In Grant we trust to defend the NHS (1 of 3)

November 10, 2011

You report that students at University College London have passed a motion of "no confidence" in Malcolm Grant, provost of the institution and the new chairman of the NHS Commissioning Board ("Running £730m UCL budget is a part-time job", 3 November). At the end of the article, you quote me as one of those who has welcomed Grant's appointment. Perhaps I could amplify my reasons for supporting his dual roles in the short term, and for his continuing NHS position in the longer term.

While I remain a strong opponent of health secretary Andrew Lansley's NHS reforms, I recognise that his plans may well pass into law. Opponents of the reforms need a Plan B. My Plan B is to fight for effective and accountable leadership of the new NHS structures created by Lansley. Such leadership needs to have at least three characteristics: proven leadership and management skills; independence of mind; and a commitment to improving the quality of care for patients using the NHS.

First, Grant has a proven track record of leading one of the world's top research-intensive universities from a period of uncertainty in 2003 to one of sustained strength today. He has built a highly effective management team and academic faculty to deliver some of the highest standards of education and research in the contemporary UK university sector. To have achieved this in only eight years is little short of remarkable. It is this proven track record of leadership success that is so crucial to the NHS at a time of enormous and potentially dangerous change.

Second, Grant's independence of mind is shown by the fight he had with the Labour government over a public consultation on genetically modified organisms, a fight he won.

In his evidence to the Commons Health Select Committee, he again demonstrated his independence by describing the Lansley NHS bill as "unintelligible" and "confusing". Grant is clearly no government patsy: on the contrary, he has stressed his commitment to promoting collaboration in the NHS while opposing fragmentation, a key concern for those of us opposed to the bill.

Third, his commitment to improving the quality of NHS care is evident from his leadership at UCL. He has worked hard to position the university as a driver for better patient care through the creation of UCL Partners, a supremely coordinated network of specialist NHS services that is enhancing the delivery of patient care in London.

One final point. I know the man. He is someone with exceptional personal integrity. He has not commercialised UCL - far from it. He has looked deep into the university's history - its founder was, of course, Jeremy Bentham - to formulate a vision that has reinvented UCL as a truly global university, putting its educational and research capacity in the service of equity and social justice around the world. These are the values that are so precious to the future of the NHS.

There is not one shred of evidence to suggest that Grant has been "complicit in the carving up of the NHS", as the student motion states. Nor does he have "a track record of actively undermining public services". In Grant, the NHS has a passionate and successful defender of the core values that underpin our health system. His appointment should be welcomed and supported.

Richard Horton, Editor-in-chief, The Lancet

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