news focus: Is it possible for senior managers to implement the Improving Working Lives agenda and leave their desks at a reasonable hour? Ann McGauran reports

Published: 07/06/2002, Volume II2, No. 5808 Page 14 15

The Improving Working Lives agenda is well established as a Department of Health campaign. Are chief executives and other senior NHS managers among those reaping real benefits, or is it a case of rhetoric without reality?

HSJ asked the DoH to provide specific information on how the work-life balance of senior staff has improved under Improving Working Lives. In particular, was there any attempt by the centre to convey the message that long hours working by senior managemers are not conducive to good performance?

But the DoH could only say that 'achieving the [Improving Working Lives] standard means making real and tangible improvements in the working lives of all staff in the NHS at every level, and this includes managers'.

Is more attention to joined-up government messages required, given trade and industry secretary Patricia Hewitt's recent attack on the macho work culture and her call for ministers to jobshare? It is important for people in senior positions to take a lead, Ms Hewitt believes.

So are the working styles of NHS chief executives changing? In Manchester, Christie Hospital trust chief executive Joanna Wallace stresses that 'we have never had a long-hours culture.

'If I spent more hours here, people would probably tell me I was a sad git. Sometimes people stay because they think That is what's valued by their manager.'

Her first child, Erin, is now five months old and Ms Wallace is back at work on a 'very full time' basis. Does she feel the NHS is making strides in terms of Improving Working Lives?

'I think we [the NHS] are definitely making progress, but large employers like the NHS have opportunities to do better.

A lot of it is about managing expectations and starting a culture that does not value just being there. That includes accepting that people work in different ways and have different commitments.'

But the arguments around work-life balance should not be polarised into one of gender, she believes. 'It is probably more a question of age rather than gender. People are generally more energetic before they have families.'

She wants recognition that demands on time often change in different phases of life - such as parenthood. For those without children, she suggests 'more sabbaticals and breaks - to give staff a pause from pressure and a break from the day-to-day'.

What are the effects of a longhours culture? 'You do not get a good product. Everyone loses perspective. If you are working through the night, you have to look at the way you are working.'

She accepts that her career will look different now she has had a child - 'and That is a choice'.

She adds: 'I moved fast [in my career] because I like challenges, and I worked hard along the way.

But there was a personal toll.My first marriage did not work. Now It is not just about the hours I work. There is a balance in my head. I always take my holidays.'

Confidence in your position is vital, she adds. 'You have to be very secure as a chief executive to take maternity leave.'

University Hospital Birmingham trust chief executive Mark Britnell is overseeing a£350m private finance initiative scheme.What is his work-life balance? 'I am working between 60 and 70 hours a week, but I do know when It is time to recharge the batteries and go to the gym.'

He sees burn-out as a danger for senior staff, 'and That is why I think we need to be more supportive of chief executives'.

Doncaster and Bassetlaw trust chief executive Nigel Clifton says: 'I have never worked such long days on so many issues. I begin to wonder how many six-day weeks you can work in a career.Many senior managers do not see their families from the beginning to the end of the week.'

He adds: 'The days and weeks are immense, and 12-hour days are not sustainable.'

He points out that ministers are sheltered from some of the extra stresses that chief executives cannot avoid. 'When they go to meetings, someone drives them. I am white-knuckled on the M1.'

Does he believe initiatives such as Improving Working Lives are leading to less pressure on all staff, including chief executives?

'We are trying to improve the work-life balance, but it never feels like that when every communication you get has 25 items on it.There is a tyranny of e-mail and fax.

'Clinicians' goodwill has been exhausted and not many people are putting themselves up for chief executive positions.A chief executive's career is like that of a butterfly - a short and beautiful life.'

NHS Confederation policy manager for human resources Alistair Henderson says: 'There are plenty of managers who find themselves working long hours.

'They are not necessarily showing an example.There are others that handle things rather better.'

So is not it time for the centre to take a lead, and perhaps to use a ministerial speech to encourage chief executives to turn their backs on the long-hours culture?

'It is a question for people at the top of the organisation. It is not as simple as saying you shouldn't work past 5pm. That will not resolve the issue.'