INTERVIEW: ROB WEBSTER
“It’s always interesting to invite people from outside to come and have a look – they recognise the quality of people we have.”
that doesn’t sound too pious. “We have to get into a position where the staff we employ and the leaders we select reinforce values-based leadership. The idea is that when we have bad apples who shout at people, bully and try to shut up whistleblowers, they become the exception and they stand out.” This extends to the non-NHS organisations the Confed works with, he says, where the question will be, do their values match those of the NHS? “The NHS does not have a monopoly on values. Lots of private sector organisations are fantastic values-driven organisations.” The issue of incompetent leaders is more difficult, he admits. There is the question of who judges incompetence, and also a tendency to blame people rather than the system when things go wrong. “As a trust chief executive I got ten times as many compliments as complaints. But we don’t talk about positive things – we’re British.” But how is the NHS going to find the resilient and diverse group of leaders it needs? “Sometimes we beat ourselves up on where we are on equality 14
and diversity,” says Webster. “We’re ahead of most FTSE 100 companies. But there is enough evidence that there is discrimination.” When he worked in the Yorkshire and Humber area, research showed that BME staff did not feel they had opportunities to progress, whereas white people felt both that they did and that BME colleagues did as well. “We need to sort it out. It can’t be allowed to continue. Different leadership creates strengths. We need to create the conditions where we have the best leaders possible to meet the toughest challenges.” He does not call for positive discrimination but stresses instead the importance of talent development programmes. “I can’t not be white, middle aged and a bloke, but I can be passionate about [the need for change].” More generally, Webster fears clinicians could be put off coming forward for top management jobs. “The tone around the chief executive leadership means... people are saying why would anyone want to do this? We could be speaking more positively about being chief executives in the NHS.” More clinical leaders are emerging, he suggests, with some fantastic indi-
viduals coming through in CCGs. Depending on how a manager is defined, four out of five managers in the NHS are already clinicians, he points out. He adds that the NHS reforms set out to deliver three things – accountability, improved outcomes, and the clinical leadership of change. “The agenda that we have and the way that we describe it has to be attractive to clinicians.” He suggests that deciding how to get the best clinical outcomes has to be a clinically led process – and that will enable “the money to drop out”. But he agrees that managers are always going to get a rough ride from politicians and the press. “We have to recognise that manager-bashing will always be a political reality. In the run up to the election I don’t expect there will be any back slapping. “But it’s always interesting when you invite people from outside to come and have a look – they recognise the quality of people we have.” Webster was particularly pleased to invite Sir Stuart Rose (ex-M&S boss and now adviser to Jeremy Hunt) to the Confederation conference. The drivers for quality have to come from inside rather than just from regulation, he says. He points out that Mid Staffs was preceded by other care failings – Bristol, Maidstone and Tunbridge Wells, Winterbourne View. “We have to be constantly vigilant about how this might happen. The way we make sure it does not happen is creating the right culture and values. What frustrates me is that if we talk about the positives people think we are denying the negative.” He is particularly positive about his regular visits to the frontline when he was chief executive at Leeds (usually working in a support role, doing “the grubby stuff”) which he is trying to continue at the Confederation. “The discretionary effort we get from [frontline staff] is superb,” he adds. “The NHS is made up of people, it is not made of buildings or drugs or kit.”
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healthcare manager | issue 22 | summer 2014