Health minister Lord Prior on how to improve our NHS

Lord Prior at his home Swannington Manor. PHOTO: ANTONY KELLY

Lord Prior at his home Swannington Manor. PHOTO: ANTONY KELLY - Credit: © ARCHANT NORFOLK PHOTOGRAPHIC

Lord Prior thought his political career was over.

David Prior, pictured in 2010, while chairman of the Norfolk and Norwich University Hospital Trust.

David Prior, pictured in 2010, while chairman of the Norfolk and Norwich University Hospital Trust. - Credit: ©Archant Photographic 2010

Since he was defeated in the North Norfolk election contest in 2001 he has forged a career as the Norfolk and Norwich University Hospital chairman, becoming head of the high profile Care Quality Commission in 2011.

But a 'surprise' phone call from Number 10 after a Conservative victory in May has seen him return to parliament and Whitehall, with a life peerage and ministerial post too.

In our region alone, there are big issues to grapple with in the Department for Health in-tray.

The chief executive of the Norfolk and Norwich University Hospital Anna Dugdale left last month amid a report suggesting bullying at the Trust, and morale at the Norfolk and Suffolk Foundation Trust (NSFT), responsible for mental health, is at rock bottom, according to a recent report.


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The East of England Ambulance Service Trust, while on a more even keel than it has been, is about to lose its largely popular interim chief executive, who was working across two trusts.

It is a vicious circle. Improving staff morale 'comes back to leadership', he says.

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But he acknowledges there is a chronic shortage of good leaders in the NHS.

On a more practical level, he points to the need for an effective graduate recruitment programme, training, development and appraisal. But he also criticises the trigger happy approach to replacing leaders. 'You have got to trust people... and give them a chance to make some mistakes along the way. It takes time to do that. I think rather tragically in the NHS we have lost a lot of good leaders over the years,' he said.

'The average tenure of a chief executive in the NHS is two-and-a-half years. It is not long enough,' he said. 'If something goes wrong, the level of public exposure is much greater than it would be in a private company. When things go wrong in a hospital people die. The consequences of failure are dramatic. They are really, really tough jobs to do and it is not for everybody.'

He looks to the United States, which he said had a hugely different culture when it came to leadership, with medics aspiring to be managers.

'Through the medical schools we are recruiting some of the best and brightest people in the country. If just 5pc of them could be persuaded there was an alternative career in management then it would make a huge difference. In America, if you are a clinician and you go into management it is regarded as equally as great a career path as being a clinician.'

One leader who he said had done a 'remarkably good job' was interim chief executive of the East of England Ambulance Service Trust Dr Anthony Marsh.

News of the petition by hundreds of staff to keep Dr Marsh in post had reached him (through his former political foe Norman Lamb), something he said was 'quite a tribute'.

'Anthony Marsh is obviously a man who has in a fairly short time put his imprint onto that trust and is an example of a very successful leader.' Lord Prior, who is responsible for ambulances in his new role, was clear that it was up to the board of the EEAST to find a more permanent leader, but the Department for Health would have a say. 'I think the answer is that the job in the East of England [ambulance service] is not yet done, but it is going in the right direction.' While leadership is important for staff morale, the government has come under fire for its budget announcement that public sector pay would rise by just 1pc.

'To an extent the 1pc pay rise will have an impact on staff morale. But in my experience of quite a few different businesses, pay is one aspect. There are other aspects though. If you love your work, you love your job and you feel you can do a great job – and you have good colleagues and a good environment in which to work and you have a bit of a laugh and feel you are doing something useful and you are allowed to do what you do best if you are a doctor, nurse, physio – then there are other things that are important to you as well as just pay,' he said.

When it comes to money for the NHS, though, he said he was not afraid to march into the Treasury.

He said there was not much more the Department for Health could ask for above the £116bn already in the pot, but the NHS had to be funded properly.

'The argument is not embarrassing because unsafe care is not only extremely bad for patients but it is also extremely expensive. Clearly it would be naive to say money is not a factor. But there were times in the last 15 years when there has been more money than people know what to do with sloshing around the system. Changes did not happen. Money came into the system, but it did not change,' he said.

And like many across the political spectrum, he sees integration as the key to a successful future for the NHS.

'If every part of the NHS tried to paddle its own canoe, or hoe its own furrow then none of them will succeed. If they work together well there is a chance.'

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