The Gloucestershire NHS is the county’s biggest employer with a turnover of around £1billion.
International businessman Peter Lachecki has just retired after five and a half years as chairman of Gloucestershire Hospitals NHS Foundation Trust, which had a huge financial black hole when he took over.
Ian Mean, director of Business West Gloucestershire, told him how he had brought the Trust back to financial health and how he had seen the challenges facing the NHS.
*When you took over, the Trust’s finances were pretty dire, weren’t they? How did you manage to resolve this?
“The surprise deficit was well over £30m. The first thing we needed to do was really understand what the scope of the problem was, and then dig into it all.
“We then had to be very transparent in what we found across the organization, our partners and the NHS.
“Little by little, with everyone’s support, it took us almost three years to get where we wanted to be.
* Was it the hardest thing you had to do in your professional career?
“Yeah, no doubt partly because some of the previous leaders had pretty much let the staff down, and as a board we stood up in front of the staff and apologized for that.”
*The NHS is Gloucestershire’s largest employer, with around 20,000 people. It’s a huge undertaking isn’t it?
“Our turnover needs to be around £1billion. I think that comes with leadership responsibilities and we have taken that very seriously, in employment, investment, sourcing and l environment to name but a few areas”
* Do you think the NHS is broken as a business model?
“No, it’s not because the NHS is still delivering excellent quality care to many millions of people across the country. Essentially, it’s still delivering, however, it’s not doing what people expect and what people who work in the NHS would like to donate.
“I think the model is not broken, but it needs structural reform in terms of long-term thinking, especially on workforce planning.
“We don’t have this longer-term vision linked to the necessary investment and without that, we run out of steam.
“And I think society has to decide what it wants to pay for.
“Longer-term workforce planning is essential, as are long-term care for the elderly and investment in public health. We are going in the wrong direction as a country in terms of general health.
“Fundamentally it’s not broken but it needs longer term investment. Politicians are often not prepared to do that.
*How will we reduce the waiting lists which now exceed 6 million?
“It will take a long time.
“Even if you could bewitch money, you cannot bewitch people.
“One of the things NHS staff do is look at priorities for people who are on waiting lists. So it’s not just in chronological order.
“There is no magic formula. The responsibility of leadership is to be honest with people and to keep them informed of what is happening.
“People could wait a year and more for a considerable time to come.”
How long will it be before we get to an appropriate hospital and social care plan for the NHS that works?
“It’s a million dollar question. There has to be a proper joint strategy between social care and health.
“Locally, everyone is doing a great job, but essentially the jobs in the social sector are very poorly paid.
“People have wrongly labeled them as less qualified, but it’s criminal to say that. This is a structural problem in welfare.
“What does society want? Are we interested in taking care of our
elderly and more vulnerable or are we more interested in potholes. Are we becoming a less compassionate society?
*If you were health secretary tomorrow, what would be your priority?
“I would like to think that I would look at the longer term issues.
“Workforce planning, how does social protection actually work, how do we invest in preventing ill health and health care inequities.
“All of these long-term things not only improve the health of the nation, but they’re actually likely to be cheaper for the taxpayer.”