Julia Manning is Chief Executive of 2020Health.
It may be April Fools’ day to some, but in the NHS it is Saint Simon’s Day – our new patron saint and NHS England CEO has arrived and NHS watchers and workers are waiting with bated breath for miracles to unfold. Which, given the economic circumstances, is what is required.
Like the real Saint Simon, much mystery currently surrounds Simon Stevens’ intentions, but to take this job we know that he has to be a zealot, an extremely passionate adherent to the cause of the NHS.
The question is – can Simon balance safety with scandal? His task is simple…to describe, that is.
All he has to do is enable the public to feel safe and secure whilst encouraging the workforce to be bold and specific; to simultaneously take responsibility and risks with kindness in order to recreate a sustainable NHS. And balance the books while he does it.
Simon’s arrival is politically fascinating. On the surface he makes life difficult for both Labour and the Tories. In the 1990’s, he was a Labour Councillor and NHS graduate trainee, who moved on from being a special adviser in the Department of Health to become Tony Blair’s health policy guru. It was he who expanded the NHS market and promoted competition.
His return is awkward for Andy Burnham MP, who when Health Secretary tried to reverse some of Simon’s policies such as reverting to the NHS being the ‘preferred provider’ of services. In recent months, Andy’s ideas on health and social care integration have ignored the fact that social care has a long history of plurality of providers, surely not something he could reverse? How will Andy and Ed Milliband create clear red water between themselves and the Tories, when the former architect of Labour reforms is currently singing the coalition’s tune?
With regard to the Tories, Simon will not tolerate political interference from Jeremy Hunt. Jeremy apparently only consented to the appointment on the basis of Simon agreeing to have weekly meetings. Both are astute political operators who like to be in control, but sparks have been flying for some time already between Jeremy and the NHS England executive that Simon will now lead, who have protested that Jeremy won’t respect the freedoms that his predecessor gave away.
Dig a little deeper, though, and I wonder if Simon’s appointment is part of the David Cameron’s redemption plan. The PM lost all his NHS capital when he bet on Andrew Lansley. Simon’s appointment could bring some forgiveness from and healing to the battered NHS if he can instil renewed confidence in the coming months. This, the PM might hope, may reflect back on him personally, as he, like the rest of us, was led astray.
Simon can carry on ideologically where he left off. The recent reforms might have been incredibly messy but the direction of travel has remained the same.
He now has to be the great persuader: ensuring management are to up their game; getting GPs to stay with the leadership; convincing the commissioners to try radical new models of care; insisting on making savings. He’s already moved some people on and some people in, but the really interesting part is going to be about how he communicates. He can have conversations that politicians wouldn’t dare, both because he doesn’t rely on votes and because he’s new-with-a-track-record. Finances, behaviour, care.data, limits, candour, mutuality, doing more for ourselves all need to be brought into the light.
The public may never know about “NHS England”, but they will hear of and from Simon Stevens. Today he takes office and his ability to reassure us on, and cast a vision for the NHS begins immediately. There could be an election riding on his success.