So, the world has changed again. Locally our trust has lost yet another chief executive at no notice, and nationally that nice Mr Lansley has told the GMC to defer the introduction of revalidation for another year. Let’s look at the issues separately.
When I became a consultant, in 1989, my first CEO was the longest serving in the same hospital in the history of the NHS. Seventeen years; a record which I doubt has been beaten. He was a pit-bull in many ways (without the lipstick) but I suspect a pussy cat at heart, and although he scared me a bit I always got on well with him and learned a lot. However after 17 years you make enemies and he sure had plenty. His fall was a bit like watching the last few months of our late Prime Minister, fighting like a wounded animal, but still insisting to the end that he was right. (Since then he has proved a highly successful CEO in a neighbouring trust).
Since then we have had a succession of CEOs (five or six I think), all worthy people in their own way. But the ever-changing goal-posts of high NHS politics coupled with a top-down, bullying, target-driven management culture always defeated them in the end. Since I no longer have a management role I was only superficially acquainted with the most recent so I pass no judgement and wish him well. But I do say that 18 months is much too rapid a turn-over for such a crucial role. I do not know the back story behind his departure (there surely is one) but his farewell statement, posted on the trust website, makes fascinating reading: “I will be working at the strategic health authority, taking forward the work I have been undertaking as regional lead for equality and diversity.” Deconstruct that if you can!
I await the appointment of his successor with interest, but at a crucial time for the organisation we again seem rudderless.
The intervention of the new Secretary of State for Health in the revalidation debate in fact comes as no great surprise. The HCSA executive committee (of which I am a humble member) had heard rumours, well before the election, that the Conservatives were fairly cool on the matter. The issues of concern are obvious – the burgeoning bureaucracy and costs both in terms of financial support for the programme plus the loss of clinical time – against the lack of any objective evidence that the process had any proven benefit or merit and a challenging financial climate.
I have personally spoken and written against the GMC proposals in various places for some time. The HCSA has also made the concerns of our membership known, both in response to official consultations and also in a face-to-face meeting with Lansley last year.
Of course professional regulation is important to protect the public from the very small number of rogue doctors. However, I do not think the GMC have proved their case for the current proposals, and they have certainly failed to take the profession with them despite heavy marketing.
Twelve months gives all parties breathing space for re-evaluation. I will be interested to see what emerges.