HSJ50 2006 supplement - Health Service Journal

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EMPICS/PA, REX FEATURES, ED MAYNARDSIMON STEVENSPRESIDENT, UNITEDHEALTH EUROPE31Barely into his 30s whenappointed then healthsecretary Frank Dobson’sspecial adviser in theearly days of the Labour government,Simon Stevens had alreadyestablished himself as one of theleading NHS managers of hisgeneration. Although later specialadviser to Alan Milburn during thecreation of the NHS plan in 2000, itwas as health adviser to prime32At press conferences,ministers and seniorofficials watch warilywhen a slim, bearded andbespectacled journalist raises hishand. This is Nicholas Timmins,whose question will cut straight to theeffects of their announcement – orpinpoint its weakness. They knowwhen they’ve been ‘Timmins-ed’. Yethe remains highly regarded by hissubjects – a tricky balancing act.33The paper’s MiddleEngland coalition ofsmall-c conservatives,professional women andaspirational ethnic groups reflects thepersonality of Paul Dacre, editor since1992. He once said: ‘If there are twowords that sum up the Mail’sphilosophy, they’re “aspiration” and“self-reliance”.’Dacre is no celebrity editor, usually34Liz Kendall’s recentviews have depicted thestate as the enabler ofpeople, indicating adesire to go beyond the nanny state.Choice, patient involvement and roleredesign for staff are her key themes.As lead researcher on health andsocial care at the Institute for PublicPolicy Research, Kendall was adviserto Harriet Harman (then social35A tall, energetic figure,Professor Rawlins’mixture of rock-solidacademic achievement,political nous and wit have beencrucial to NICE’s successful infancy asthe NHS’s rationing body. He has therare treble of support from ministers,the Department of Health and thepharmaceutical industry.The NHS’s current financialminister Tony Blair from 2001-04 thathe cemented his reputation.During his years at Number 10 hewas the intellectual engine behindincreasing the role of the independentsector in a bid to drive innovation andefficiency through additional capacity.He has been a powerful advocate ofNHS independence from centralgovernment, recently arguing in hisHSJ column for a service run in asimilar way to the BBC.NICHOLAS TIMMINSPUBLIC POLICY EDITOR, FINANCIAL TIMESPAUL DACREEDITOR-IN-CHIEF, DAILY MAILOften breaking key news, MrTimmins’ inclusion on this list is notmerely a reflection of the importanceof the Financial Times in a healthsystem which today must befinancially aware to a degreeimpossible to imagine a decade ago.His journalism makes the FT a mustreadfor directors and chief executives.Public policy editor since 1996, MrTimmins was previously a foundermember of the team which createdavoiding the limelight. Yet his oldschool,shouty personal style sets thetone for the Mail’s mix of editorialmoralising, hard news, celebritycoverage, health and women’s issues,with its disapproval of illegalimmigration, single parents andworking mothers.NHS bad news stories are fertileterritory, as are health scares – MRSA,MMR and vCJD ‘apocalypse’LIZ KENDALLSPECIAL ADVISER TO THE HEALTH SECRETARYsecurity secretary, and unofficialminister for women).She then went to the King’s Fundas fellow in public health, where someof her initiatives (including asuggested programme on publichealth for the London mayor)surprised academic colleagues whofelt it was ‘dumbing down’.Critics regard Ms Kendall as ‘not adetail person’. Yet they acknowledgeimbalance will make focus on NICEadvice even sharper at a time when ithas come under new pressure. Itsmethodology for assessments hasevolved in pragmatic partnership withthe pharmaceutical industry. ‘Risksharing’schemes (such as the onedeveloped for MS patients beingtreated with beta interferon) areleading the world in the assessment oftechnologies for health.His move to US healthcare providerUnitedHealth two years ago stirredcontroversy, although few healthservice figures are so widely liked andadmired.A regular on the conference circuit,he is well connected at the highestlevel. His direct influence has slippedin the past year as his vision hasturned away from the UK but hiscentral part in the Blair reforms of theNHS will have a lasting impact.The Independent. His understandingof health-adjacent topics is alsosignificant: his career has spannedscience and medicine, health services,social services, politics, labour andemployment.He is the author of the seminal TheFive Giants: a biography of the welfarestate (Harper Collins 2001), and thisyear wrote Designing the New NHS:ideas to make a supplier market inhealthcare work (King’s Fund).scenarios racked up thousands moreMail column inches than the eventualscientific rebuttals.Even ideological opponents respectthe Mail’s success: its circulationrising over recent years when mostdailies lost readership.Yet some observers wonder if theMail has peaked. The relaunchedtabloid Times is seen as making inroadsinto traditional Mail readership.her networking skills and politicalinstincts.At the IPPR she was a strongadvocate of creating new types ofpractitioner to supplement doctorsand nurses, and the patient-centredagenda. She warned that separatingdoctors’ pay from Agenda for Changecould create a problem for nursestaking on roles traditionally carriedout by doctors.PROFESSOR SIR MICHAEL RAWLINSCHAIR, NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCESir Michael wants to strengthenother parts of NICE’s remit, such asits role in recommending thediscontinuation of outdatedtechnologies and treatments that are‘on the books’ of the NHS throughformularies or traditional practice. Hethinks NICE needs to recommendthat some things should be taken outof use, as well as introduced and,indeed, this is like to happen in future.12 Health Service Journal supplement 14 September 2006 hsj.co.uk
ANNA WALKERCHIEF EXECUTIVE, HEALTHCARE COMMISSION36As the quality regulator,the HealthcareCommission has anenormous role in thenew NHS market. Its chief executiveis a highly capable, dedicated anddetermined leader, working inpartnership with chair Professor SirIan Kennedy (9).Ms Walker was appointed chiefexecutive after disagreementsbetween Sir Ian and original chief37Bernie Ribeiro entered hispost as president of theRoyal College of Surgeonsof England with a bang.Just a month after taking up the post,he said that a tax-funded NHS isunsustainable and should be scrappedin favour of a social insurance system.Mr Ribeiro is a unique president inmany ways. He is the college’s firstblack president, he continues to workpart time as a surgeon and he wants38What patient power canachieve can be summedup with the name ofBarbara Clark. Ms Clarkis a Somerset nurse with breast cancerwho was prepared to sell her house toraise £27,000 for a year of the drugHerceptin.Ms Clark was denied the drug bySomerset Coast PCT. After a highprofilemedia campaign she raised39A career civil servant,Ian Dodge has nowreturned to the DoH,where he heads the newpolicy and strategy directorate. Forfive months in 2005, he was the primeminister’s shortest-lived specialadviser on health, treading in theheavy footsteps of Simon Stevens (31)and Professor Julian Le Grand.His period at Number 10 coincidedPROFESSOR CHRISTINE BEASLEYCHIEF NURSING OFFICER40Professor ChristineBeasley began workingtowards cleanerhospitals on herappointment in 2004, which coincidedwith the unveiling of A Matron’sCharter: an action plan for cleanerhospitals, which laid the responsibilityfor infection control on all NHS staff.As lead director for reducing healthassociatedinfections and the cleanerinspector Peter Homa, whichprompted his resignation. Colleaguesdescribe her as open, forceful andsometimes tough with top staff.However, the same staff still regardher management style asparticipatory. Other observersspeculate about creative tension in herprofessional relationship with Sir Ian,noting his academic background, and‘big picture’ vision.Horizon scanners are alreadyBERNIE RIBEIROPRESIDENT, ROYAL COLLEGE OF SURGEONSBARBARA CLARKPATIENT AND NURSEto be more politically engaged.His key priority at the college is toensure that surgeons are properlytrained to serve the community and toguarantee patient safety. Over the pastyear, he has been outspoken on thisand other issues.Mr Ribeiro says the government‘lost the plot’ on independenttreatment centres, and criticised it forfailing to consider the impact onsurgical training when they were first£25,000 towards the cost but, onappeal, an exceptional treatmentpanel found in her favour because ofher exceptional circumstances; MsClark is a single parent and fostercarer of a terminally ill child. She hadthreatened to take the case to theEuropean Court of Human Rights.The case fuelled a debate about theprescribing of Herceptin, which at thetime was unlicensed for use in the UK.IAN DODGEDIRECTOR, POLICY AND STRATEGY DIRECTORATE, DoHwith the furore over the launch ofCommissioning A Patient-Led NHS.The Financial Times saw his return toRichmond House as ‘a sign that theprime minister is deeply worried thatno-one in the DoH appears to keep afull grasp on the complexity of thegovernment’s health reforms’.They also quoted a Whitehallinsider on the need for ‘a politicaltake’ as well as a technical one, whichhospitals programme, she advocatedinfection-control training for NHSstaff to help fight MRSA and hospitalacquiredinfections. And she helpedadd Clostridium difficile to themandatory surveillance system to cutinfections.Many nurses are grateful forProfessor Beasley’s contribution tonurses now being permitted toprescribe from the full formulary.wondering what will happen after theHealthcare Commission’s proposedmerger with the Commission forSocial Care Inspection, scheduled forApril 2008. Others wonder how thecommission’s recent move to a selfinspection-basedsystem for trusts’assessment will be audited.The new system will clearly standor fall on whether the healthcommunity trusts in the honesty ofself-assessment declarations.proposed. He has asked Tony Blair toconsider exempting junior doctorsfrom the European working-timedirective, which he says will make italmost impossible for surgeons tocomplete their training satisfactorily.After the announcement of SirNigel Crisp’s departure from theNHS’s top job, Mr Ribeiro questionedthe practicality of the ‘enormous andrelentless change’ that is beingdictated by politicians.In a sense her influence goesbeyond a particular case or drug andis felt in what will be a definingdebate about rationing.Patricia Hewitt later ordered PCTsto consider granting use of the drug inindividual circumstances. Earlier thisyear it was reported that Ms Clark wasin remission, although she says sheknows she is not cured. Herceptin hassince been permitted for use by NICE.was deemed problematic for MrDodge, a civil servant, to provide.He was regarded by commentatorsas ‘joined at the brain’ with PatriciaHewitt’s special advisers Liz Kendall(34) and Matthew Swindells (12).A former head of primary carecontracting at the DoH, Mr Dodgealso held roles as a seniorperformance manager and head ofgeneral and personal medical services.Earlier this year she called on thegovernment to ringfence money fortraining and professionaldevelopment for nurse prescribers.Professor Beasley has looked at thetraining and skills needed by differentnurses, including a general review ofdistrict nursing education, and aframework outlining skills needed bycommunity matrons to help patientswith long-term conditions.hsj.co.uk14 September 2006 Health Service Journal supplement 13
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Page 17 and 18: RICHARD DOUGLASDIRECTOR OF FINANCE
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