HEALTH MINISTER LORD DARZI RETURNS TO THEATRE
Sam Lister
The Times
July 24, 2009
UK
Lord Darzi’s review of the NHS has been broadly welcomed, so why has
he decided to quit the Government now?
To watch Lord Darzi of Denham on ministerial business is to observe
a clinician first and a politician second. A radial angioplasty to
his right, an aortic valve implantation to his left, surrounded by a
bank of monitors showing blood pressure rates and real-time X-rays,
the Health Minister is in his element.
"Ah, there, he’s got it," he says in a conversation with a cardiac
surgical team at King’s College Hospital in South London, pointing to
one of a dozen screens. On the monitor, he can see that the surgeon
conducting the angioplasty in the next room has completed a difficult
manoeuvre to open up a blocked artery near the heart. The patient is
an awkward case: an elderly man with blood flow problems around the
heart bypass he had 15 years earlier.
While the minister’s managerial and political colleagues look around
with appreciation, Lord Darzi remains focused on the challenges of
the operation. "Well done him, tricky," he says, almost unheard.
The scene says much about the professional ambitions and tensions with
which Lord Darzi has wrestled as one of the country’s most eminent
doctors and — for the past two years — the20man chosen by the Prime
Minister to devise and implement a decade-long reform programme for
the NHS.
The Darzi review has marked a deliberate change of direction from
the reorganisation of the last decade. This review concentrates
on quality of care, directed at a local level and led by the staff,
rather than outputs driven by top-down targets and competition between
health providers.
While some initiatives — such as the network of health centres
which GPs claim could wreck traditional general practice — have been
divisive, the introduction of specialist care centres (such as for
heart attack and stroke), greater local control over budgets and the
devolution of more services from large hospitals to community outlets
have all been broadly welcomed by the NHS and Parliament.
The key planks of the review include encouraging innovation
and — after a big consultation — the introduction of the NHS
constitution.These changes were sold successfully to a reform-weary
NHS, in no small part because of the Health Minister’s insider
knowledge of the system.
His trip to King’s, which took place on Tuesday, was his last as a
minister after his unexpected decision to step down after just two
years in the Government.
His decision to leave has ignited controversy. He is the third of
Gordon Brown’s much-trumpeted Goats (outsiders so-named for their
introduction to a ‘Government of all talents’) to leave apparently
prematurely.
Speaking to The Times during his last week in office, Lord Darzi
insisted that the decision to cut short "one of the most stimulating
and productive periods of my working life" was no reflection on his
political masters.
"I was brought in to implement changes because of my expertise as
a clinician in the NHS, and the Prime Minister felt strongly that
I should be in a ministerial post. I didn’t understand that when
he asked, but I do now, because you need to be a minister to make
things happen.
"I have now done two years in the role, which is when you will get
your best out of an expert. If you take a colleague away from their
daily work, you are no longer an expert and it defeats the purpose
of your appointment.
You will become no different to any other politician that is available
to take office. I was brought in not for my political skills, but
because of my other interests."
His interests in the science of surgery — in his colorectal specialty
and the broader field of robotics — and medical academia are now
pulling him back to the NHS.
Lord Darzi makes self-effacingly oblique references to "keeping his
hand in" while in Westminster — he resuscitated Lord Brennan after
a heart attack on the floor of the Lords chamber and paid a visit to
Peter Mandelson at 3 o’clock in the morning when the then Business
Secretary was doubled up with kidney stones — but he clearly misses
his medical vocation.
Leaving will also ease his workload. He currently juggles his
ministerial duties and Friday and Saturday mornings in surgery with
his research and teaching programmes. His only down-time, he admits,
is Saturday evenings and Sunday mornings with his wife and two
teenage children. After Sunday afternoons of homework (schoolwork
for the children; two red boxes for the minister) he enjoys watching
Top Gear, the motoring show, with his son, Freddie. (One of the few
goals still yet to be achieved, at the age of 49, appears to be the
chance to race a car on the show).
His family life may have suffered and this may be a reason to leave
the job.
But many still question how Lord Darzi can walk away from so large a
reform programme only a year after its inception. As Olaf Wendler,
King’s clinical director of cardiology and cardiothoracic surgery,
told The Times: "If only he could have stuck around a bit longer."
Lord Darzi’s answer, in well-learnt political speak, is that the
necessary momentum has been created, with innovation — the focus
of his second year in post — the "key to achieving the quality we
are after". "We should have the confidence that this movement has a
momentum. The people working for the NHS are the champions of this,
and it is their confidence behind it. I have just helped people make
that change happen."
An important precedent — that of clinical leadership — has also been
set, he said. "I was of a generation where people said I had moved
to the dark side taking the jobs that I did, and that generation has
now totally changed," he said.
But Lord Darzi’s involvement in politics will not end. He is a
member of the House of Lords and the Privy Council and has a new
ambassadorial role for health and science. More titles for a man
who, at the last count, had 54 letters after his name, but for whom,
he insists, only three really count.
"The NHS is my work. I have done what I wanted to do at a national
level, and if any politician asked me about the health service I
will say my bit. But I still have the best part of 20 years left of
my NHS career."
A life in surgery
Professor Lord Darzi of Denham, KBE, holds the Paul Hamlyn Chair
of Surgery at Imperial College London, is Honorary Consultant
Surgeon at the Imperial College Healthcare NHS Trust and the Royal
Marsden Hospital NHS Foundation Trust and was formerly Parliamentary
Under-Secretary at the Department of Health. Of Armenian descent,
he was born and educated in Iraq. He studied medicine in the Irish
Republic and became a British citizen in 2003.
Life and times
A consultant at 31, he was in the vanguard of the revolution in
laparoscopic (keyhole) surgery.
His team at Imperial are internationally recognised world-leaders
in minimally invasive surgery and allied technologies in biomedical
engineering and robotics
The Next Stage Review on the future of the NHS was published in 2008,
after his appointment to the Government a year earlier. Immediately
prior to this, he completed a review of healthcare strategies for
London, which recommended the development of academic health science
centres and the introduction of a national network of GP-led health
centres, or ‘polyclinics’
However, he endured a number of run-ins with doctors’ leaders over the
introduction of polyclinics, with more than one million people signing
a British Medical Association petition calling on the government to
halt the project
Lord Darzi admits he broke parliamentary protocol while saving
the life of Lord Brennan after the Labour peer had a heart attack
during a debate on the Human Fertilisation and Embryology Bill. "You
forget where you are, start jumping on top of benches and I ended up
resuscitating him. I used the F-word in relation to the defibrillator,"
he said.