Field: My journey from council house to 10 Downing Street

Professor Steve Field, the NHS Commissioning Board's (NHSCB) new deputy medical director, tells GP's Neil Durham how attacking health inequalities is at the heart of his new role.

Prof Steve Field: 'We modified the Act to the point where I became comfortable with where we are.’
Prof Steve Field: 'We modified the Act to the point where I became comfortable with where we are.’

‘It was described to me as a job where I could change the world,’ reflects Professor Field during an interview in the NHSCB’s new central London offices about his latest role, ‘and I believe that.

‘I’ve been given the fantastic opportunity to lead the NHSCB in its attack on health inequalities, to support CCGs and to influence across all the strategies to make a difference.’

Perhaps to best understand Professor Field and his motivation we should turn back the clock and switch location to Wollescote, Stourbridge in the West Midlands, where the young Steve grew up on a council estate and was the first member of his family to go to university.

His role model as a schoolboy was his local GP whom he admired for his caring, sharing and respect won in his local community.

‘As I grew up I became more interested in inequalities and answering the simple question: why did my relatives die young? Mostly it was smoking-related illness,’ remembers Prof Field.

‘I went to medical school and when asked why I wanted to become a doctor I felt that, having grown up in a deprived part of the West Midlands, I wanted to give something back and to try to ensure people who lived in areas like the one I grew up in, had the same opportunities as others in posher parts of the country.’

He met wife Lynn, a nursing director, when she joined his practice. Together they have twin daughters who are now not contemplating medical careers. ‘They don’t see much of me and I don’t have much of a life,’ he offers as an explanation. Although one is studying geography and the other history, his two main passions outside medicine, which he regards as a success.

‘From a work point of view, I love everything I do; seeing patients and having a variety of regional and national roles. One of my big regrets though is that I probably haven’t seen as much of the twins as I could’ve done in some of their formative years.’

Leading NHS Future Forum

Professor Field’s CV is full. He wrote the RCGP curriculum for training GPs, was RCGP chairman before current incumbent Professor Clare Gerada and helps to lead a course for international clinical leaders based at Harvard University in the US with ‘disrupting innovation’ as its core theory, meaning disrupting the current model to bring care closer to patients.

After leading the RCGP, Professor Field went on to chair the NHS Future Forum, a role that drew criticism from some quarters for helping an unpopular Health Bill into law.

He remembers: ‘It was the most wonderful experience being asked by the prime minister to lead such an independent group. I do believe we managed to significantly alter the Bill, helped to refocus Monitor so that we looked at competition as something that was useful but not the end in itself, it was a means to an end, and flagged up a lot of issues including collaboration, integration and making every contact count.

‘On the negative side, people seemed to think that by leading it I was speaking on behalf of the government but I know it valued its independence. Chairing meetings in Downing Street with the PM sitting next to me was an amazing privilege.

‘The NHS will shine, grow and prosper through all of this. It is politically polarised at the moment but we modified the Act to the point where I became comfortable with where we are.’

Attacking health inequalities

Back to the familiar surroundings of the NHSCB and his current role. His priorities include improving palliative care, moving care closer to the community, improving access to healthcare and ensuring people have the same health outcomes across the country. He rejects criticism that the NHSCB is too top-down in its management style and not nurturing innovation from the grass roots.

Asked about Labour plans to downgrade CCGs to advisory bodies to health and wellbeing boards if the government changes in 2015, Professor Field stresses his role is apolitical.

But he adds: ‘I think we need a time, as Labour has said, where we don’t have much change. I do also agree we must get much more joint commissioning involving health, social care and local government.

‘CCGs need time to develop and to grow and they do need work hand in glove with local authorities.’

Much has been made of the differing styles of the last two RCGP chairs but Professor Field says of her: ‘Clare is one of the most value-driven people I know, cares about human beings and her track record working with deprived communities is absolutely wonderful.’

Looking back over Professor Field’s CV, they could also be qualities he could be said to possess.

Professor Field’s NHS Future Forum leadership, the challenge it presented and the criticism it sparked should all stand him in good stead when the NHSCB officially goes live in April.

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