IT is a job that could easily be described as a poisoned chalice.
As the new chief executive of NHS Lothian, Tim Davison is facing challenges on all fronts, from sorting out the biggest waiting list crisis in Scottish history to overturning a culture of bullying within the organisation.
Added to that is an ongoing battle with private company Consort over maintenance of the Capital’s flagship hospital, and the added problem of investing in the treatment of a growing number of patients at a time of huge financial upheaval.
Since being parachuted in as a short-term firefighter after ex-chief executive James Barbour retired under a black cloud in the wake of revelations over the bullying culture and falsification of waiting lists, however, Mr Davison has already shown he is up to the task.
Four months on, and with his interim position having been made permanent, he says he can already see the light at the end of a five-year tunnel.
The 51-year-old, speaking in his first interview since he learned earlier this month that his application for the full-time chief executive post had been successful, said that during his time in the interim role he had already set a “series of balls rolling” and had become determined to finish the job he started.
“In the interim role you’re focused on the short term,” he said. “I was asked to stabilise and get a recovery plan developed and I did that. Now I can raise my gaze and plan for the next five years.”
Already a £20 million plan to treat the patients who have been languishing for too long on the waiting lists has been put in place.
Mr Davison admits the early stages of the drive to treat patients waiting for inpatient and day case procedures had been “frustratingly slow”, but said the health board “could not be spending more time or effort” to address the issue.
He said: “I would have loved this to have been turned around almost overnight, but the reality is this backlog is the biggest that any health board in Scotland has ever been asked to turn around.
“We are clear for these patients this is a major issue and for us reputationally as a board it’s major issue. But it’s important that people understand that the vast majority of patients in Lothian are being seen within the waiting time guarantee. That’s not to minimise the impact on those that are waiting too long but I think it’s important to see context.”
It is now hoped that 1600 patients who have been waiting too long for inpatient or day case care will now be treated by Christmas, while a backlog of 6000 people waiting for outpatient appointments is expected to be clear by March.
Mr Davison said a number of initiatives were already under way to deal with the underlying capacity problems which are behind the waiting list crisis, hopefully leading to an end of private sector involvement within two to three years.
More staff are being recruited and last week a £2m investment in internal capacity was approved, with ten times that amount expected to follow in the coming years.
Alongside pressure over elective care, the health board will also look at investing heavily in emergency departments, with Mr Davison admitting that NHS Lothian does not have the capacity to cope with the pressure it is facing, particularly at the Royal Infirmary.
Mr Davison said: “The capacity problem in unscheduled care is as significant as the problems in elective care. We will be bringing a paper to the board saying our demand is greater than capacity to cope and we need to invest more.”
There is also a commitment to building a new relationship with Consort – the PFI company which built and runs the Royal Infirmary and has been involved in a series of scandals.
Mr Davison said incidents such as the one earlier this year which saw the power to a theatre cut during an operation would not be tolerated.
He plans to visit the Royal Infirmary with a senior Consort director and discuss maintenance issues with staff.
He said: “We’re going in to our discussions with Consort in a marriage guidance sort of way – there are difficulties and we need to resolve them.
“If we need to take punitive action in the way of things like financial penalties, the contract does allow us to do that.
“But when you’re trying to build relationships you don’t lead with a left hook. You say ‘look, what’s gone on before hasn’t been that clever. We now need to improve’.”
Already, he says, a more open atmosphere exists at the health board, with staff members willing to discuss problems with senior management. Mr Davison said that some NHS Lothian employees had been “embarrassed” by the revelations published in a report earlier this year and wanted to restore public confidence.
Other issues which he now faces include the integration of adult health and social care, which will see health boards increasingly working with local authorities.
It is one of a series of developments in healthcare which Mr Davison sees as part of an “exciting landscape” in coming years, with his permanent position allowing him to look beyond the immediate problems that NHS Lothian faces.
But he is clear that he will not be able to succeed alone.
He added: “For any chief executive of a huge organisation like this, to think they can transform the place in a few months is deluded. I can do nothing without the team.
“It’s a huge honour and a privilege to manage the health board of the capital city. I am going to give it my best shot for the next five years.”
GETTING TO KNOW YOU
Tell us about your family.
I have one grown-up son who’s at Glasgow University. His name’s Ruairidh and he’s studying psychology. He’s 22.
My wife’s called Fiona. She runs the Strathearn Art Gallery in Crieff. I’ve been married to Fiona for four months and we’ve been together for eight years.
Getting married, starting a new job and moving into a new house all at the same time was a bit much. It’s just as well my son does psychology!
Where do you live?
I live in Perthshire, near Crieff.
What about your education?
I went to Kenton Comprehensive School in Newcastle-upon-Tyne between 1972 and 1979.
What are you interests?
Tennis and golf – I probably do a bit more watching than playing but I do play.
Military and political history is my main passion. My first degree is in history then I became a health service manager. That’s the way it goes.
What music do you listen to?
I’m very much a retro music fan. My heroes are Bob Dylan, Neil Young and James Taylor, but Dylan is my absolute hero.
I’ve used Bob Dylan quite a lot in the past in doing talks to people. We had a big mental health strategy conference in Glasgow which was about closing the bigger institutions and developing community care.
We wrote a book about it and I called it a Slow Train Coming [after the 1979 Dylan album] because of this idea that it had taken a long time to get to where we were getting to, but it was relentless.
People who are Bob Dylan fans would get it.
But I have occasionally been known to listen to Adele when I’m driving.
What other qualifications do you have?
While working I did three further qualifications – a diploma in health services management, Master of business administration and a Master of public health degree at Glasgow University.
It meant for eight years on top of my normal job I was studying at the evenings and weekends, and using my annual leave to write essays and dissertations.
There’s been a lot of studying along the way!