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News: the NHS at last has a CEO with true moral courage: focused on patients, not targets

March 29, 2013

Few men are willing to brave the disapproval of their fellows, the censure of their colleagues, the wrath of their society. Moral courage is a rarer commodity than bravery in battle or great intelligence. Yet it is the one essential, vital quality of those who seek to change a world which yields most painfully to change.     

Ernest Hemingway (1899 – 1961), A Farewell to Arms, 1929

Sir Bruce Keogh is the courageous, bold hero that the NHS – and its patients – needs. On Thursday he visited the Leeds General Infirmary to present evidence that the children and babies there might not be getting the highest standard of care and the Trust immediately decided to suspend operations, pending a detailed review. This was the right thing for the Trust to do and they should be applauded.
As Medical Director of the NHS, Sir Bruce listened to concerns amongst the UK community of cardiothoracic surgeons, and spoke to surgeons and cardiologists as well as personally reviewing the data showing a death rate twice the national average.
You’d think, and as a parent and doctor I’d hope, that such a clear, bold move – one totally focused on saving the lives of the most vulnerable patients the NHS cares for – would be universally applauded. Especially so after the many recent, clear examples of senior NHS managers failing to act on clear evidence of sub-standard care in Mid-Staffordshire, Morecambe Bay and others hospitals across the NHS.
Worryingly, some of the comments reported today appear to challenge the fact that Professor Keogh acted out of anything other than total focus on, and passion for, NHS patients and a determination that mediocre standards have no place in a modern healthcare system. I’ve even seen comments suggesting that Sir Bruce should have waited until after the Easter weekend as the NHS is undergoing reorganisation. Maybe I’m naive, but I think that the time to save lives is when you can, not when it suits a political or religious timetable!
To those of us who have met Professor Keogh and seen him at work it will come as no surprise that he took brave, decisive action even though in his own words the timing was “embarrassing”, coming so soon after much legal wrangling about how the NHS should provide paediatric cardiac surgery.
“As medical director I couldn’t do nothing. I was really disturbed about the timing of this. I couldn’t sit back just because the timing was inconvenient, awkward or would look suspicious, as it does.”


These are the words – and the values – of a true leader, one with deeply held values and a conviction that doing the right thing for patients is not a choice – but a moral imperative. We’ve seen it many times before from Sir Bruce when he has spoken out about the scourge that is variance in the NHS, or the disgraceful fact that large parts of the NHS gives substandard care 104 days a year. And of course it was he who “braved the disapproval of their fellows, the censure of their colleagues, the wrath of their society” when leading the demand that adult cardiac surgery outcomes and mortality data be made public – a step that remains a shining example of medical leadership in the UK.


At last the NHS has an example of true courage, someone not afraid to do the right thing, at the right time, for the right reasons – protecting patients and improving the NHS for all.


Being a modest man, he would be the last to admit it – nor indeed to want the job – but if by chance there should happen to be a pressing need for a courageous leader to make the NHS truly great again, there is one man who fulfils Hemingway’s criteria. Sir Bruce truly has the “one essential, vital quality of those who seek to change a world which yields most painfully to change”.

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