Just over 30 years since Margaret Thatcher’s government bought in one the country’s best known retailers to review NHS leadership, Jeremy Hunt has called on the saviour of another British institution, Marks & Spencer, to do a similar job.
The 1983 review undertaken by Sainsbury’s boss Roy Griffiths concluded “If Florence Nightingale were carrying her lamp through the NHS today she would be searching for the people in charge” and led to the introduction of general management to NHS.
Sir Stuart Rose’s remit is narrower but could also have an important impact on NHS management culture – if not structure. The Griffiths report effectively saw the rejection of consensus management and its replacement by what the government referred to as a “more dynamic approach”.
Sir Stuart has been chosen by the health secretary because “he did a very good job of reconnecting M&S to its customers” and can help NHS managers adopt the more “visible and in-touch” style which the Francis and Keogh reviews indicated was required.
He is apparently an inspiring boss with a firm commitment to good leadership and the NHS managers who come into contact with him will learn a lot. But more significant will be: first, what those managers tell Sir Stuart about the challenges they face and why, as a result, there is so much reluctance to take on the top jobs; second, how sympathetic he is to that message; and third, how effectively the health secretary responds to what he is told.
The health secretary is very keen to avoid any suggestion that Sir Stuart’s review is a Trojan horse for a private sector take over, while at the same time suggesting the NHS could benefit from talent recruited from outside the NHS.
‘There is no doubt some of the best NHS leaders would welcome being able to spread their influence more widely’
It would be very disappointing if other Tory influencers attempt to spin this into a more negative line over the next few days. Mischief could also be caused by the left-wing press pointing out that Sir Stuart is a member of the advisory board of private equity firm Bridgepoint which owns Care UK.
Experienced hands will know the call for more private sector leaders within NHS management is one repeated every few years. They will also know that while an injection of new blood is always welcome, it is only ever going to be a very partial answer to improving the performance of the NHS for a wide range of technical and cultural reasons.
The NHS already employs the great majority of good leaders it needs to succeed. Mr Hunt’s well known admiration for education sector reforms has led him down the “superheads” route – and there is no doubt some of the best NHS leaders would welcome being able to spread their influence more widely without unduly risking their reputation and organisation’s hard won success. However, it is Sir David Dalton’s accompanying review which will seek to end the isolation of struggling trusts – so presciently identified by the Keogh review – that could do the most to raise the NHS’s game.
Former M&S boss to review NHS management
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Thirty years on – the NHS returns to retail for inspiration on leadership