A Provider Perspective

Abstract

In my two-year experience as a chief executive I have found a widespread tendency to greatly over-simplify trust status. This has led to casual observers adopting a stance regarding NHS trust, often based on the most flimsy acquaintance with any facts concerning them. For me, the reality of ‘self-government’ has been a complex blend of liberation, frustration, enervation and a heightened sense of both organisational potential and personal achievement.

I have no doubts that trust status has very positively aided the development of Christie Hospital; however I can be equally confident that few first wave chief executives could be as unequivocally positive as myself. Much of this relates to our former position as one of four units within a very large, financially challenged teaching authority. The Christie is a specialist cancer centre with substantial research and specialist facilities which are almost entirely non-exchequer funded. As such it was always a cuckoo in the health authority nest. Attempts at becoming the first non-London special health authority had failed and consequently the prospect of self-governing status was immediately attractive to a number of key opinion formers on the site. This is not to down play both the internal and external opposition to the Christie Trust Application, but rather to indicate at the outset that the organisation had an instinctively more positive reaction to the allure of trust status than was the case in many other places.