Kevin McGee speaks to local democracy reporter Paul Faulkner about his vision for the future of the NHS in the county - and why he has decided not to be a part of it.
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00:00 Kevin McGee, you've been at Lancashire Teaching Hospitals for just about two years now in
00:05 the Chief Executive role, and I think it's fair to say it's been a tough two years for
00:09 the NHS. You've had, of course, the COVID backlog of operations and appointments to
00:14 deal with, and then last winter a really high demand for services, and now of course this
00:19 year the pressure of the nurses and doctor strikes as well. Do you feel in some ways
00:24 that you've been constantly firefighting and so standing still during your time at
00:28 the Trust? So it's fair to say the last two years have been immensely challenging for
00:35 Lancashire Teaching, but for the NHS generally. We've had the COVID backlog from elective
00:41 recovery, from cancer recovery, we've had the worst winter that the NHS has ever been
00:46 through, and over the last six months or so we've been dealing with all the industrial
00:51 action. But I'm really proud of the way the organisation's performed in spite of those
00:56 pressures. We've continued to develop the services, we've continued to support staff,
01:02 and we're in a really good and strong space in spite of the pressures that the NHS is
01:07 under, and that's testament to the brilliant work of the staff who work for Lancashire
01:12 Teaching Hospitals. You've always been quite candid throughout your time at Lancashire
01:17 Teaching Hospitals about the need for the NHS to transform. Do you really think that
01:22 it's geared up for the transformation you believe is necessary? And when the new Royal
01:26 Preston opens in probably a decade's time from now, how do you think services will look
01:31 in central Lancashire? So there's a lot of hard work that needs to be done between now
01:36 and the opening of the new hospital, and they don't underestimate what the work will be.
01:41 However, the NHS has continually changed, it's continually evolved. If I look at what
01:47 the NHS was like when I first started, it was completely different to how it looks now.
01:52 We had a perforation of smaller hospitals, we had lots of separate hospitals, now there's
01:58 much more sort of concentration. So what I think I would like to see in Lancashire and
02:02 South Cumbria is a really outstanding world-class tertiary hospital providing all of the specialist
02:11 services for the residents of Lancashire and South Cumbria, that has education and training
02:17 and research and development wrapped around it, that attracts the best and the brightest
02:21 staff, allows the inflow of resources into Lancashire and South Cumbria. And we can do
02:27 that and we can deliver that and the new hospitals programme gives us the ability to do that.
02:32 I also think we need to think about how do we undertake elective care, and I do think
02:38 that will be concentrated on fewer sites, but will be much more efficient in terms of
02:42 the way that we were on our theatres, for instance. So, you know, we only run theatres
02:47 generally five, perhaps five and a half days per week. We need to be able to run them seven
02:52 days per week for the future and, you know, have them running 12 hours plus every day
02:58 to really use our assets in a much more productive and efficient way that gives capacity, that
03:04 allows patients to be seen much quicker. So I think all of that needs to be worked through.
03:10 But I also think there needs to be a real focus on community-based services and particularly
03:16 things such as for elderly, long-term conditions. You know, people don't generally need to come
03:22 into hospital for those conditions. They can be treated much more efficiently and effectively
03:28 in the community or in their own homes by bringing services to people. So I think what
03:32 we'll see is a concentration, perhaps centralisation of specialist services, but the general services
03:39 should be developed much more locally and with a real focus on keeping people fit and
03:45 healthy and resilient in their own communities so they don't need to come into hospital.
03:51 And only then, when they need hospital, will they come in and those hospitals then will
03:55 be world-class and outstanding. The NHS, there seems to be pretty general
04:01 consensus, is under pressure like never before. How optimistic are you for the future of the
04:05 service as a whole and Lancashire Teaching Hospitals as the trust for central Lancashire?
04:11 I am genuinely, genuinely very optimistic. The NHS is continually under pressure and
04:17 will continue to be under pressure. The expectations that are placed on it quite rightly
04:22 grow every year and that puts pressure on the services and it puts pressure on staff.
04:29 But every year the NHS manages to cope in the most difficult of circumstances and I
04:36 am immensely proud of the staff across Lancashire and South Cumbria and particularly the staff
04:41 at Lancashire Teaching Hospitals for the work that they do day in, day out.
04:45 I think the NHS, I've worked in the NHS for 38 years, I think it's something very precious
04:50 and something that we all should fight for and hold on to.
04:53 And we don't do everything perfectly. There's a lot that we need to improve.
05:00 There's a lot of change that we need to put forward.
05:02 But you know what, I'd rather be, you know, I'd rather have the system that we've got
05:08 in the NHS than other systems across the world. I think it's an outstanding system.
05:13 And if the NHS is set for a transformation, you're set for a personal transformation,
05:18 aren't you, heading off to head up the health service in Gibraltar.
05:22 If it's not an obvious question, what attracted you to those sunny climbs?
05:26 So I've worked in the NHS for 38 years now and I've had a fabulous career.
05:36 I've been immensely lucky. But I actually think it's the right time
05:41 for me from a personal perspective to do something different outside of the NHS,
05:47 but also for Lancashire and for Lancashire Teaching. I think it's a good break point.
05:53 So over the last couple of years, I've worked, we have worked incredibly hard
05:57 to get the business case approved for the new hospital programme.
06:01 We've now got that approved. We've got the capital secure for the new hospital to be built
06:06 somewhere in Preston, surely South Ribble area. And all of that's taken an awful lot of hard work
06:14 and graft to get that to the point it is. But it's now secure.
06:17 What we now need to think about is the planning for the implementation of the new hospital
06:23 and all of the service changes that that's going to drive.
06:26 And that needs somebody who's going to be in the system for five to 10 years
06:32 to really drive that forward. I wish I was 10 years younger.
06:36 If I was 10 years younger, I would be so up for this challenge and so
06:40 excited about driving those changes forward. But given where I am in terms of my age,
06:46 given where I am in terms of my career, I thought it was the wrong thing to do to
06:50 start the next phase of this transformation and then leave and hand it over.
06:55 I think it's a natural break point now for me to pass the baton on to somebody else
06:59 who can come in and can drive the service changes that are going to be required.
07:03 It's a really exciting role. I think like teaching is a really good organisation.
07:09 I think you're going to get a lot of really high calibre candidates who want to take over the CEO
07:15 role. And I think it's a good time for them to come in.
07:18 What would be your biggest challenge in Gibraltar, do you think? A very different
07:22 health landscape to the UK, obviously. It's very different, but you know,
07:26 the challenge is probably the same. The biggest challenge is workforce.
07:29 Healthcare worldwide, every system in the world is really struggling in terms of training enough
07:38 staff, recruiting enough staff and having the retention of those staff. So we're in a worldwide
07:45 market for healthcare. It's really, really difficult to get hold of staff and to keep those
07:50 staff. And that's exactly the same issue in Gibraltar as it is in the NHS. So, you know,
07:59 it's a different system, it's a different culture, but those workforce pressures would be the same
08:06 regardless of where you are in the globe. You know, we need to develop systems and keep staff
08:15 in those systems because staff want to work in them. And I think that's one of the proudest
08:19 things and one of the things I'm really proud about in terms of Lancashire teaching. We've
08:23 done a lot of work over the last few years in terms of staff morale, supporting staff.
08:28 And if you look at, you know, in most organisations in the NHS, staff morale and
08:35 satisfaction is declining. In Lancashire teaching over the last few years, it's been improving and
08:40 that's the deliberate effort in terms of trying to do our best to support our staff. We can't
08:44 meet all of the demands and all the wishes of our staff. National pay negotiations, I can't do
08:49 anything about that as such, although we have tried to support our staff through that, through
08:54 those processes. But where we can, we've put an awful lot of effort and energy into developing a
09:00 positive culture, a culture of trying to do things differently and to support staff.
09:05 Kevin McGee, thank you very much indeed for talking to us.