Personnel Today interviews: Steve Barnett, chief executive, NHS Confederation

As the NHS is thrust into the spotlight over issues including inadequate management, ‘unjust’ pay awards and high sickness absence rates, Steve Barnett, chief executive of the NHS Confederation remains adamant the health service is on the right track.

Since Lord Darzi’s Next Stage Review was published last July, highlighting the need for a new workforce strategy in the NHS, with front-line staff given more power to initiate change, the organisation has been repeatedly forced to defend itself against damaging reports and surveys regarding its staff.

In March alone, the Healthcare Commission revealed “appalling” standards of leadership and management at Mid Staffordshire NHS Trust had led to patient deaths, top NHS chiefs were found to have enjoyed pay awards three times higher than the average for the public sector, and the Fit for Recovery report by think-tank Reform showed high NHS sickness absence rates cost the service £1bn a year.

Independent body

As an independent body representing 95% of NHS organisations, the NHS Confederation has an instrumental role to play in helping the government to address the problems within the health service.

Holding his hands up to admit where failures have occurred, Barnett remains defiant, insisting improvements are being made in the NHS and trends are heading in the right direction.

“Staffordshire was absolutely shocking and there certainly was a failure of leadership there, I wouldn’t pretend otherwise.

But that does not mean it is indicative of something systemic across the NHS. [The media and politicians] pick up on a few small bad examples and extrapolate and generalise in an inaccurate and unfair manner,” he said.


With many recent criticisms of the NHS centred on poor management processes, promoting good leadership and changing the way managers are perceived in the health service is the Confederation’s natural priority, said Barnett.

Concerned that this culture of manager bashing across the NHS and public sector has made managers an “easy target”, Barnett is now calling for a new narrative around NHS managers to balance perceptions about their role within the organisation.

“It’s easy to talk of managers as though they are part of some bloated bureaucracy, overpaid, not contributing sufficiently to making public services work properly – but the fact of the matter is that any large-scale organisation has to have an infrastructure of management.” he said.

“I would like to have a much more honest and open debate including politicians, the media, leaders of public sector organisations and trade unions, where a more honest description is given of the roles of managers in these larger organisations and why it is necessary for these big organisations to have some sort of management infra-structure.”

For perceptions to change, managers need to ensure they are integrated within the service, and HR functions have a critical role in helping them to achieve this, he said.

He urged HR to ensure management development programmes are closely linked to patient outcomes so managers do not work in silos but as part of the care team responsible for delivering treatment to patients.

Refusing to be drawn on figures from the NHS Boardroom Pay Report 2009 that trust directors enjoyed on average a 6.4% pay award in 2008 – compared with only 2.2% for nurses – Barnett said: “If we want to retain and attract good talent into the NHS then rewards have to be sufficiently competitive to do that. But that isn’t to say we’ll pay over the odds.”

Sickness absence rates

The publication of the Fit for Recovery report by think-tank Reform dealt a further blow to the NHS as employees were found to cost the service £1bn a year by taking an average 12 days off sick, compared with 7.2 days in the private sector.

Defending the health service, Barnett admitted while sickness absence rates are “still too high” they are continually dropping. The NHS is one of the few areas of the public sector which is showing a steady decline in rates, he added.

To bring absences down at a faster rate he said HR functions must ensure staff ratios are correctly balanced to meet demand, that return-to-work interviews are carried out as a matter of course not an optional extra, and that sickness absence is more closely monitored so problems can be quickly pinpointed and investigated.

Corporate responsibility

But far from focusing all their attention on internal strategies to deliver better NHS services, Barnett also called on individual health organisations to act upon their corporate social responsibility during the recession.

He said HR functions within the NHS should work closely with local agencies such as jobcentres and educational organisations to create jobs and offer their resources for training opportunities and career guidance to ensure the economy locally is the first to come out of the recession.

Barnett’s CV

  • Feb 2009-present – Appointed chief executive of the NHS Confederation
  • May 2008-Feb 2009 – Acting chief executive of the NHS Confederation
  • 2005-2008 – Director, NHS Employers
  • 2001-2005 – Senior HR director, Home Office
  • 1998-2001 – Deputy director general of HR for the NHS, Department of Health
  • 1994-1998 – Director of HR and organisational development, Central Manchester healthcare NHS trust
  • 1991-1994 – Director of HR and organisational development, Leicester general hospital trust.

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