‘I always knew that my anchor was health’: GGF’s latest Leading Questions podcast with former UK health department chief, Dame Una O’Brien
In this episode of Leading Questions, Una O’Brien, who was permanent secretary of the UK Department of Health between 2010 and 2016, joins podcast host Siobhan Benita for a chat about her unconventional route into the civil service, and what she learned along the way.
Having been appointed health department permanent secretary just as a coalition government was formed, and responsible for implementing sweeping and controversial healthcare reforms, Una was right in the thick of it – being scrutinised before a parliamentary committee no less than 28 times.
It was a “bumpy” ride, she admits, but one she was absolutely ready for – not least because a breadth of experience acquired outside the civil service in her 20s stood her in good stead for the challenges to come.
Listen to the podcast here:
The daughter of Irish immigrants who were “firm believers in giving back”, Una decided to pursue a career in either politics or the civil service.
She soon realised she wasn’t cut out for the misogynistic political environment in the UK at the time – “I wasn’t prepared to fight that fight”, she says, acknowledging that other women had “much more moral courage than I did”.
So, when viral meningitis struck leading to months in hospital, Una re-evaluated her career path, and after 10 years in politics and parliamentary and academic research, moved into the health sector and later the civil service Fast Stream, landing first at the Department of Health in her early 30s.
Though she went on spend time in the Cabinet Office and transport department, she always returned to health. As she describes, the experience prior to joining the civil service that had “the most profound effect” on her in the decades afterwards, was the three years she spent working to set up a hospice and care centre for people with AIDS and HIV “right in the white heat of the controversy about that disease” in London in the late 1980s.
She saw first-hand the people who were on the receiving end of poor care and discrimination and who felt excluded from public services – something that “gave health a centrepiece in my inner world” and spurred her on in subsequent work.
Having risen up the ranks – Una spent time as the health department’s director general of policy and strategy – she was appointed permanent secretary exactly 20 years to the day since she joined the civil service. She describes vividly the vision she had while waiting to go into the interview room of all the women who had supported her in the past standing behind her, willing her to succeed, and thinking “I can’t let you down”.
She also shares the part she played in the Bristol/Kennedy Inquiry into children’s heart surgery at the Bristol Royal Infirmary and an inquiry into poor care at a hospital in Staffordshire. The latter led her to the “deeply hurtful” realisation that her department’s responses to letters from patients’ families lacked empathy and that troubling patterns of substandard care had been missed – leading to reform of the department’s handling of letters from the public.
Going on to touch on her current work as a career and leadership coach, insights into working with ministers, and the skills needed in this new world of hybrid work, this is an episode packed with personal reflections from a leader whose motivations never wavered.
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This is the fifth episode of Leading Questions Series 3. Other episodes feature:
Phindile Baleni, South Africa’s cabinet secretary
Noreen Hecmanczuk, senior adviser to the US federal CIO
Iain Rennie, New Zealand’s former public service chief
Israel Pastor Sainz-Pardo, the Spanish government’s deputy director of learning
Guests on upcoming episodes include Taimar Peterkop, Estonia’s secretary of state, and Andy Haldane, former chief economist of the Bank of England.
Listen to all episodes of Series 1 & 2 here: Leading Questions podcast: civil service leaders share what they learned from their time at the top.
We are searching the globe to find the best examples of public sector leadership for Leading Questions Series 4. If you’d like to recommend someone to feature in a future episode, please get in touch.
About Mia Hunt
Mia is a journalist and editor with a background in covering commercial property, having been market reports and supplements editor at trade title Property Week and deputy editor of Shopping Centre magazine, now known as Retail Destination. She has also undertaken freelance work for several publications including the preview magazine of international trade show, MAPIC, and TES Global (formerly the Times Educational Supplement) and has produced a white paper on energy efficiency in business for E.ON. Between 2014 and 2016, she was a member of the Revo Customer Experience Committee and an ACE Awards judge. Mia graduated from Kingston University with a first-class degree in journalism and was part of the team that produced The River newspaper, which won Publication of the Year at the Guardian Student Media Awards in 2010.
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