news focus

GP contracts, service reconfiguration. . .Stephen Thornton's successor at the NHS Confederation, Dr Gill Morgan, will have a lot on her plate.How will she handle her new role? Laura Donnelly reports

When Stephen Thornton arrived to head the NHS Confederation, he came to the job with an oddly-earned notoriety.Many felt his curriculum vitae had been boosted when he 'showed his mettle' by his refusal to budge on the 'Child B' case while he was chief executive at Huntingdon health authority.

There is no one issue you could pin on new chief executive Dr Gill Morgan. But she has been known in the inner circles of senior management for years, having been president of the Institute of Health Services Management for 1997-98 and chair the previous year.

Dr Morgan, who takes up post at the confederation in February, is hardly a newcomer. She was chief executive of North and East Devon HA for six years. Before that she spent five years as public health director for Leicestershire HA, where she was originally a consultant in public health medicine.

Perhaps that background will give her extra credibility when the confederation is negotiating GP contracts. But how far will Dr Morgan be prepared to go to stand up for those she represents - in particular, in the face of government manager-bashing?

In a speech as outgoing ISHM president in 1998, she said the then health ministers were 'not an easy set of politicians to deal with. They have a very clear vision of the world.

They can at times be very intolerant of debate and discussion.

'We have found it difficult to position ourselves in an appropriate way, where our voice is listened to, but We are not seen as being universally critical, ' she said.

That dilemma will only be intensified in her role as head of the more influential confederation. But when HSJ spoke to Dr Morgan at the annual confederation conference in July, her stance on the government was overwhelmingly positive.

Asked her opinion of health secretary Alan Milburn's speech - which revealed the plans to hand over GP negotiations to the confederation - she described it as 'brilliant', paying tribute to his affirmation of the 'public sector ethos'.

She welcomed the move to strategic health authorities which would bring 'a philosophy that ensures standards and accountability'. Dr Morgan also welcomed the speed of change, because 'the worst thing in any massive transition is fear and uncertainty'.

Dr Morgan said that she, as a member of the confederation council for South West region, was ready for challenges such as structural change and GP contract negotiations, insisting, 'We are up for it.'

Since joining North and East Devon HA Dr Morgan had, she said, seen widespread improvement: 'Five or six years ago we were the bottom of the pile, but now the balance has shifted.' But she said there was excellence even in the worst-performing organisations.

Was she contemplating a change of job? Back then, she told HSJ: 'People can't be complacent, can't take their eye off the ball. People get stale - even the best people - and if we can harness the energy when things are going well That is a real opportunity to improve.'