the columnist

Published: 15/01/2004, Volume II4, No. 5888 Page 17

Lord Hunt, chair of the National Patient Safety Agency, is a former junior health minister

Membership of the House of Lords is not, perhaps, the most obvious qualification to lead a dispassionate debate on our country's honours system. But the endless fascination so many people have in the twice-yearly hand-out of gongs is surely testimony to the endurance of the British class system.

Not surprisingly, the furore over the extraordinary decision by a bunch of top civil servants to veto a knighthood for the new head of the Medical Research Council Professor Colin Blakemore has led to what is promised to be a far-reaching review of the honours system.

And not before time. The various gradations of class in the British Empire have been difficult to justify since the union jack was run down across a whole swathe of Africa in the 1960s. The Buggins'turn approach to many of the top honours has also seemed increasingly out of place.

Hopefully, the review will restore credibility to a system which risks falling into disrepute and undermining the achievements of the great majority of ordinary people who receive honours. At the least we can expect a more transparent approach, with more of the senior awards going to women and those with a black and minority ethnic background.

The NHS ought to get more honours out of the review. It always has a goodly number each year, but whether that number matches the importance of the NHS or its sheer size is open to some doubt.

The awards in the new year certainly brought recognition to some well-known NHS people - (Dame) Rabbi Julia Neuberger for one. I was delighted that her championing of the poor and disadvantaged in London was marked.Also that Professor Alasdair Breckenridge, chair of the Medicines and Healthcare Products Regulatory Agency, the key regulatory body for medicines safety, received a knighthood.

Closer to home, Birmingham and the Black Country strategic health authority chief executive David Nicholson fully deserved his CBE.When at the Department of Health, his coolness under pressure was a fine and oft-needed attribute.

No knighthoods for NHS chief executives this time. But one of my minor victories at the DoH was to press the case for top honours to go to the people who do the hardest jobs. Professor Sir Ron de Witt and Sir Ian Carruthers broke the mould and let's hope many more follow.

If the current honours system has more than its fair share of detractors, what should not be in question is the need for public recognition of his achievements. The NHS has traditionally been pretty bad at this, but there are signs of change. The HSJ Awards have led the way and, increasingly, individual NHS organisations are holding their own ceremonies where good work is applauded and celebrated.

My local primary care trust - South Birmingham - at its annual meeting pulled in over 200 people to an amazing celebration of excellent work by staff culminating in a dance session led by the director of public health.

The point here is that the NHS is under enormous scrutiny as it starts to spend the huge amount of extra money it has been given. The pressure to perform is as intense as ever. It is surely right to recognise that excellent work by its staff is acknowledged and praised.