknesses, with the health portfolio consequently being viewed as a challenge. English believed that the unpopularity of the reforms was in part due to a failure in messaging, and encouraged his National colleagues to avoid bureaucratic and money-focused language (such as references to "balance sheets" and "user charges") and instead talk about the improvements to services the government's reforms would bring. He also rejected the idea that public hospitals could be run as commercial enterprises, a view which some of his colleagues had previously promoted.