Professor Sir Cyril Chantler

NHS Managers Health Chat, Kings Fund London


Sir Cyril in full flow!


Roy Lilley was in conversation with Sir Cyril Chantler last night. I confess to not really knowing who or what Sir Cyril was or had done…That is the joy of these chats! You discover the person behind the position and career.

Roy promised a lot in the pre-marketing.  Apparently, we were unlikely to find a more experienced, knowledgeable, thoughtful and enlightening person in the Health service arena. Hyperbole justified or not?

Usual health warning here – these are my take on the event, and even if you were there you may be thinking ‘I didn’t think that’.  OK – I’m opinionated (maybe not as much as Roy!) – but if you are upset – write to me or do your own blog!

The lovely thing that happens is we get to know the person underlying their current position. What shaped them. Why they do what they do or are what they are.  That’s Roy’s gift and skill.

Why medicine? He was an ill child – Asthma before inhaled steroids.  Sir Cyril knew he wanted to be a doctor then.  To help the sort of ill child he was?

I started to note many quotes – always hard to write the whole thing without tape or shorthand…so apologies, Sir Cyril and Roy if they are slightly wrong, but the flavour is right I think.  Let’s go!

“This is the first day of the rest of my life” First day at Guys – it sounds like he felt he had come home.  After becoming a little disillusioned with medicine at Cambridge (too much science, not enough patients).  The reverse was true at Guys.

“The paediatricians seemed the most human of doctors”. Which I why he ended up there.  Or could his childhood experiences of asthma attacks have pushed him that way?  He counted it as “serendipity”.  As did the specialisation in Nephrology.  This sounded like just being in the right place at the right time, and having the right pioneers around you – a chap called Norman Veal, the father of nuclear medicine.  Great answer to ‘why kidneys’?  “Much easier to understand than the brain”.  Touché!

“I knew my limitations” . Interesting answers around doc training. You had to be qualified in Adult medicine before specialising in paediatrics. 8 years training after 2 years SHO to be considered for Consultant status. “We were trained in things we did not need”.  Germany and France – the path is 6 years and 4 years respectively.

Politics and power? Interesting glimpses. He has been around and both watched learnt and advised. :

  • “Managing Chaos is enormously expensive”. The problem though with just throwing money at chaos is it gets lost? More money and no plan doesn’t work.
  •  Holland – the health care model deserves importing.  Some local taxation.  Buurtzog Homecare involves nursing at home, so keeps the hospital bed occupancy rate at 80%.  Which means no hot bedding.  Which means cross infection  rates were ZERO (mainly because you can fumigate the bed and sterilize the bedsteads between patients).  Can I just repeat. Zero.  Zilch. Nada. (Now we have privatised to the cheapest providers, will we ever be able to reverse that?  Not until someone takes a whole systems view of health care in the UK, I think.)
  • Doctors and Budgets: Clinicians have to have responsibility for efficiency and expenditure, in Sir Cyril’s view. I agree.  At Guys he worked with the top team to make efficiency savings of £7m in a £50m budget over 5 years. “Give me £1m now” he said. Here’s the quote of the evening – so, a separate line!

“You cannot do change unless you front load it”

And guess what?  He got the pump priming money.  And delivered the savings.  Although, he didn’t do that himself.  “Chairman don’t run things”.  As Roy said – management’s job is to make the space for good people to do great things – and get out of the way.
Wow.  And you need excellent administrators “Administration is a profession.  Management is a job”.
Yes, there need to be new ways of providing care.  Social care and health care need to be merged. Some parts of social care have to be means tested in his view (Roy worried how the sort the grey areas – which is always the problem – devil is in the detail). Yes, we may need more professionalism (clinicians who are professional administrators too?). Maybe Doctors who don’t strike, or who don’t feel the need to strike?  Allow clinicians to have proper family lives? Keep the politicians away from Health Care?   It was all discussed.  Some final quotes to get you thinking:
“Conscience versus contract – you need to start with Conscience…”  Also, he felt ‘contract’ should be replaced by ‘Compact’.  I like that – much more of an equal partnership, a meeting of minds with the same end game view. Together, not adversarial.
“You get better outcomes with very good team work”  Amen.
And finally, Roy asked,”So what would you advise Jeremy Hunt to do now?”
“I’d send Roy Lilley in”.
It may have been in jest, but you feel it might help!