David Nicholson: Some newspapers 'hate the NHS'

Sir David Nicholson was speaking in his final interview with HSJ before he leaves the NHS at the end of the month.

He announced his retirement last May. It followed months of scrutiny and criticism of him in the wake of the Francis report into the Mid Staffordshire Foundation Trust scandal.

The public inquiry report, published last February, did not directly criticise him, but did highlight failings of two health authorities in the West Midlands, which he led, and of the NHS overall.

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It was followed by calls for Sir David to go from campaigners, politicians and newspapers. The Daily Mail published several front pages about Sir David, including one calling him “the man with no shame”.

Asked if he thought the newspaper coverage was motivated partly by wanting to attack the public sector, Sir David said it was an “element”.

He added: “It’s no accident is it that the people who led it hate the NHS? The whole idea of universal healthcare free at the point of use is not in my view naturally the bedfellow of some of our national newspapers.” However, Sir David said he had never worked with any politicians who did not support the NHS.

He plans to apply to be a non-executive director of the proposed press regulator being set up in the wake of the Leveson inquiry into press standards. This was not to prevent criticism of individuals or to “stop the Daily Mail doing whatever it does”, he said, but to protect confidence in public services as they publish more information on performance and quality.

Greater transparency was “absolutely vital” to “renew public services”, Sir David said, but also meant failings and variation, which are often already recognised by NHS staff, would become widely known.

He said: “We’ve got to have a media and a context which is supportive of that happening.” Otherwise coverage could result in staff being “frightened or hiding things”, which would be “really dangerous”, he said.

“My real worry is… we get attacked and what gets undermined is the principle of public services [and] public confidence.”

Sir David said he also planned to promote and offer advice on the uptake of universal, free at the point of use health systems internationally.

“The only thing on offer [to countries developing their health systems] seems to be a mixture of private health insurance, slash American, slash management consultancy offers for the way in which you organise your healthcare.

“People try to paint a picture of [the NHS] being a hangover from the past, a nationalised industry sort of model. But I think… systems which share risk across the whole population [such as the NHS] will be more sustainable in the future than the alternative.”

Sir David also wants to develop and promote “patient empowerment” and learning disability services.

He said he would not take on any other chief executive roles and did not plan to work in consultancy to the NHS.