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Editorial Monday 4 July 2016: Why Simon Stevens is the Heineken of leaders

Health Service Journal's leak of Simon Stevens' weekly email to NHS staff shows why he is the Heineken of NHS and public sector leaders: he refreshes the parts other leaders cannot reach.

Simon puts the Government on notice that the Leave campaign's funding commitments must be honoured, and puts clear markers down to support staff who come from beyond the UK.

His next health select committee appearance on 19 July, at which he will give greater detail on the NHS 'ask' for the Europe transition, promises to be a popcorn-worthy event.

Setting the agenda; framing the issues; being 'the voice of the NHS'. How does Simon pull this off?

Firstly, because when it was flagrantly clear that nobody was in charge following the mess of the Lansley reforms, Simon decided that he was. Nobody disagreed with him, from the Prime Minister sideways.

Secondly, because whoever becomes the next Tory leader, the party will still be traumatised by the 2012 Act - and no less inclined to carry on the policy of offshoring all policymaking to Simon Stevens.

So the day is saved, and we can all relax?

Um, no.

As Nida Broughton of the SMF demonstrates and the splendid Flip Chart Rick concurs, the financial consequences of the advisory referendum's Brexit majority are very bad indeed for tax revenues.

The Office for Budgetary Responsibility have cancelled their planned July forecast because the uncertainty is so high.

Even before this, NHS finances were fucked.

The referendum's unique, deeply special act of national economic, political and cultural self-harm makes things far worse.

Sterling's steep fall; the total uncertainty about the situation for non-UK health and social care staff; and a highly likely recession mean lower tax revenues to fund the NHS, and a smaller pool of potential staff from which to recruit - let alone to retain those staff who now feel unwelcome.

So why won't any new Tory leader/chancellor/health secretary look at this and say, 'right, not having lèse-majesté, you're fired, Simon Stevens'?


Because they voted for the 2012 Health And Social Care Act. Which makes it unambiguously clear that they can't fire the chief executive of the NHS Commissioning Board.

Only Chairman Mal can. And that ain't going to happen.

More to the point, Simon has the unique combination of money in the bank and a globally high reputation which leave him in about as strong a negotiating position as you're likely to find. Unlike whatever expert migrants we hire to do the Brexit negotiations on our behalf with the highly experienced negotiators of the EU. Yep, that's irony, right there.

Why has Simon Stevens done this? For the two best reasons in the political playbook.

Number One: because he can, and because nobody can stop him.

Number Two: because it's the right thing to do.