OCTOBER 2016 Harkness Report THE NEWSLETTER OF THE HARKNESS FELLOWS ASSOCIATION imon Stevens, the Chief Executive of NHS England, who The changing face Sis due to speak to the HFA on Monday Octobers 31st in London is a Harkness Fellow himself. of the NHS He spent 18 months in New York in 1994- A profile of 95 with bases at the Columbia University School for Public Health and the City’s Simon Stevens, health department. He will not forget his time at the latter. It was there that he met his wife, Maggie, an American the Chief Executive public health specialist. The department was testing a new innovative therapy for of NHS England. homeless people and prisoners suffering from multi-drug resistant tuberculosis. It proved so successful that it was introduced into India by WHO to fight TB. Was he daunted at the prospect of becoming the head of the largest employer in Europe with some 1.4 million had won universal endorsement from the Some 44 areas have been identified where employees, a budget of £110 billion, and medical establishment, a wide array of this better collaboration is being explored. a service that was constantly scrutinised patient groups and the media. He then Under the 2012 Act, which established by the media, ministers and high powered spent a decade in the international private NHS England, his team are public officials lobby groups such as the BMA? Not at all. sector, with an American firm, United not civil servants, with more freedom to He could not have been better prepared. Health which provided services in the US, speak out, which he has seized. His well After picking up an Oxford degree and Europe, Brazil, India, China, Africa and the received five year forward plan in October an MBA from Strathclyde University, he set Middle East. 2014, left no doubt who was in charge. out in 1988 on an NHS graduate training From the start of becoming NHS chief on He has been open and forceful about scheme in the first week of which he April 1 2014, he made it clear that one of the current government’s squeeze on the worked as a porter in a Durham hospital. his first priorities would be to correct the service and its readiness to renege on He went on to become a frontline senior most damaging fault in the original NHS earlier agreements. Between 1948 and manager on multiple fronts: hospitals, structure: a GP service totally separate 2010 spending on the NHS averaged a mental health, community services, from hospitals leading to patients with 3.7% annual increase. Since 2010 it has primary care and health commissioning chronic conditions increasingly passed averaged 0.9%. in the North East, the South Coast and from pillar to post. The financial crisis He openly admits the new NHS will look London. From there he moved into the helped him take up this cause. The need different: “It is tempting to think in a heart of Whitehall, first as the principle for more collaboration between hospitals, country so concentrated that everything policy adviser to two successive Labour GPs, and social care became acute as should look the same everywhere. I do health secretaries (Dobson and Milburn) local councils, faced with up to 50 per not go along with the view that one size and was then poached by 10 Downing cent cuts to their budgets, were forced to fits all. I am happy with diversity because Street, which had admired his skills in the shut down a large number of care homes different starting points might need formulation of the NHS Plan 2000, which creating massive bed blocking in hospitals. different approaches.” in 2011, but had produced the hard copy for Peter Maxwell Davies (pg 14 and 15), two WHAT’S INSIDE people where we only had a home address. visits by fellows to Eltham Palace (pg 16) and This is the last hard copy of the Harkness If you have an email address can you please Syon Park (pg 15), a report by Peter Jenkins Report you will receive. We’ve produced five send an email to Rachel Arnold at on the Iran nuclear deal (pg 10), and then of them in the last six years. We’ve enjoyed [email protected]. Overleaf Judy Hargadon the usual succession of lectures examining doing it, but we are ready to make way for reports on a new survey she has organised the refugee crisis, the media, the UK’s someone else. Coinciding with our views, the to update our records. Her survey form is problems with the EU, new challenges facing HFA committee had come to the conclusion enclosed with this report. democracies, and the difference between that the Report should be confined to We hope you will enjoy this last bumper issue. running the Tate and the Royal Opera house. being online. The printing and the post are It includes all the reguilar features: news on Malcolm Dean Editor and expensive. We’ve been online since we started fellows (pg 2 and 3), obituaries which include Veronica Plowden Assistant Editor 2016 SURVEY established an international network of Harkness news Fellows and Simon is currently working to Your help please for our 2016 survey establish a new think tank in Finland. www. We enclose with this latest Harkness Report centreforwelfarereform.org a request to send us your up to date contact Alison Gomme (HF1990-91) was information. It is over 15 years since our awarded a CBE last year after retiring database was updated so this is definitely over- from running the Isle of Man prison and due. And we have an extra reason for wanting probation service for 6 years, following her to be sure we can easily contact all Harkness Daniela Abravanel (HF 1977-8). career as a prison governor. Fellows – 2018 sees the Centenary of the Her book Secrets of the Hebrew Alphabet Aphra Green from New Zealand setting up of the Commonwealth Fund and we has been translated and published as an has recently returned from a three- would like to be able to engage with all former ebook. It can be found on Amazon. month Harkness Fellowship, under the Harkness Fellows as plans are developed to Adrian Beecroft (HF 1974-6) has Fulbright umbrella, in the USA where she celebrate this. For many of you we only have become a trustee of the MCC and of the was based in the US Federal Department of postal addresses, and yet we imagine that most National Science Museum Foundation. Justice. Her research compared evidence-to- Harkness Fellows will have an email address. Dr Diane Bell (HF 2010-11) is Director action criminal justice reform programmes The Harkness Fellowships Association plans to of Insight at Cobic Ltd. After her currently under way in the US, as well as catch up with the times – this report is the last undergraduate degree from the University having a particular focus on bail decision- one that will be printed and posted to you. In of Cambridge, Dr Bell completed her making tools there. New Zealand Harkness future there will be electronic newsletters. In medical training at Imperial College Fellowships are for emerging New Zealand addition to checking your contact information, Medical School in London, then specialised leaders in any field of study or vocation we have asked an additional question about in internal medicine and public health. (excluding health care policy and practice) your areas of interest. Harkness Fellows Her interests lie in the influences to study or research in the US for between have a wide range of careers and expertise that health care systems have on the eight and twelve weeks. as the follow on discussion at our regular practices of individual clinicians. Her Tom Hayhoe (HF1978-1980) is Chairman topical lectures attests. Knowing more about Harkness Fellowship was spent under the of West London Mental Health NHS Trust, Fellows’ areas of interest will help us tailor the mentorship of Prof Larry Casalino at Weill responsible for local mental health services programme. Please do let us know if you have Cornell Medical School, New York, and in Ealing, Hammersmith & Fulham, and suggestions of speakers or topics for future she has been a visiting Fellow at the Kings Hounslow, and for Broadmoor Hospital. gatherings. Fund health policy think tank in London. David Hoare (HF 1975-7) was appointed Living outside the UK? She has been director of strategy at Chair of Ofsted, Britain’s Schools Inspection Please still send us your information. We several payer organisations in the NHS and Agency, in September 2014. ( Office for know that you may only occasionally be able she led the planning, development and Standards in Education, Children’s Services to attend our talks or the Harkness Birthday implementation of some of the first large and Skills). dinner in London, but with the developments scale capitated outcomes-based contracts Dr Terry Kemple (HF 1992-3) is currently in communication technology there may in England. She has recently collaborated elected President of Royal College of be ways we can get the Harkness Family with Nicholas Hicks (HF1991-92) General Practitioners 2015-2017 together without being in the same room. The writing about the lessons beginning to Bridget Kendall (HF 1978-80) the BBC’s committee is looking at ways we can enhance emerge from English developments in diplomatic correspondent becomes the first our offer for Fellows living in other countries. value-based and ACO-like care which may female master of Peterhouse, Cambridge. In case you have mislaid the form, it can also have international relevance.