Should Jim Easton be censured for his decision to quit a senior post within the NHS Commissioning Board in favour of the managing director’s job at private provider Care UK?

Should, more significantly, the system which allows senior public servants to move into the private sector be overhauled to slow what some see as a “revolving door”?

There is an important debate about the role of the private sector in helping deliver NHS services. The question whether the introduction of the profit motive undermines focus on patient care or supplies an incentive to improve standards will be a live one for the foreseeable future.

‘These leaders will not want or expect to leave the majority of public service values behind’

Then there is the issue of whether private involvement in support services should be treated differently from the managing or supplying of hands-on patient care.

One line of inquiry would simply ask if the private sector has anything to offer that cannot be provided by state-funded organisations and, if so, why NHS patients should not have the right to benefit from that service.

Crossing the floor

However, if we accept for the moment that private sector involvement is going to continue to grow (as it has done since the 1990s), then is it a good idea for NHS leaders to switch “sides”?

The three commonest objections against the kind of move made by Jim Easton are that: it will accelerate private sector influence in the NHS; it will give unfair advantage to a particular company; and that it somehow displays a lack of loyalty to the service that trained and promoted the individual.

The first objection is an honourable one to make and, as we have discussed, will be the subject of fierce controversy. The second objection might be termed “technical”. There are rules in place to provide a sufficient interval between a public servant leaving their post and taking up a position in a business which might benefit from their knowledge and contacts.

These rules need to be policed and if necessary their robustness challenged. The importance of “a level playing field” between sectors was highlighted during the Health Act’s passage through the House of Lords and resulted in Monitor’s ongoing review of the issue for the Department of Health.

The third objection is a matter of personal conscience.

The arguments for such moves are less often heard, but are no less significant. It is often claimed the NHS could do with an injection of private sector leadership skills. But there is little doubt public sector leaders tend to be better in key areas such as managing the bewildering range of partners, professional groups and other stakeholders involved in supplying health services. If the private sector is to play a more extensive role in the NHS, then having those skills in key suppliers is crucial.

Common language

It is also commonly said the NHS and private sector often fail to work effectively together because they “speak different languages”. The presence of more “bilingual” leaders should be welcome.

The size of the NHS means the private sector is always likely to draw much of its leadership from the service. Those “crossing the floor” will be clinicians, such as Bupa’s medical director and former primary care trust chief executive Paul Zollinger-Read, as well as general managers like Mr Easton.

These leaders will not expect or want to leave the majority of public services values behind along with their email address. They will arrive at their new employers wanting to combine those principles with delivering the organisation’s objectives. Some will become disillusioned, others will forget their roots.

It is the proportion who can remain true to their beliefs while forging a successful career that may determine whether the NHS can benefit from an increase in private sector provision.

Easton’s move stokes debate on private sector’s value to NHS