Roy Lilley is an established, independent health policy analyst, writer, broadcaster and commentator on health and social issues. He is a former NHS Trust Chairman and is the author of over twenty books on health and health service management.
He has written for the Guardian, Sunday Times, Daily Telegraph and other newspapers, journals and management periodicals including a regular column in Pharmaceutical Marketing magazine. He runs the nhsManagers.network which produces an opinionated free newsletter four times a week which is claimed to reach 100,000 NHS managers inboxes.
He was an active opponent of the Health and Social Care Act 2012 and during the campaign produced a draft NHS Emergency Powers Act giving an alternative approach to NHS reform. In 2013 he chaired the People’s Inquiry into London’s NHS. He also chaired the 'Speaking out Summit' in 2014, on Whistleblowers in the NHS. In his spare time he enjoys painting, drawing and magic.
PRN: How would you define your role with regards you being an analyst and commentator on the NHS? – as an advocate for the people? an agent provocateur? an agent for change?
RL: I'm just an informed spectator. Because no one pays me I can say what I think needs saying and that often chimes with people who think the same and are unable to express a view. So, I regard myself as very lucky
PRN: Where does your drive and passion for the NHS stem from?
RL:I was born before the NHS and know the difference it made to my family. The thought of it being broken up horrifies me. Young politicians with no hinterland have no idea how important it is to working people. I travel the world talking about it and everywhere I go people want to imitate it, copy it and have their own NHS. It is not perfect but it is the best there is for the money we pay.
PRN:You chaired ‘The Speaking out Summit’ in May 2014 on whistleblowers, and your solution to the issue was very simple “If the NHS is properly resourced, well run by skilful, thoughtful and careful managers and enthusiastically served by staff who are skilled, trained and valued… the problem will go away.”
This is often the case with problems in the NHS – in my piece on burnout and ‘uncaring nurses’ the conclusion was simple - ‘ care for the nurses and the nurses will care better’. Why do you think simple solutions often seem to be the hardest to carry out in the NHS?
RL:The NHS is full of complexity. Careers are built on it. When you are not in the wood you can see the trees. I think it is simple. There are not enough leaders in the NHS who can take a pace back and see the whole picture.
PRN:The common thread in many of the whistleblowers stories was the appalling treatment they faced at the hands of their employers once their concerns were raised. Why do you think this type of treatment was the one so often metted out to people when as you say managers should be ‘crawling on their hands and knees to find out what’s going on at the front line?’
RL:They manage-up. There is no promotion in passing bad news up the line. So, bad news is fixed or stifled.
PRN:What has been the aftermath of the Speaking Out Summit? Have you sensed a culture shift?
RL: No, I failed. I had high hopes of the summit but I can’t say anything has changed. It was never going to be an epiphany, and maybe a few more conferences, like it, down the line might change something.
PRN:You were a vocal opponent of the Health and Social Care Act in 2012 which, amongst other things, opened the NHS up to competition, and you chaired the People’s Inquiry into London’s NHS – which aims to understand the impact of this Act across London. The inquiry set out 18 recommendations for an alternative way forward. What has been the response so far to the findings of the inquiry ?
RL:A deafening silence!
PRN: There are many different groups such as ‘Save our NHS’, ‘Our NHS’, ‘Keep our NHS public’, ‘999 call for the NHS’ which all have the same message at the heart of them. Do you think it’s time there was a more organised alliance of anti-privatisation groups in order to mount a more cohesive campaign that has one collective voice?
RL:I do. There is an election coming and instead of going for trophy constituencies and standing against the PM of SoS Health, they should target seats with known health issues and stand on the NHS ticket.
PRN:In the current climate what do you think the NHS will look like in five years?
RL:Another 5 years of flat funding will kill the NHS off. There has to be more money but neither of the main Parties is willing to commit to how much and how. It will be a poor service for poor people.
PRN:You are an artist as well as everything else – do you see a correlation between health and creativity and if so do you think the NHS should pay more attention to this, especially in areas such as care of the elderly and rehabilitation?
RL:I love to paint and draw. I find it relaxing and I can think whilst I do it. I know Art and art-therapy could have a much bigger role in healthcare. People often have talents they don’t know they’ve got. They just need an opportunity.