• DH permanent secretary to step down next year
  • Dame Una joined in 2010
  • Announcement comes amid severe financial strain in the department

Dame Una O’Brien, the Department of Health permanent secretary, will step down next year. The news comes at a time of severe financial strain for the department.

She took the top civil service job at the department in 2010, having previously worked as its director general of policy and strategy, and director of provider reform policy.

Una O'Brien

Una O’Brien

Dame Una O’Brien has been permanent secretary since 2010

Dame Una will step down at the end of April, the DH told staff today. No replacement has yet been appointed.

The announcement comes at a time of intense financial pressure in the DH. In 2014-15 it underspent its revenue budget by just £1.2m in 2014-15 – a fraction of its £110bn budget – despite a £250m in-year increase to its budget and a £640m capital-to-revenue transfer. 

There has been speculation that the department may not be able to balance its revenue budget overall in 2015-16, although so far ministers and officials have said they believe it will. Work is under way to again transfer substantial resources from the DH capital to revenue budgets.

Dame Una said in a statement: “It has been and remains a huge privilege to work with so many talented and skilled colleagues at the Department of Health, with our national partner organisations, the NHS and beyond… As we plan for the next phase of change in the department and the wider health and care system, with the spending review complete and the government’s plans for the parliament set out, I feel the time will be right, next April, for me to leave.

“My successor will be arriving at a good time to take on leadership of change in the department and the implementation of ministers’ agendas through to 2020.”

Health secretary Jeremy Hunt said: “Una leaves the DH after more than five years as permanent secretary, and a quarter of a century in the civil service. In that time, she has been at the centre of real and lasting improvements in the NHS, so her consistently wise advice will be much missed.

”She has made a huge contribution as we have worked together towards the goal of creating the safest and most compassionate health service in the world and I wish Una every success for the future.”

Cabinet secretary Sir Jeremy Heywood said: ”I am hugely grateful to Una for all that she has done over the last 25 years in the civil service, and in the last five in particular where she has expertly led the Department of Health. Una has also made an enormous contribution to the wider leadership of the civil service, including on important issues such as talent and diversity, for which I am hugely grateful. I wish Una all the very best in the next phase of her career. We will miss her.”

One of the policies Dame Una championed particularly visibly during her time as permanent secretary was that its civil servants be required to spend time with frontline health and care services. She also oversaw implementation of the huge NHS reforms put in place by former health secretary Andrew Lansley, including transferring substantial responsibilities from the DH to NHS England; and the DH’s response to the Francis review.

Asked last week about the consequences of the overall DH revenue budget being overspent this year, which would breach the parliamentary “vote” on spending, NHS Improvement chief executive Jim Mackey said: “I can’t emphasise enough that this is really, really serious stuff. The provider sector has to do its bit to get to a position where we don’t bust the vote this year. I don’t know [the consequences] but I can’t think they’re very pleasant.”