The Health and Social Interview: Chris Smyth
As the NHS reaches its 70th birthday, all eyes are turning to this great institution to appraise where it has been and where it will go next. The Health and Social interview series delves into the minds of respected health leaders, who offer their views on the future health landscape.
Our second interview is with Chris Smyth, one of the UK’s most prominent health journalists. Chris Smyth has been Health Editor of The Times since 2015. Before this he had been Health Correspondent there since 2010. Over the years at the paper he has written on health policy, medicine, science, culture and politics, and has been a news reporter, letters editor and obituary writer. Previously he worked in the Brussels bureau of the Financial Times. Chris has a PhD from Cambridge University on the scientific culture of the English enlightenment, a Masters in the history of political thought and an undergraduate degree from Oxford. He is author of a novel, Dinner at Mine (Simon & Schuster 2012), and co-author with Professor Robert West on an evidence-based guide to quitting smoking, The SmokeFree Formula (Orion 2014).
If you could change one thing in the health and care system, what would it be?
The boring answer is the way in which services are set up around organisations, not patients, but national policy is already trying to do that. More fundamentally, closing the ‘them-and-us’ divide that exists between frontline staff and management, encouraging doctors particularly to get involved in the organisation of services and try to change it for the better, rather than just moaning about problems.
Will NHS England and NHS Improvement continue as separate organisations or is a merger on the cards?
As soon as the legislation allows it I should think they’ll merge. In practice it’s happening, which should help give local trusts more consistent direction, and Simon Stevens seems to be winning the battle for control.
How long do you think Simon Stevens will stay on for? And any ideas who might succeed him?
Now that Theresa May is loosening the purse strings, he’ll want to stay to take credit for the extra cash and write his own plan for the next 10-20 years of the NHS. Perhaps also to help steer through legislation to undo the Lansley reforms. But questions about whether he is the right man to do the detailed implementation work will remain, so he may decide he’s had enough shortly after that.
What do you make of STPs/ACOs/ICSs and their chance of success?
They will work in some places and not in others. Where local leaders have good relationships and aren’t too distracted by the constant change of acronym there is a good chance of seeing more joined up services and eliminating glaring fault lines. But the idea that they will save money seems over-optimistic.
Single biggest challenge for the NHS?
In the short-term: getting itself out of the mess it made for itself by failing to realise how many more doctors and nurses it was going to need to care for an ageing population. In the long term: persuading voters and governments that there is just no way round the need for substantial tax rises as health takes up an ever-growing share of national income.
What’s going to be headline news in the health world this year?
There is a lot of headline news in health! Apart from NHS funding and its long-term plan, the battle over obesity will be fascinating as the government sets out to change the way Britain eats.
If you could interview one person, who would it be and why?
We’re lucky enough to be able to interview most people we want now and then but there is one glaring exception: civil servants. The government does its best to keep officials away from the media (with some honourable exceptions in quangos). Why Whitehall is so terrified of journalists speaking on the record to people who actually formulate and implement policy is baffling.
How can we improve innovation in the NHS?
Stop talking about nebulous words like ‘innovation’. Ask people on the frontline what they need to help them do a better job for patients and let them make the link to novel products, drugs, devices and techniques. Then they’ll actually want them and make it happen.