The Chief Executive of our Health Service is a quiet but radical reformerby John McTernan / March 29, 2016 / Leave a comment
Is leadership about forcing people to do your will or is it about persuading and inspiring them? It may seem a crude dichotomy but both modes of leadership are currently on display in the National Health Service (NHS). The Health Secretary Jeremy Hunt is engaged in a bitter and divisive struggle with the doctors’ union, the BMA, over junior doctors’ contracts. Meanwhile, the NHS England Chief Executive Simon Stevens is leading the most radical reshaping of the health service since its foundation—without enforced organisational change.
Each model of bringing about change has been highlighted in the last few weeks. On the one hand, the BMA responded to Jeremy Hunt’s threat to impose the new junior doctors’ contract by calling an all-out strike—the first in the history of the NHS. On the other, the Government announced a “sugar tax” in the Budget.
Much ink will be spilt on the junior doctors’ dispute between now and the inevitable deal but the more fascinating subject is the quiet revolution symbolised by the “sugar tax”. Stevens has been a strong advocate of this, having earlier this year proposed a 20 per cent “tax” on sugary drinks in NHS facilities in England. This would have raised a projected £20-30m a year by 2020, but more importantly it was intended to change behaviour. It has now been superseded by George Osborne’s Budget announcement. The details of the “sugar tax” can be mocked. Why are sugary yoghurt drinks excluded? Why, indeed, is sugar itself exempt? The point of maximum controversy occurs at the actual announcement—Gordon Brown prepared for one in 2009 but backed off at the last moment—but that has passed quickly for Osborne and its impact will grow over time.