Filed Under (Culture of the NHS) by Paul on 25-01-2010
Most of my posts are a commentary on the powerful and internal nature of NHS culture.
Most people in senior positions in the NHS have only ever worked in that service and their experience and ideas are nearly all self referential. They compare themselves internally and tend to think that they represent the entire world of possibilities.
The monopolistic nature of NHS culture is demonstrated when there is any discussion about the internal nature of most big appointments and the expectation that the NHS has that all the big jobs will be filled by people from within that culture.
For example just last week Richard Vize, editor of the HSJ, commented on his blog that the new CEO of Oxford Radcliffe Jonathon Michael could be the next CEO of the NHS simply because he had just been appointed to a new and difficult provider trust.
This is a really odd way of looking to the future. It is much more like a feudal court than a modern organisation. As the old King nears the end of their reign – and why people assume this is happening with David Nicolson is beyond me – everyone looks round the court and considers whose star is on the up and whose is on the wane? Has this person had a good week with some smiles in his direction? Has this person had some frowns? Who is in and who is out.
The fact that the next King will come from the court of the old one is taken for granted. So we are meant to spend hours looking at the relative merits of the different directors-general at the centre and the CEOs of the SHA and see who is on the rise.
I think a much more interesting response to the question “Who will be the next Chief Executive of the NHS?” is that I hope I don’t know.
Wouldn’t it be refreshing to say that, actually, we really don’t know who will have the job?
Wouldn’t it be great if we had a process which was not feudal but genuine?
Wouldn’t it be even better if we knew that there would be a lot of candidates from completely outside the existing culture so that we really don’t know who will be successful?
That would mean that the NHS was really strong. So strong that it can be open to being lead by someone from completely outside of its culture.