Harassed, pulled every which way, but committed to her workers

June 7, 2002

Maggie Pearson has to turn the NHS, the third largest workforce in the world, into a learning organisation. She spoke to Claire Sanders

Maggie Pearson's job is best seen as one long balancing act. Pearson, the deputy director of human resources for the Department of Health, arrives breathless for this interview. "You'll have to excuse me," she says. "I got the late train this morning from Liverpool." By "late" she means that she missed her normal 5am start. Her next appointment is at the Department for Education and Skills. She has just under an hour to outline exactly what she does - and what that means for universities and colleges.

Her post, which she took up last October, is a new one. "I have responsibility for the learning and personal development of the National Health Service workforce," she says. "For the first time, medical and non-medical learning have been brought together." She covers pre and post-registration health education as well as quality assurance and partnership arrangements. The University of the NHS, a manifesto commitment, also comes under her remit.

She describes the NHS workforce as "massive". "The NHS is the third largest employer in the world, topped only by the Chinese army and the Indian postal service," she says. It is her job to turn the NHS into a "learning organisation". Delivering a workforce fit for the future is a key part of the delivery contract signed between the DoH and Number 10. "The commitment to creating a learning organisation comes right from the top," she says.

But it is not yet clear whether this political expectation is backed up by funding since the NHS University has not announced its budget. "The NHS already spends £2.5 billion a year on education and training," Pearson says. "Some of this can be better spent."

Last November the DoH published Working Together - Learning Together: A Framework for Lifelong Learning in the NHS . Health secretary Alan Milburn described the framework as "fundamental to delivery of the NHS Plan". As such, it is equally fundamental to the success of the Labour government.

The framework, in keeping with the NHS Plan, placed the patient at the centre of reform. "Lifelong learning is about ensuring our staff are equipped with the skills and knowledge to work flexibly in support of patients, and supported to grow, develop and realise their potential," Andrew Foster, director of human resources for the NHS, writes in the foreword. The framework sets out to create a skills escalator for staff through flexible courses delivered on new technologies.

Pearson adds: "To deliver on this, we need to work with our partners in higher education. This means bridging the different traditions and cultures in higher education and the NHS." She is in a good position to know, having worked in both academia and health. Before coming to the DoH, Pearson was regional director of research and development in the NHS's Northwest regional office. She holds a chair in health and community care in the department of health studies at York University. She is a social scientist and was previously director of the Health and Community Care Research Unit at Liverpool University. "I've worked in a medical school, and I understand the pressures of the research assessment exercise. I also understand the pressures of service delivery on the NHS," she says.

Pearson believes that the relationship between higher education and the NHS has been transformed radically. "There is a commitment to partnership from the top of both organisations. It is a window of opportunity that must not be squandered," she says.

For some, this closeness brings insecurity. Medics have long feared a secret agenda to take the funding of medical education away from the Higher Education Funding Council for England and shift it to the DoH. "This was raised when Frank Dobson was health secretary, but was knocked on the head and has not re-emerged," Pearson says. "I am a pragmatist, as long as medical schools deliver good doctors for the NHS, it doesn't matter where their funding comes from."

What medics will need to watch is how the new multi-professional education and training levy will operate. Pearson is working on a consultation document on this, which will go out later this month.

While medical student placements have brought their own funding stream to the NHS, student placements for nursing, midwifery and other health professions have not. The unanswered question is whether there will be any new cash or whether institutions will just share existing funding. "We are on our final draft of the consultation document," Pearson says. "We are committed to flexibility of provision with stability of contracts."

What Pearson can be clear on is her commitment to widening access to health courses, particularly medical courses. She does not believe that widening access means lowering standards. "At Liverpool, I worked with local further education colleges to improve access to health courses for people living in Toxteth. I was staggered at how much the students achieved given their family and financial circumstances."

And she is committed to delivering a flexible workforce. "NHS staff need to work in teams where appropriate, to learn new skills where appropriate and to continually embrace change. The NHS must not be a static organisation - the needs of patients and the treatments available continually change."

Pearson's own life reflects this need to change. She has a degree in geography from Cambridge University and is also a qualified nurse. She wrote her PhD on leprosy control in Nepal. As she rushes off to the DFES, she laments that she did not have time to brush her daughter's hair this morning. Rather like the workforce she is seeking to develop, she is often harassed and pulled in different directions. It is a difficult balancing act, and one that will take years before the results show.

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