Jacqui Smith looked pretty pleased with herself as she addressed her guests at the Home Office new year drinks reception for journalists.

These events are traditionally jinxed, with some crisis or other breaking out just beforehand – police records being mislaid, foreign criminals not being deported – to put ministers on the defensive over the warm white wine.

This time around, as the home secretary pointed out, there had been no such mishap. And indeed, Smith is proving successful in the task she was picked for: moving the Home Office down the political agenda.

If crime, terrorism and asylum dominate the headlines less than they did when John Reid was in charge, then that is a good thing for Labour.

Yet hours after Smith spoke, three immigration officers were entering a Cardiff hospital to seize and send home Ama Sumani, a 39-year-old Ghanaian woman who needs dialysis three times a week to stay alive. The Home Office was once more in a dilemma of its own making.

Doctors and bishops have condemned Mrs Sumani’s removal and likened it to a death sentence. However, the officials who took the decision – it was not cleared by ministers – are in a difficult position. They are charged with upholding immigration law, and Mrs Sumani was clearly a visa overstayer and serial rule-breaker.

Moreover, so-called health tourism is an expensive problem for the NHS. Millions of people in the developing world are dying of diseases we could treat in British hospitals. The effective way to help them is through aid to overseas healthcare systems, not to offer free NHS care to a handful of individuals who find their way here.
Yet for all those rational arguments, the prospect of sending a woman to her death is a terrible one. The issue has divided the public.

What undermines the Home Office case is not simply that it was too tough with Mrs Sumani, but that at the same time it is too lax in other cases.

A BBC Radio 5 Live investigation, broadcast a few days after Mrs Sumani’s removal, revealed that when police arrest crime suspects who they believe to be illegal immigrants, they are routinely advised by Home Office immigration officials to release them from custody and back onto the streets with instructions to make their own way to an immigration centre. The cases uncovered by the BBC involved Chinese sellers of pirate DVDs, who carried on their trade once they had been freed.

If the public had confidence that foreign lawbreakers would be detained and removed from the UK, then attitudes towards the wider issues of immigration and asylum would soften dramatically.

Jack Straw asserts that his new Justice Ministry contains ‘slightly over half’ of the old Home Office, following its merger last year with what was once the Constitutional Affairs Department.

This is arguable. Of the three main business areas of the old Home Office, Smith has held on to two: immigration and asylum, and crime and policing. Straw has only taken one: prisons and probation.

In terms of personnel, there are more police officers than prison officers. In terms of public profile, crime and immigration are surely hotter potatoes than prisons. And when the New Local Government Network recently identified the ‘gang of four’ senior ministers who chair the most cabinet committees and have responsibility for the most targets, they included Smith but not Straw.

As Gordon Brown’s campaign manager last summer, many expected Straw to land a bigger cabinet job – but he is doing a good job of talking up the one he has got.