It is a family affair

Published: 19/12/2002, Volume II2, No. 5836 Page 28 29

How strong an influence is childhood on subsequent choice of career? What is the power of values absorbed at an early age? Joanna Lyall spoke to individuals who have achieved eminence in the field about their early influences and memories of Christmases past

Joan Higgins Professor of healthcare, Manchester University centre for healthcare management, chair of Christie Hospital trust and president of the European Health Management Association. She was born two weeks before the start of the NHS.

'M y parents were both nurses at Storthes Hall Hospital near Huddersfield, one of the largest psychiatric hospitals of its day (around 2,000 beds), but now closed. It was largely self-contained, with a farm, cricket ground, football pitches, tennis courts, huge grounds and a large ballroom.

We lived a couple of miles away. Apart from being a senior nurse, my father ran the patients' cricket team and took the first group of patients on a camping holiday in France in the 1960s.

I was an only child and my parents used to work different shifts, so there was always someone at home. I used to be 'handed over' at the lodge or on one of the wards. I came to know the patients very well. They had often been there for most of their lives and were in their sixties or seventies. Some had been admitted for having an illegitimate child while some other patients' psychiatric symptoms had disappeared long before.Many had lost touch with their families because of the geographical isolation of the hospital and the stigma of mental illness.

The long-stay patients played a vital role on the wards: food, cleaning, beds.When I worked on the wards years later during student holidays, I would be advised to check with the patients how the ward should be run, rather than the nurses, because the patients had been there longer. It was rumoured these patients would be kept away from consultants on their infrequent ward rounds in case they were discharged. The hospital and the patients needed each other.

Looking back as a health policy analyst, I realise that the community of the hospital only worked as it did because of the incredible lengths of stay that most patients 'enjoyed'. It would be impossible to recreate the positive elements of this culture where lengths of stay - at least in the acute sector - are now down to five days on average.

Christmases were great fun. There were dances and parties in the ballroom and a play, which would sell out night after night. The decorations were fantastic and the wards always warm and cheerful, with plenty to eat and drink. The sweets came in boxes, which seemed unbelievably luxurious in those days. The staff bought presents for all the patients.As an only child, I loved the party atmosphere.My parents worked at Christmas to give bigger families with more children a chance to stay at home. It was really difficult when they had retired to create Christmas traditions for ourselves as a family.A small turkey and the three of us together seemed quiet after the fun of the hospital.

I considered working in the NHS but my parents were keen that I complete my education before deciding on my future. In the event, my first job was as a social worker in a psychiatric hospital in the North East, but I left within a year to go back to academic studies.

Though my memories of Christmas at Storthes Hall are all positive, there was a dark side of psychiatric hospital care which was later exposed. The hospital was named in Barbara Robb's book Sans Everything, which started the wave of exposés of cruelty and corruption in long-stay hospitals.My father gave evidence to the inquiry that followed and was bullied by colleagues for doing so. The staff closed ranks to avoid exposing bad practice and to protect their 'perks'. It was not uncommon for hospital staff to help themselves to patients' pocket money, sweets and cigarettes. Some furnished a very comfortable retirement from the additional money. They also took hospital property.

Most of the staff were totally honourable and caring, but dishonesty was evident and often condoned.

'Robert Naylor Chief executive of University College London Hospitals trust and a non-executive on the ministerial advisory board on procurement.

Aged 52, he remembers his father, Frank, and his twin brother, Maurice, talking about hospital management from his early childhood.

' My father and his brother were both in hospital administration in quite lowly positions from the late 1940s in Manchester, where they had been at university. They then moved around the country and up the system.My father ended up as group secretary for Reading and district hospital management committee - the equivalent of a chief executive's job today.He took early retirement in 1974 and, at the request of local consultants, took over the management of a local nursing home and turned it into a private hospital.My uncle Maurice stayed in the NHS and ended up as Trent region chief executive and president of the Institute of Health Service Management. They had six children between them and five are in the NHS.

One of my earliest memories is sitting in a car with my sisters outside an isolation hospital in Taunton on Christmas morning while my father carved the turkey inside.We were not allowed to open our presents until he'd visited the local hospitals.His job made him very much part of the community and there was always much talk about the hospital at home. I spent all my university holidays working in hospitals as a porter or nursing auxiliary.

That put me in a strong position to get on to the general management training scheme after university and I have been in the NHS ever since. I feel I have a fantastic job with enormous diversity and freedom. It is wonderful to be working in a system with such strong social values.

'Lorraine Lambert Chief executive of South Tyneside Healthcare trust, a member of the regional modernisation board for older people and a non-executive director of the National Clinical Assessment Authority. She was born in Yorkshire in 1957.Her father left when she was three, leaving her mother to bring up three children under 10.

' My mother took a job as a hospital domestic, but the hospital encouraged her to train and she qualified as a state enrolled nurse so I really grew up with the NHS. It was all I ever knew. She worked at St John's Hospital, Halifax, an old workhouse, then as a district nurse, then for 20 years at the Northowram Hospital, Halifax, looking after elderly people. She was passionate about the job and always put it first. She would never leave a patient who was near to death, even if it was past the end of her shift. I remember spending hours waiting for her outside the hospital with my stepfather.

I used to spend every Christmas on the ward and paint huge Christmas murals and take part in the carol service; it was just part of normal life.

Everyone knew me and I felt part of that community and That is something I have tried to continue with my children.

I learned an enormous amount about people and relationships.My mother said, 'Really talk to older people and discover their history so you will see who the person really is, not just what you see before you.' It left me with a strong interest in the care of older people. I learned about the importance of dignity and realising that the patients all had years of experience and were all individuals. I do really believe we can make a difference to patients' lives. I am incredibly proud of what my mother achieved. It couldn't have been easy as a woman on her own in the 1960s, working shifts in a physically demanding job.

I worked as a nursing assistant at the hospital during my university holidays and realised that I had a lot to learn. It was quite a regimented system - we clocked in and out - and I remember some stentorian ward sisters. But it did leave me with a conviction that standards mattered and how important it is to communicate appropriately - not calling people by their first names without asking them first, for example. I thought about becoming a nurse and had a place to do a postgraduate nursing course at Sheffield, but then I was offered a job as committee clerk to Gateshead health authority and from there I went into operational management. If you had told me 20 years ago that I would become a chief executive, I would have been surprised because It is not something I set out to achieve. But I get a real buzz from it, and particularly from meeting patients.

My mother died last year and I am glad she lived to see what I had achieved. One of my benchmarks