11 June - NHS Non-Executive Directors webinar

14 June 2021

This week’s session opened in conversation with Stephen Smith, GGI special advisor, former chair and CEO of NHS trusts and Dean of Medicine in UK, Singapore and Australia.

Stephen said: “There are two fundamental questions for us in Britain. The first is, what is the nature of medical care in the United Kingdom? The second is, is the system which we have evolved able to deliver that?

“The first crucial point is that medicine and health is not a widget industry. It is not like any other business.

“One of the problems we’ve had in Britain is that we forget that it’s a professional service. We took waiting times, eight-minute GPs, 20 people in a clinic, how many operating lists, efficiency, bed occupancy. But when every single one of you, and every single one of your relatives, your partners, your children, your mothers, your fathers, interacts with the healthcare system, it’s not as we all know like buying a commodity. You expect a professional service. You do not expect the doctor or the nurse to come in and say, ‘you need your right leg amputated but we can’t do it, we can only amputate half of your leg because of some other extraneous reason’.

“You don’t work for a hospital, you don’t for a university, you work at a hospital, you work at a university. And as a doctor the only person you work for is the patient. That’s who your employer is and that’s the nature of the professional service. I think we need to have a major national debate about how we recreate a professional service.”

Also overheard during today’s webinar:

“We have a merry-go-round of political figures which doesn’t help. To be an innovator you must be curious – to want to explore. Doctors are inherently risk-takers. But the NHS has not condoned a risk-taking culture, or condoned failure. We have two hats: one very risk averse, zero tolerance of failure, the other promoting innovation. There’s a conflict between the top and the bottom which creates a tension. [Whether change is achievable] depends on the political figures we have. If they try to smooth things over, we won’t. Organisations that took up digital platforms faster recovered faster.”

“NEDs also have to exercise judgement. You can have all the data you want; you still have to decide and be accountable. A surgeon doesn’t know what they’ll see until they open somebody up - they have to decide.”

“Other health systems have better outcomes and better ways of doing it. We have huge pride in our NHS but in other countries they are proud too. A tax-based health service. But maybe that protectiveness isn’t allowing us to have the critical thinking needed to move these things forward.”

These meetings are by invitation and are open to all NHS non-executives directors, chairs and associate non-executive directors of NHS providers. Others may attend by special invitation. For further details, visit our events page.

If you have any comments, questions or suggestions about these webinars, please contact: events@good-governance.org.uk