It would be interesting to hear from the Secretary of State for Health and Social Care any day. But on the morning Matt Hancock was due to speak to Leaders In Healthcare 2018, the cabinet was in turmoil and the Brexit Secretary had just resigned. Naturally the delay to the Secretary of State’s appearance piqued the audience’s interest. When he arrived on stage he apologised for “a busy morning” but did not use the B-word once in his talk. Nevertheless Hancock shared a vision for his leadership of the leaders of the NHS.
“There is a difference between achieving targets and transformational change”
Hancock implicitly rejected recent history of the NHS by downplaying the importance of targets. This was in keeping with other snappy soundbites in the speech. He argued that NHS leadership needs to “Empower, not direct”. Together, these comments hint at a light-touch leadership rather than the dramatic managerial leadership of the NHS reorganization under Andrew Lansley or the Labour government, and a less confrontational approach that his immediate predecessor.
Perhaps playing to the audience, Hancock seemed to challenge the conventional wisdom that the NHS is bogged down by middle managers:
“We need more leaders in the NHS”
But fascinatingly, in the next breath, Hancock called for “less hierarchy”. This is certainly in keeping with our ethos at Medical Leadership in the Foundations. Leaders must emerge at all levels of the NHS. Prior to this session, one audience member had claimed that consultants are too busy focussing on the big picture to empower their juniors to make small changes. More leaders across a flatter hierarchy is a way of mitigating this dissatisfaction.
Learn, Not Blame
The risk of gross negligence claims in an imperfect system is another concern of junior doctors. Hancock explained that he had listened to voices in the NHS calling for organizational learning rather than blaming individuals when things go wrong.
“We need to get much better at learning from our successes – and our mistakes.”
Hancock emphasised that this is about leadership because leaders create culture. He highlighted the virtues of “integrity, honesty and transparency” and argued that spotting and acknowledging mistakes is a necessary prerequisite to improving systems. Hancock called for “a culture that expects and requires open learning”.
Diversity of Thought
The other theme of the speech was unity in diversity. Hancock argued that the NHS needs a plurality of perspectives in order to move forward, borrowing the phrase “diversity of thought” from actor Idris Elba.
Specifically this meant increasing the numbers of women in NHS leadership. 75% of NHS staff are women, but only 40% of board members are female. While it doesn’t necessarily follow that 75% of board members should be female, Hancock claimed that 500 more women board members were needed in order to achieve gender balance.
Hancock also rejected the divisions between professions, and between the frontline and the leaders.
“Not us and them, but We The team”
All in all it was an attractively positive message. Although out of kilter with the big challenge the country faces – the big thing on the Secretary of State’s mind that morning – the speech set out a positive vision for a united, diverse, learning NHS led by leaders of integrity. Hancock acknowledged that he is learning fast 4 months into the job. Time will tell whether he will show the integrity and wisdom to lead the NHS through whatever comes next.
The Secretary of State for Health and Social Care’s address took place on November 15th 2018 and was part of Leaders In Healthcare 2018 held at the ICC, Birmingham.