HSJ50 2008: controversy and change
- Published: 13 November 2008 09:00
- Last Updated: 13 November 2008 09:00
- Reader Responses
This year's HSJ50, the ranking of the 50 most powerful people in NHS management policy and practice in England, reveals dramatic changes in who is wielding power (click here to see the rankings in pictures).
This was drawn up by an expert panel in association with our partners, recruitment consultancy Harvey Nash, and management consultancy Ernst & Young.
This is the third year we have published the HSJ50 and no fewer than 20 of this year's most powerful people are new entries. The list is controversial and we do not expect everyone to agree with the judges' decisions. See below for the judges' names and details of how they came to those decisions.
We decided to restrict the HSJ50 to England because we did not believe it would be valid to make comparisons between, for example, politicians in different parts of the UK.
As well as managers, politicians and government advisers, the rankings include clinicians, senior civil servants, strategic health authority chief executives, key players in the royal colleges, trade unionists, journalists, policy experts and regulators.
The ministerial team has made a stronger showing than last year, although only three of them made it, while public controversy over access to drugs has sent the leadership of the National Institute for Health and Clinical Excellence flying up the rankings.
"As well as managers, politicians and government advisers, the rankings include clinicians, senior civil servants, strategic health authority chief executives, key players in the royal colleges, trade unionists, journalists, policy experts and regulators"
The NHS senior management team is still a dominant force, while social care director general David Behan has, as we predicted last year, gained places. The Audit Commission continues its approach of growing influence by stealth, in contrast to the misjudged grandstanding of bygone years. The departing Healthcare Commission slips down, but the Care Quality Commission is still only in the power foothills - that will change rapidly in the new year.
Acute sector managers make a stronger showing, but it is still a struggle to find primary care big hitters.
Finally, the prospects of a change in political power are reflected in shadow health secretary Andrew Lansley jumping up the list for the second year running.
HSJ would be delighted to publish your views on the HSJ50. Email hsjfeedback@emap.com
Judging
The judging was carried out by a panel of experts from across the health policy and management field, who excluded themselves from consideration.
The prime minister, chancellor and leader of the opposition were also excluded. Those on the list had to be influential in constructing or delivering healthcare policy.
The judges created a long list of over 80 names, which involved culling a number of names from HSJ50 2007 and adding many whose influence had grown since last year. There followed a long and lively debate on the final rankings, punctuated by discussions on the nature of power and influence. The most difficult discussions were around judging the influence of opposition politicians and the national role of regional health chiefs.
While not everyone agreed on every ranking, a consensus was achieved for the final list. The results were closely guarded until they were revealed this week.
List of judges
Lord Warner, former health minister; Richard Vize, editor, HSJ; Alpesh Patel, partner, Ernst & Young; John Appleby, chief economist, King's Fund; Rebecca Evans, news editor, HSJ; Stephen Ramsden, chief executive, Luton and Dunstable Hospital foundation trust and director of the National Patient Safety Campaign, with Mr Patel, Matt Tee, chief executive, NHS Direct, and Professor Kieran Walsh, professor of health policy and management, Manchester Business School; Frank McKenna, director of NHS and healthcare at Harvey Nash, and Sir John Oldham, GP and head, Quest; Emma Dent, features editor, HSJ.
HSJ50 at a glance
1 Lord Darzi
2 David Nicholson
3 Alan Johnson MP
4 Mark Britnell
5 Mike Richards
6 Sir Bruce Keogh
7 Sir Michael Rawlins
8 Andrew Lansley
9 Bill Moyes
10 David Behan
11 Steve Smith
12 Ben Bradshaw MP
13 Sally Davies
14 Sir Graeme Catto
15 Andy McKeon
16 David Flory
17 Andrew Dillon
18 Chris Brinsmead
19 Hamish Meldrum
20 Don Berwick
21 Bob Ricketts
22 Dame Carol Black
23 Dominic Hardy
24 Cynthia Bower
25 David Fillingham
26 Nick Timmins
27 Steve Bundred
28 Paul Dacre
29 Mike Farrar
30 Anna Walker
31 Neil Hunt
32 Sir Liam Donaldson
33 Sir Robert Naylor
34 Baroness Young
35 Niall Dickson
36 Stephen Thornton
37 Jeremy Heywood
38 Martin Roland
39 Malcolm Lowe-Lauri
40 Steve Field
41 Kevin Barron MP
42 Greg Beales
43 Peter Carter
44 Alwen Williams
45 Sian Thomas
46 Lord Carter
47 Hugh Taylor
48 Sir George Alberti
49 Gordon Hextall
50 Helen Bevan
