In January 1923 Elliot was appointed Parliamentary Under-Secretary for Health for Scotland in the government of Stanley Baldwin. He briefly lost the post during the Labour Party's 1924 first MacDonald ministry, but regained it after Baldwin's return to power that same year. In July 1926 Elliot was made to Parliamentary Under-Secretary of State for Scotland, a role he filled until 1929. He made an official visit to Colonial Nigeria in 1927. He was involved in the passage of the Local Government Act 1929, as well as reforms to administration in Scotland in 1928 and changes to Scottish ministers' positions in 1926.