It was a Labour peer who despairingly drew my attention to the vote against Professor Malcolm Grant’s appointment as chair of the NHS Commissioning Board by Labour MPs who sit on the Commons health select committee down the corridor at Westminster.
They did so despite lawyer Grant calling the Health Bill, created by the man who appointed him, Andrew Lansley, “completely unintelligible”.
“What do they think that vote says about us?” asked the peer, admittedly a Blairite, not wildly keen on Ed Miliband. It’s a good question, although I think I can answer it. Having listened to the provost of University College London present his credentials in a brisk evidence session the Labour trio concluded that Grant didn’t know – or care? – enough about the NHS and didn’t seem to grasp the political and public accountability he will be required to demonstrate.
It is what this column calls the dropped-bedpan-in-Tredegar-hospital question, in honour of Nye Bevan’s claim that he would be responsible for it; never literally true, but faithful to Labour’s post-war vision of central planning. Some folk still cling to it.
I missed Professor Grant’s session, but read the transcript and thought he did pretty well for an outsider with no NHS experience – “just 100 hours in the job”, as he tactlessly put it, though the committee has no power of veto. But you could see why he annoyed Grahame Morris, Rosie Cooper and Virendra Sharma (he turned up late).
“Demonstrate some passion,” Ms Cooper kept saying, as if it was Strictly Come Dancing.
A great British institution, replied Grant, a Kiwi (64 next month) from near earthquake-wrecked Christchurch who arrived here in 1972, married a GP and has a spectacular great and good CV. It includes finding a consensus on GM crops as chair of a very divided Labour-appointed commission as well as turning UCL into a top 20 (sometimes top 10) global university. A “small l” liberal, he has defended Muslims, women, even (from the academic boycott) Israel.
I must declare an interest here. As a UCL graduate, more recently a fellow too, I’ve met him once or twice and heard him speak. A tall, dapper smoothie – is he related to Cary Grant? – he’s an impressive technocrat, temperamentally cool I would guess, a useful foil to the passionate NHS-soaked Sir David Nicholson, the commissioning board chief executive he must stand up to. A smart outsider with modernising credentials to police NHS culture and practice? It sounds OK to me, though it is also clear that Grant doesn’t yet know how commissioning GPs’ accountability to public and Whitehall is going to work. What he keeps saying is: “If everyone is responsible, no one is responsible.” He’s right about that.
“It’s absolutely critical to be clear about the difference between governance and management. Sir David will have responsibility for managing the board. The board will have responsibility for governing… I’m very strongly against full-time chairmen – I’ve seen too many instances of full-time chairmen confusing themselves with the chief executive and vice versa,” Grant told MPs.
Tory medico-MPs Dan Poulter and Sarah Wollaston voted yes to his appointment. So did bloody-minded Cornish Lib Dem Andrew George. Committee chair Stephen Dorrell cast the 4-3 deciding vote. What worried me about Labour’s stance was that it sounded chippy and parochial, a bit like Mr Lansley’s hapless halt to reorganisation of NHS London in May 2010.
That prompted the resignation of its chair, the redoubtable Sir Richard Sykes, whose CV is even bigger than Grant’s. As head of Imperial College London in 2004 Sykes, tried to “merge” it with UCL. Guess who saw him off?