Former Health Boss: ‘Why Travelling Would Have Made Me A Better CEO’

By on 31/07/2015 | Updated on 25/09/2020
Sir David Nicholson retired from the UK's National Health Service (NHS) in 2014.

Sir David Nicholson, who stepped down from his role as chief executive of England’s National Health Service (NHS) last year, has told Global Government Forum that learning about other countries’ healthcare systems and practitioners would have made him a better NHS boss.

Since leaving the NHS, Nicholson has travelled around the world advising around a dozen governments and a number of global organisations on health policies.

Speaking during an in-depth interview with Global Government Forum, he said the experience had provided useful connections and valuable perspective. He said excitable media reports, including those highlighting the NHS’s failure last winter – the coldest in a century – to meet its target of treating 95% of Accident and Emergency patients within four hours had led people to think that “the NHS is on its knees because of its inability to deliver that particular thing.”

However, speaking to many of his peers overseas, Nicholson realised that “there isn’t another country in the world that can deliver anything like this.” The proportion of patients seen within four hours on average ranged between 87% and 93% between November 2014 and March 2015 in England.

But as Nicholson recalled, “I was talking to some Canadians and they laughed when they said: ‘We tried to treat people within four hours in A&E’. They couldn’t get anywhere near that.

“The Australians tried it and gave up. In Sweden they started off on four hours, and now they’ve moved it to eight. It’s a very difficult thing to do. “The NHS is undoubtedly under stress, but we do [hit the four-hour target] for nine out of ten patients – and that’s remarkable. But the media, the press, everyone seems to have completely lost perspective.”

This understanding of other countries’ positions would have put him in a stronger position when speaking to ministers as NHS chief, he said: “It would have strengthened my arm in persuading politicians not to develop knee jerk reactions to the problem.

“I would have been able to stop secretaries of state ringing up chief executives of hospitals trying to persuade them to meet their target, for example.”

Nicholson also said that through his travels he has come across innovative techniques and technologies that could provide valuable lessons for the UK.

In India, for example, cardiac surgeon Devi Shetty has set up a project to deliver healthcare to people at affordable prices.

“To do that, he needs to deliver cardiac surgery for US$800 per operation.

“As a comparison, in the UK, we can spend between $7,000 and $8,000 per patient,” Nicholson said.

“So they focused their attention on how to do it and they’re doing it, because that’s all they can afford. For instance, one of the disposable drapes you put over a patient you operate on cost £150 here. But Shetty said: ‘We can only afford £12. So they went to the local business school and got half a dozen young people with MBAs and said: ‘Do it’, and they went off and they’ve done it. They’ve now got regulators’ approval to use them. So they’ve come at it from a different perspective. They asked: ‘What can we afford and still give quality?’. Fascinating.”


See also: our full interview with Sir David Nicholson

About Winnie Agbonlahor

Winnie is news editor of Global Government Forum. She previously reported for Civil Service World - the trade magazine for senior UK government officials. Originally from Germany, Winnie first came to the UK in 2006 to study a BA in Journalism & Russian at the University of Sheffield. She is bilingual in English and German, and, after spending an academic year abroad in Russia and reporting for the Moscow Times, Winnie also speaks Russian fluently.

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