NHS Managers Health Chat, Kings Fund London
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”