In England, the NHS is run by an organisation with an identity crisis. It calls itself NHS England, but that’s just self-promotional branding. In law, it is the NHS Commissioning Board, created by Andrew Lansley’s controversial 2012 reforms which gave the NHS a high level of autonomy from direct government control.
The NHS Commissioning Board was first run by ex-Communist Sir David Nicholson; then by a former Labour councillor and ex-New Labour special advisor Sir Simon Stevens, who steps down at the end of July. Based on that trajectory, a cynical observer might suggest that in the distant future even a former Liberal Democrat could one day get the job.
But could the ‘NHS England’ top job go next to a prominent Conservative? And could it be the infamous head of the test and trace programme, Dido Harding?
Speculation among NHS ‘lifers’ about Steven’s successor began as soon as he announced his retirement in April. Stevens will certainly leave a gap in the organisation. His tenure is widely seen as successful, given the NHS has recently had the lowest increases in funding in its history. The NHS has also coped as well as possible during the Covid-19 pandemic: it adapted fast to the massive surge in demand for critical care provision for the sickest; and segued into the brilliantly successful roll-out of the vaccines procured by the Vaccines Taskforce under the leadership of Kate Bingham.
Sir Simon won funding increases for the NHS under every government administration he worked with. His mastery of his brief in front of select committees and interviewers was machine-like and his political skills are widely admired. He was a ‘golden boy’ hire for Cameron and Osborne, who could rarely resist an authentic Blairite and they rarely denied his requests for funding.
Stevens’ competence and savvy meant that most people outside the health world didn’t spot the increasing underlying deficit