Analysis

‘Bubbling with new ideas to achieve change’ Nick Triggle profiles the incoming head of NHS England, whose career ranges from cabinet adviser to purchaser of private health care NEW NHS England chief executive Simon Stevens spent the first nine years of his career working as a front line health manager. But his working life since is the best indicator of the direction he will take the health service in the coming years. When Labour won power in 1997, he became special adviser to the then health secretary Alan Milburn. He helped create the National Institute for Health and Clinical Excellence, now the National Institute for Health and Care Excellence, and what has become the Care Quality Commission. He also played a significant role in expanding the use of the private sector and oversaw a record increase in the NHS budget. He proved so influential that, in the Department of Health, he became known as the ‘second secretary of state’. After four years, he became health adviser to the then prime minister Tony Blair. Mr Stevens left to work for US private health firm UnitedHealth. He has been there for nine years, most recently as head

of its global division. His role has involved buying health care, so he is likely to take a particular interest in the commissioning element of NHS England’s work. It is this international experience that prime minister David Cameron, who was said to have lobbied him to take the job, so values. Guardian columnist Richard Vize expects him to play a greater emphasis on non-acute care as a way of investing in prevention and saving money. He adds: ‘It will take all his political skill and guile to communicate to the public the distinction between not having an unnecessary procedure and denying a patient care.’ Prevention Despite working and living in the US, he has written in defence of former health secretary Andrew Lansley’s reforms in the UK and on the importance of disease prevention and overhauling care for older patients. It is also worth noting that UnitedHealth has a strong record in terms of long‑term conditions management. Andrew Harrison, who worked as media adviser for Mr Milburn alongside Mr Stevens, says: ‘Simon is wedded to NHS principles, but he will be unsympathetic to the areas in need of reform and bubbling with new ideas for how to achieve change.’

Not everyone is so positive. While RCN general secretary Peter Carter says he is looking forward to working with him, Unison head of health Christina McAnea says: ‘I am surprised they haven’t been able to find someone in the NHS, and somewhat concerned that this is the government trying to install American medical values.’ Another school of thought is that the politics of the job may make radical change impossible. King’s Fund chief executive Chris Ham says: ‘He will take up a very different role to the one David Nicholson took up in 2006. Although still the most senior leader in the national health system, he will not be the chief executive of the NHS. ‘It will mean treading a careful line between responding to the priorities of ministers and working with colleagues from the other main national bodies to provide strong collective leadership.’ What is more, when he steps into post in April, there will be little more than a year to the general election. With the NHS expected to be one of the battlegrounds where the political campaigns will be fought, he may well need to tiptoe through the minefield of NHS politics. It promises to be a demanding job. Nick Triggle is a freelance writer

See opinion, page 13 Neil O’Connor

Curriculum vitae  xford University graduate Simon Stevens was born in Birmingham. O 1988 Joined the NHS graduate training scheme, working in various management roles running hospitals, health authorities and community services. 1997 Became health adviser to then health secretary Alan Milburn. 2000  Co-authored the NHS Plan. 2001 Worked for then prime minister Tony Blair and was a strong advocate for increasing use of the private sector. 2004 Spent nine years working for UnitedHealth, first across Europe and then as president of the company’s global health division. 2013 Appointed chief executive of NHS England. On accepting the post, he announced that he would be taking a 10 per cent pay cut on his £211,000 a year salary because of ‘spending pressures’. NURSING MANAGEMENT

December 2013 | Volume 20 | Number 8 11

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