Sir Ian Carruthers
Doctor of Laws
Wednesday 20 July 2011 - Orator: Professor Selby Knox
Ian Carruthers is a north countryman, brought up in a council house in Carlisle. He attended the local state grammar school and excelled in sport, representing Cumbria at rugby, cricket and football. There was interest from Everton and Leeds United, and he was offered a contract with Carlisle United, but his father, despite having been a professional footballer himself, or perhaps because he had been, insisted that Ian should focus on school work and then get a proper job. Ian cried that night, but what Match of the Day was to lose the National Health Service was to gain.
Ian did indeed focus on his studies and having decided on a career in the church he gained a place at the University of Edinburgh to study Divinity. But he turned this down in favour of staying close to a ‘young lass’ in the lower sixth, now his wife of 38 years, Joan, whom we are delighted to welcome to the University today.
So a job it was to be and his first was in the motor department of Royal Insurance, where he recalls calculating the rebate due to Sir Chris Bonnington when he went off to climb in the Himalayas. Despite this heady excitement, insurance was not for him, and he ‘stumbled’ (his word) into the NHS, starting in 1969 at the local hospital as a wages clerk on the lowest administrative grade. Thus began a journey from the bottom rung of the NHS ladder to the very top, working in his spare time in the early days to obtain an Open University degree. From admin he moved into management posts in Barnsley, Blackpool, Southend, Portsmouth and Plymouth before taking on District General Manager positions at East and West Dorset Health Authorities. He then had Chief Executive roles at the Dorset Health Authority and in Somerset, and, having impressed ministers with his ability to hit healthcare targets rapidly and within budget, was invited to sort out Hampshire and the Isle of Wight, which were then projecting a huge annual deficit of £120 million pounds. He reduced this to £25 million within 8 months and notes that this was ‘challenging for the people concerned’. The call to become Chief Executive of the South West Strategic Health Authority followed and then almost immediately to become Acting Chief Executive of the entire NHS when the then CEO unexpectedly departed and the organisation was in financial difficulties. He enjoyed the role but, to the surprise of many, resisted the pressure to stay and returned to his South West SHA post. Why? Because although he found the political side of the top job exciting he says you need to know what you enjoy and what you do best - and that meant being closer to doctors and patients.
So, back to the South West Strategic Health Authority it was, and to taking what was an umbrella for 40 organisations, a large number of which were in deficit and not meeting performance targets, and with £200 million pounds of debt, to the very top of today’s NHS performance tables. He likes to say, in one of the many football metaphors which pepper his conversation, that he took the South West SHA from the bottom three of the division to the Champions’ League.
Alongside his regional responsibilities, Ian has had many national roles. To mention just a few, he has been: Transitional Director of the NHS Institute for Innovation and Improvement; a member of the Chief Executives Reference Group on delivering Race Equality in Mental Health, and a member of the NHS Modernisation Board. Currently, he is Chair of the Health Honours Committee and of the Life Sciences Delivery Board, and he is the National Champion for Dementia.
This lifetime of service to the NHS and the nation led to his being appointed an OBE in 1997 and to a Knighthood in 2003.
Madam Chancellor, how was all this achieved? How did a boy from humble origins end up in the highest echelons of the third biggest organisation in the world, after the Indian Railways and the Red Army, employing 1.3 million people and with a budget of over £100 billion pounds? He says he was lucky, but when I put to him the saying of the great South African golfer Gary Player – ‘the harder I practise the luckier I get’ – he agrees that he did in fact ‘practise’ very hard at his career. He wanted to be the best at everything he did. He confesses, however, and this will be a surprise to many, to a fear of failure, that he is driven by the self-doubt that eradicates complacency. Throughout his career, when invited to take on some new challenge, his first reaction was to ask: ‘Do you think I can do it?’ Events have shown that he always could.
Those who have worked with him say that he is passionate about patient care, he has an uncompromising, relentless approach to improving care for the individual patient, whom he calls ‘Mrs Snooks’, that he is clear on what is expected, he sets the bar very high, he challenges vested interests. They also say he is not a man you want to disappoint.
This last is illuminated by two of his now legendary statements: ‘there is only one job round here that’s safe - and it’s mine’ and ‘people who deliver usually enjoy working with me, those that don’t rarely do’.
His management style is undoubtedly robust and it has not always endeared him to those who could not meet his standards, but he accepts the unpopularity that often comes when driving through change.
If this suggests we are honouring today the Genghis Khan of the NHS, it is necessary to complete the picture - to show that we are actually, to adopt an analogy he would surely appreciate, honouring the Sir Bobby Robson of the NHS. So, while he can blast a room full of hospital chief executives for letting him down over a target, he will then metaphorically put an arm round their shoulders and say how talented they all are. He himself uses the language of the dressing room to describe his style: don’t criticise the team, manage them as individuals, emphasise their strengths, rather than their weaknesses. People are keen to say that he can also be very kind; that he never forgets people, always asks after them individually. That he is supportive, brings people on, makes them believe in themselves, that he shares the credit for success (‘it was the players what did it’) and – in the words of Sir David Nicholson, the current Chief Executive of the NHS – that he wants everyone to succeed . He is proud that his success in turning round NHS organisations has been achieved with the same people who had been underperforming. In other words he is, like Sir Bobby, a very good people-manager, and he attracts similar respect and loyalty. He himself says he is just a plain-speaking northern lad and a big softie.
People also find him great fun to work with and great company. He is a passionate supporter of Somerset Cricket and of Southampton Football Club and for many years he saw every Southampton game - even when NHS Chief Executive – travelling on the supporters’ bus to away games with his work on his knee. This year he managed to get to ‘only’ 45 out of the 51.
Madam Chancellor, Ian is also passionate about the value of education and its ability to transform lives. Undoubtedly he has a personal perspective here - he says he has never stopped learning. This passion has led to his being installed as Chancellor of the University of the West of England this very week. The evidence of his career so far is that the University of Bristol will have to watch this new kid on the block very carefully.
The University of Bristol awards honorary degrees for two reasons: to recognise great personal achievement and to demonstrate to our graduating students just what a difference one person can make. Sir Ian Carruthers is an outstanding example. He has risen to the very top of the NHS through hard work, a commitment to learning, demanding the highest standards of himself and others, and by inspiring people to produce more than they believed they were capable of. By so doing he has improved healthcare not just for Mrs Snooks, but for millions of his fellow citizens.
Madam Chancellor, I present to you Sir Ian James Carruthers, OBE, as eminently worthy of the Degree of Doctor of Laws, honoris causa.