Cowper’s Cut 449: Leadership schmeadership
Former NHS England national data and tech director Ming Tang previously featured in these columns for her obtuse comments suggesting that provider trusts’ non-Federated Data Platform technology systems were ‘ugly babies’ (“the biggest challenge to the adoption of technology in the NHS I’ve seen over 15 years is egos”) and for her delusional refusal to admit the reality that hospital Electronic Patient Record implementations are (even after decades of practice and a duopoly of suppliers) invariably associated with a collapse in provider trusts’ performance.
So it was not an unalloyed surprise to read this week in the Financial Times that Ms Tang had been unwise enough to leave FOI-able emails showing her attempt to get National Data Guardian Nicola Byrne to make a “substantial rewrite” of a statement criticising the Federated Data Platform procurement and NHS England’s preferred bidder Palantir.
Most readers will be aware of my longstanding conflict of interest declaration that from 2021 to 2023, I was a paid member of Palantir’s Health Advisory Panel.
National Data Guardian Ms Byrne’s original draft of the blog piece said she was responding to widespread concerns about “privacy, procurement and commercial matters” to do with the FDP: “most notably in the public discourse, the involvement of one potential supplier, Palantir, is particularly contentious”.
The FOI emails reveal that having read this draft, Ms Tang wrote to Ms Byrne, “I am really disappointed that you wish to publish this document as the content will create significant problems for me and the programme”. Ms Byrne was clearly leant on further in a subsequent phone call alluded to in the emails: the published version of the blog was reworded, “some of these concerns have arisen because public discourse about one of the potential commercial suppliers, Palantir, has been particularly contentious”.
As the FT article notes, the National Data Guardian is supposed to be responsible for safeguarding patients’ confidential information and operates with “independence, autonomy and freedom to challenge the government on data matters”. Clearly, this incident tells us that as National Data Guardians go, Ms Byrne was lacking in sufficient autonomous backbone to do the obvious and right thing: tell Ms Tang to fuck off.
This comes on top of the National Data Guardian having to make inquiries about why non-clinical Palantir-contracted staff were accessing unrestricted and identifiable patient FDP data, and of the FT reporting that NHS England has quietly been adding GP data into the Federated Data platform, with NHS Cheshire and Merseyside Integrated Care Board being the first mover.
The original ministerial statement to Parliament about the FDP award to the Palantir-led consortia stated that the contract “makes strict stipulations about confidentiality”, and that “no new data will be collected, and GP data will not be part of the national platform”.
Ex-PM Keir Starmer approved £860,000 payoff to ex-DHBSC Perm Sec Chris Wormald to resign as Cabinet Secretary
Sir Keir Starmer’s appointment of Chris Wormald as Cabinet Secretary was baffling to all of us with any knowledge of his track record as permanent secretary at the Department For Health But Social Care.
Well, he who laughs last laughs lucratively, it would seem. To the news that Sir Chris Wormald has trousered an £860,000 pay-off for his troubles, all I can say is, find someone who looks at you the way Chris Wormald must look at his employment lawyer.
And spit with indignation, obviously. This is almost a million pounds of taxpayers’ money, that has been entirely avoidably wasted by the utter ignorance and incuriosity of a PM and a Whitehall system that could and should have known that Wormald had less reforming dynamism and change management zeal than a doormouse that died in 2017.
Mackey’s denial over DHBSC civil service hold-out over NHSE transfers-in wears thin
“But … but … Interim Jim told us that media speculation that DHBSC civil servants were using naked protectioninsm to deal with the obvious 18-month-old consequences of the political choice to abolish NHS England and their scheming to get NHSE staff moved into a new QUANGO was inaccurate!”
I know. It’s hard to believe that Sir James Mackey wrote about “inaccurate media speculation, which I know is always destabilising and unhelpful”.
But this week, the Financial Times joined The Times and HSJ in the ‘inaccurate, destabilising and unhelpful’ business of writing about what is very obviously happening in The Real World, which is a near-open civil war waged by civil servants who are all sad-face that NHS England staff got paid more than them, and who have sat on their hands until pretty much the last minute, hoping to strong-arm mostly new and inexperienced health ministers into the creation of a new QUANGO.
Sigh.
Nick Kituno
This comes as Health Service Journal’s Nick Kituno reports on the unsurprising news that the next substantive NHS chief executive will have equal status to the DHBSC Permanent Secretary, currently Samantha Jones.
This is, as I say, unsurprising. It’s also unimportant until such a time as greater clarity exists about how the next permanent NHS chief executive will be recruited and how the new DHBSC-dominated national operating model for system power will work in practice.
Those are, of course, not the only important factors.
The person who becomes the next NHS chief executive will be highly important, as will their personality and political acumen. If there is one screamingly obvious point about NHS chief executives, it is that the individual and their personality and reputation have an outsized influence on their potential impact.
It’s very hard to see where the person who should be the next NHS CE is coming from, and at present it is even harder to see the job as a desirable one. Which is a fairly huge indictment of the system that has been running these past five years.
Make time for ‘Minute Six’
Let’s end with a spot of good news, then. You may not be wholly surprised to learn that Professor Kevin Fong’s new book ‘Minute Six: How High-Performance Teams Navigate The Unknown’ is absolutely first-class.
Kevin is a friend, so I admit to an unreserved bias that would make me unlikely to shit-talk his book even if it had not been good. (If it had indeed not been good, the tell-tale phrases would have been ‘thought-provoking’ and ‘fearless’. Happily, this is not an ‘I would rather praise my friends’ books than read them’ situation.)
It is a genuinely excellent book: engrossing and erudite, while wearing its learning and thought lightly.
It’s always a delight as a reader to find clarity of ideas and thought, and when the package is delivered through some really excellent writing that explains complex topics with simplicity, you have the real deal.
Go and buy your copy: you will not regret it.
Recommended and required reading
Rob Findlay’s latest RTT analysis for HSJ needs little introduction beyond its title: ‘No elective recovery this year’.
The Larry Ellison Institute, sorry, Tony Blair Institute will be furious about Sarah Neville of the Financial Times reporting that medical AI has a proof problem.
Another spot of good news: HSJ reports that health economist Anita Charlsworth and Manchester University Hospitals FT CE Mark Cubbon will co-chair a new national board on NHS cancer services.
Balanced Times piece by the BBC’s Judith Moritz on the implications of the Thirlwall Inquiry Report.
HSJ’s James Illman reports on tech problems delaying real implementation of Single Point Of Access reforms of GP requests for Advice And Guidance.
A charity’s review finds that every year, about 20,000 disclosures of domestic abuse are estimated to be made to maternity services in England.
HSJ’s Dave West updates the provider league table. Should really be done as a ‘Top Of The Pops’-style thing, this.