Minister: Let's reset the rhetoric about NHS managers

Mon 28 Nov 2016

MiP Conference 2016: Health minister Philip Dunne promised to “reset” the political rhetoric about NHS managers, improve workplace culture and tackle bullying in the NHS, in his keynote conference speech on 23 November.

Although short on specific proposals, Dunne’s first external speech as health minister also promised action to improve NHS leadership skills, recruit more graduate management trainees and deliver parity of esteem for mental health services.

Dunne said he recognised there was a stigma attached to NHS management, which was too often seen as “the dark side” by clinicians.

“I think we do need to reset the dialogue a bit here, reset the rhetoric. I don’t personally subscribe to the view that a manager is bad and a doctor is good. And my short time in office has shown me that you only get the good healthcare by having good managers.”

He added: “There are some great leaders in today’s NHS and most managers do a great job. But the perception persists of a skills shortage across the service. I’ve already seen that it can be difficult to recruit high quality candidates to senior vacancies.

“We need to act now to improve the pipeline of leadership talent and support leaders if we are to protect health and social care for the future. I see this as a key priority for my time in the Department of Health.”

Dunne said it was “bizarre” that the NHS recruited so few graduate trainees. “It’s astonishing that we have 1.3 million staff yet we recruit only 100 graduate trainees to non-clinical jobs, while the civil service has a quarter of the staff and recruits 1,300 trainees. But that’s quite a big agenda and I don’t have an immediate answer.”

Ruling out any immediate measures to improve managers’ pay, Dunne claimed the new “use of resources” rating, being introduced by the CQC and NHS recruitment next year, would ensure the NHS was “striking the right balance between paying enough to the talented leaders we need and ensuring the affordability of the workforce.

“And making a clear link between pay and performance is something I’m keen to see as we modernise pay and conditions,” he added.

Dunne fleshed out his personal committment to tackle the rising tide of bullying in the NHS, citing staff survey findings that a quarter of staff had experienced bullying last year.

“It’s essential to tackle not only the pathology of bullying itself but also how organisations might create the positive cultures within which bullying no longer happens,” he said. “This is a shared problem; we need to recognise the seriousness of the issue not only for staff and employers but also for patients and the tax-paying public.”

“This is a complex issue; bullying is not the same as firm management, and staff need help in understanding the difference. And this is a pressing issue; leaders and managers cannot avoid facing up to the financial impact of stress-related sickness and absence on an already financially-challenged NHS.

“I’m keen to understand any initiatives that are working in this area, and if there is any evidene of results that are coming through please feel free to bring these to my attention.”

“Bullying does directly impact on patient care,” he added. “That’s why I think it’s so important and why it’s such a priority for me.” He promised to work closely with the Social Partnership Forum, whose anti-bullying work is co-lead by MiP chief executive Jon Restell.

Answering questions on improving mental health services, Dunne admitted that promises about “parity of esteem” had yet to be met. “It think the challenge for us all is to make sure that’s delivered,” he said. “It’s up to us in the Department of Health to apply some pressure to make sure this is coming through.

“I think it’s right that we’re held to account for our rhetoric on this – it’s been a clear committment of the new prime minister. It’s an important factor within the STP pro-grammes that mental health is addressed in STP proposals.”

On NHS finance, Dunne claimed “significant strides” had been taken in reducing trust deficits, but admitted there were “significant gaps” in social care funding. “I never thought we were going to get more money for the NHS out of the Autumn Statement,” he told delegates.

“But what’s quite striking is that there are some parts of the country where they are doing better than others, maybe because local initiatives are improving rates of discharge through better integration between NHS and social care providers,” he said.


Conference reporting by Craig Ryan.

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