Retired neurosurgeon Ben Carson was confirmed Thursday as secretary of the U.S. Department of Housing and Urban Development, bringing into President Trump’s Cabinet a Washington outsider with no prior government experience and a staunchly conservative view of public assistance.

Support for Carson’s confirmation came down largely along party lines — 58-41 — highlighting the intense partisan and ideological conflicts in Washington and around Trump’s agenda. Carson, an acclaimed neurosurgeon, ran for the Republican presidential nomination in 2016 against Trump and endorsed the celebrity real estate developer shortly after ending his unsuccessful bid. The secretary has indicated that, now that he is confirmed, he will embark on a “listening tour” to learn from career HUD employees and public servants across the country. He and his allies have expressed dismay at his delayed confirmation, which was initially expected to pass through the Senate in early February.

[Carson pushes increased private-sector role in HUD programs]

Critics on the left have openly questioned whether Carson has the necessary qualifications for the job managing one of the federal government’s most complex departments. In addition to steering housing policy, Carson will oversee an expansive set of programs that provide assistance to low-income Americans and minorities seeking entry to the middle class. HUD’s annual budget for 2017 is nearly $49 billion, which is used for various government supports, including rental assistance, programs to mitigate homelessness and investments to combat urban poverty. HUD supports nearly 5 million homes with rental assistance.

“Those concerns stem from his own statements. He said, basically, that he’s not qualified for HUD or for government service. So most people I hear ask, ‘How did they convince him to take the job?’ ” Marc Morial, president of the National Urban League, said in an interview last month.

Urban policy experts and progressive activists have expressed intense concern that Carson, in keeping with his strong conservative positions, will seek to cut money for government assistance programs and wear down the social safety net. The Trump administration has recently signaled that many government agencies can expect budget reductions in favor of increasing defense spending. Carson would be the face of any such cuts at HUD, which is not viewed favorably by conservatives and could be a prime target for reductions.

[Trump to propose 10 percent spike in defense spending, major cuts to other agencies]

In his pitch for the job, Carson pointed to his personal experience rising from a disadvantaged background to the top of the medical profession. Before running for the Republican nomination last year, Carson was a well-known name among African Americans around the country, a role model for young men and women of color to whom the neurosurgeon often spoke directly about the importance of education.

During his confirmation hearing in January, Carson strongly advocated for a “holistic” approach to public assistance and bemoaned government programs that he said encourage dependence.

“What has happened too often is that people who seemingly mean well have promoted things that do not encourage development of any innate talent in people,” Carson said. “Hence we have generation after generation living in dependent situations. It’s not that they’re bad people, it’s that this is what they’ve been given, and it’s all they know in some cases.”

[HUD job to pit Carson ideology against long-standing housing policy]

Leading progressive voices in the Senate signaled their cautious support for Carson in the weeks leading to the Senate vote — to the disappointment of many liberal activists around the country who had hoped to see more opposition.

Sen. Elizabeth Warren (D-Mass.), one of the most prominent liberal voices in the country, defended her decision to support Carson’s nomination in committee in a lengthy statement to her supporters published to Facebook. But on Thursday she voted against confirming Carson to the post.

“Dr. Carson’s answers weren’t perfect. But at his hearing, he committed to track and report on conflicts of interest at the agency,” Warren wrote. “If President Trump goes to his second choice, I don’t think we will get another HUD nominee who will even make these promises — much less follow through on them.”

“If Dr. Carson doesn’t follow through on his commitments,” she added, “I will be the very first person he hears from — loudly and clearly and frequently.”

Sen. Sherrod Brown (Ohio), the ranking Democratic member on the committee that oversaw Carson’s nomination hearing, fired off a preemptive defense in January after voting to move Carson’s nomination to the full Senate. Brown voted in favor of Carson’s confirmation on Thursday.

“Despite my reservations, and my disagreements with some of his positions, I will give Dr. Carson the benefit of the doubt based on commitments he has made to me in person and to this Committee in his testimony and written responses,” Brown said in a statement.

Housing experts have sought to parse Carson’s past comments on government assistance and housing discrimination policy for insight into how he would direct HUD, at times finding little additional clarity. Carson had not spoken extensively about housing policy ahead of his confirmation hearing before the Senate Committee on Banking, Housing and Urban Affairs.

During that hearing, Carson said that he would continue to aggressively enforce the Fair Housing Act, a key piece of civil rights legislation passed in 1968 that seeks to protect vulnerable communities from housing discrimination: “I think the Fair House Amendment in 1968 was one of the best pieces of legislation that we’ve had. It was modified in 1988. LBJ said nobody could possibly question this; I agree with him,” he said.

But Carson has remained unclear about the extent to which he supports a provision in the law known as “affirmatively furthering fair housing,” a 2015 federal rule that empowered HUD to leverage federal grants to encourage neighborhood integration. Conservatives have accused HUD of overstepping its authority with the rule and using it to coerce local communities. Carson at one point called the rule “social engineering.”

“I will be working with the local HUD officials and the communities to make sure that fairness is carried out,” Carson said during the hearing.

Carson was similarly vague when asked how he would direct HUD to protect the rights of lesbian, gay, bisexual and transgender Americans. When asked directly if he would protect them from housing discrimination, Carson said he “absolutely” would. But activists voiced concerns when Carson, in another instance the same day, said that LGBT people do not deserve “extra rights” relative to the rest of the population, suggesting that he believes anti-discrimination provisions are unnecessary.

“Of course I would enforce all the laws of the land, and I believe that all Americans, regardless of any of the things you mentioned, should be protected by the law,” Carson said at the time. “What I have mentioned in the past is that no one gets extra rights. Extra rights means you get to redefine everything for everybody else.”

Gay rights groups disagree. LGBT Americans are disproportionately vulnerable to housing discrimination, but sexual orientation is not a protected category under federal housing discrimination laws. HUD does, however, include protections for LGBT people under the 2012 Equal Access Rule, which applies to housing providers who receive HUD funding.

Carson has been clear in his criticism of government programs he says are ineffective and create dependence.

“The programs that have been enacted in HUD over the years, you know they’re good programs, but in and of themselves they’re not bringing about the elevation of large numbers of people,” he said at his hearing. “And that’s what we’re really looking for. We don’t’ want it to be a way of life. We want it to be a Band-Aid and a springboard to move forward.”

Carson has also advocated strongly in recent weeks for expanding partnerships between HUD, the private sector, and faith-based charity groups. Carson said during his hearing that the private sector has “a lot of very talented people” and pointed to the federal Low-Income Housing Tax Credit Program as an important model for this type of work.

“There’s a lot of money in the private sector. There’s a lot of good will in the private sector,” he said. “I want to work on those programs and I want to study those programs that are working so we can multiply them across the country.”