Neil McKay is so delighted to take the helm at one of the largest trusts in the country that he's not even bothered about the pay. Paul Stephenson reports

Published: 14/03/2002, Volume II2, No. 5796 Page 16 17

Greater love hath no man for his new job than that he gives up his current job without knowing what his new salary will be. At least that is what Neil McKay says about his new job.Mind you, when that job is probably the highest-paid chief executive in the country, at around£140,000, he can probably afford not to worry about the final figure.

Mr McKay is keen to make clear that his move from chief operating officer for the NHS to chief executive of the largest acute trust in the country - Leeds Teaching Hospitals trust - is not down to that large salary.

And he insists he was not sidelined in his current role - although it may be that the role is set to change (see box).

He says he always wanted to go back to become a chief executive and this opportunity was too good to miss.

'Put yourself in my position.

How many other jobs are there? , ' he asks. 'This is one of the few that could give me the sort of professional job satisfaction I am seeking. A job of this nature probably will not come up often.

Here is an opportunity to transfer my experience, including the work to implement the plan, locally.What a stage, the largest trust in the country [on which] to impress.'

But do former colleagues think he was pushed? Coventry, Warwickshire, Herefordshire and Worcester strategic health authority chief executive Mike Marchment, who worked with Mr McKay at Trent region, says he always thought Mr McKay would move, but there was no question of him being squeezed out. 'I always expected him to come back into a very big trust job. As long as he was there [the Department of Health], he would not be marginalised.'

Although Mr McKay denies that changes in the DoH influenced his decision to go, he makes clear the role would have needed a rethink: 'The appointment of directors of health and social care would have meant changes in my work.'

So what will his priorities be for the trust? 'There are a number of challenges. The first is to make sure the NHS plan bits directly relevant to the trust are implemented. Improving access for people who need care. There is also the delivery of the new cancer centre and a major private finance initiative scheme. It is vitally important that is delivered on time. It is a place with massive potential, and I hope to play a part in helping the trust to meet that. It is a question of leadership.

Of being prepared to stand up for the trust. To live and breathe the NHS plan.

'The priorities will be in terms of trolley waits, cancelled operations and delayed discharges. Leeds performs particularly well, but Leeds is well aware of the need to keep working on these challenges.'

So, what can Leeds expect?

'Not just to expect to run on the treadmill harder, but to find ways of doing things differently. The prime responsibility is on leadership, a strategic vision and winning over hearts and minds.

It is going to be interesting, having talked very positively about the importance of delivering, to show there are people who believe it is possible, and will roll their sleeves up, on the ground.'

He is clear that he will not get any favours from his contacts in changing things on the ground, but he knows where to go: 'There is a hell of a lot happening in clinical teams thinking about how to do things differently, but I have a very strong network of contacts because of what I am doing now. I will be able to put people in touch with the right people, and I know a lot about the work of the Modernisation Agency. I have got good contacts, and I will use them to the best advantage of the trust.'

So will he be prepared to stand up for managers and make clear to those he now works with when there are problems?

'I will not hesitate to share my views with senior colleagues within the department.'

He says of current chief executives: 'They have never hesitated to tell me the facts of life. They tell me regularly they feel they have had too many targets and I would respond by saying we have limited the targets and also the service and financial framework requirements drastically.

'They tell me about how hard it is to change working practices.

We have to work at this. They would say people feel under enormous pressure. I would say I fully understand this.'

Come April, managers around the country will be able to see him put his money where his mouth is.And he might even know how much money that is. l After McKay: who's next?

The Department of Health has confirmed that it will shortly announce a new chief operating officer for the NHS.However, it had been understood that the four new regional health and social care directors, who will report direct to NHS chief executive Nigel Crisp, would effectively take over the role.

Coventry, Warwickshire, Herefordshire and Worcester strategic health authority chief executive Mike Marchment is surprised that a replacement is being made and he 'will want to hear' from Mr Crisp what the job is.

He says he 'certainly expected there to be discussion' about the role - its future had not been made clear to SHA chief executives.'There have got to be changes in the way the department works.'