National managing director of commissioning development, DH UP 39

Dame Barbara Hakin is important to the NHS for two reasons. The first is contingent and the second is personal.

The contingent reason is that here we are in 2010, with yet another government underlining the importance of commissioning but with the leadership of the NHS in the Department of Health nearly all with their managerial experience in running hospitals.

We have continued to have a provider dominated NHS because the people at the top have so little experience of buying healthcare and every experience of providing it. Dame Barbara is the exception and, because of that, is vitally important to the relationship between the future of the NHS and the current leadership. That future is a system that focuses on the commissioning of healthcare for England’s population but the current leadership is at best puzzled by that idea and at worst blanks it out and thinks it might one day go away. 

That’s why, in the autumn of 2010, ask anyone in the DH who is in charge of the 75 per cent of the future of the NHS that is concerned with commissioning, and time after time people tell you that person is Dame Barbara.

But Barbara is much more than an exception to the leadership rule. As chief executive of NHS East Midlands, she is an experienced GP and commissioner and is also a lot of fun. When I was working as special adviser at the DH and Number 10 she and I would meet often to try and thrash out the implementation of reform. In Richmond House, when we had turned the secretary of state out of his room, we would work out in some detail how on earth commissioning could help us chunk into the waiting times or begin to make choice work.

We would try to understand how we could expand what seemed to be a very small capacity to buy healthcare in the face of an overcapacity to lead the provision of it.

Looking back I don’t think we were bold enough in making the decisions to bring in new and extra capacity from services and industries where people are used to buying services. But that was as much my fault as anyone else’s.

Dame Barbara can help us deliver the NHS principle of universal healthcare with equal access for all free at the point of need through the power of commissioning.

Professor Paul Corrigan, management consultant and executive coach (see 92)