When the Department of Health's long-serving public relations supremo Romola Christopherson announced her retirement last year, there was inevitable speculation over who would replace her.
Would it be another career civil servant? Or would it be an outsider, a prominent journalist perhaps?
Helen McCallum, who has now taken over as director of NHS communications with the job of integrating the DoH press and publicity team at Richmond House and the NHS Executive communications team in Leeds, is neither. Her appointment might be termed, to coin a phrase, a 'third way'. A former PR and fundraiser in the university sector who worked in the NHS before joining the NHS Executive, Ms McCallum comes with a big reputation and glowing report cards, not least a clutch of PR industry plaudits for her handling of the NHS 50th anniversary communications brief.
But the task facing her is formidable. The reputation of the DoH press office is at an all-time low, having notoriously been described by one senior lobby correspondent in evidence to the Commons public administration select committee last year as 'a complete joke'.
The other damaging allegation made against the DoH press office - and other government press teams - is that it has 'gone native' and is in thrall to its political masters. To cite one instance, the Treasury committee described the presentation of comprehensive spending review figures as a 'public relations fraud'.
Ms McCallum, who was not responsible for the way the figures were presented, says that the government information service's role should be to explain policy without becoming involved in 'inappropriate mudslinging with party politics'.
That is straight from the textbook. But what of that presentation of the NHS spending settlement as£21bn 'extra' when it could be more accurately described as£9bn 'extra'?
Hardly 'mudslinging', but surely at the very least an attempt to spin a very good settlement into a miraculous, phenomenal one?
'I wasn't involved in the detail of the announcement,' says Ms McCallum.
'I think we should do our best to present sensible information to the public about the way that policy is being developed. We should develop honest and reasonable presentation of facts.
'I think actually that the politicisation debate has been blown out of proportion. What we have is a government that is clear that it needs to communicate effectively, clear that it needs to engage and listen to people and clear that it needs to present its policies in a coherent, cogent sort of way.
'Nothing wrong with that in my view. There's nothing Political - with a big P - in the terms of this debate; it's good practice.'
She adds: 'There is a bit of media excitement about 'let's pick up all the evidence about items where there has been 'spin' and put them all together and turn them all into a macro spin' when actually it is overstating the case...'
Ms McCallum says the DoH press office can expect to be 'modernised'. It has to 'rise to the challenge of a 24-hour media'. And it will have make more use of new technology. But above all it will have to engage with what Ms McCallum calls the 'continuous process' of communications - engaging its audiences, and listening as well as explaining. But the NHS cannot feel too smug that its Whitehall cousins are getting the once- over. Ms McCallum says that while trusts and health authorities have got better at communications, they are not in the same league as organisations like the Post Office, and even lag behind local councils.
Indeed, it was Ms McCallum, with her then boss at East Anglian regional health authority, Alasdair Liddell (now NHS Executive planning director), who produced a highly critical review of NHS communications five years ago.
That pointed out, in so many words, that the NHS was appallingly bad at getting its message over: it had no 'tradition' of communicating; its attempts to present a corporate view were undermined by tribal jealousies; and the public understood virtually nothing about the NHS or the need for change. Ms McCallum says surveys show that the NHS has got better since then, although with 'perhaps not as much progress as I would like'.
More NHS organisations, she says, now think about communications with their audiences 'in a planned and coherent way'.
She adds: 'There are still organisations in the NHS that behave rather like some of the university institutions I used to work for way back in the 1970s, which is that they do what they do and it is nobody else's business how they do it. Whereas, actually, this is a public service and it is everybody's business how we do it.'
She promises more work on NHS public consultation processes over service changes and hospital closures - the conspicuous failure of which was at the heart of the Liddell review.
'It's fair to say that some years ago consultation was a dirty word in the public services, and some of the worst examples of failing to communicate effectively were to use a statutory consultation period to send out a very small piece of paper that got buried in some library saying this is what we are going to do. Actually that is changing a great deal and there is quite a lot of work being done at NHS Executive level on consultation procedures and processes, in helping NHS organisations understand that consultation means consultation, and finding new ways and different ways of consulting with the public.'
All the signs from the NHS suggest that Ms McCallum is popular and well- respected. The only PR tools she appears to lack are the aggression and boorish arrogance of some exponents of the black arts in government. She offers a tongue in cheek clue as to why. A keen amateur actress, she admits she is often typecast as villains - most recently as 'Mrs Robber' in panto.
'I have played Tamora in Titus Andronicus, Medea, Lady Macbeth, the kind of people who are nasty to everybody and kill their children. Maybe it's catharsis.'
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