How do you even begin to solve the HR problems of the NHS? Not only is it the UK's largest employer, it is arguably the only one where non-employees worry about the perceived lack of people and money as much as the 1.3 million who actually work there.
Clare Chapman, director general of workforce, former HR director at the UK's second-largest employer Tesco, ponders the question. It has been a year since she took charge of the highest-profile HR job in the country.
Her appointment followed a dreadful six months for the NHS - revelations that it was £512 million in debt, the then health secretary Patricia Hewitt being booed off stage at the Royal College of Nursing (RCN) annual conference, and job cuts splashed across the media.
'The only place you can start is by looking at what you have,' said Ms Chapman. 'I spent my first three months touring hospitals simply to understand the system. What I quickly found was that, unlike Tesco, where performance is measured quarterly and occasionally every three years, reforming the NHS would be a 10-year project.
'My job boils down to one simple thing,' she added, 'working out what improves the lives of patients and employees, then seeing to what extent the NHS is designed to do this.' This interview is Ms Chapman's first since taking up the role and the first time she has felt there is something to say.
The NHS target for hospital doctors was 74,590 by 2007, but, as early as 2004, there were already 78,000, which rose to 82,000 just one year later.
If there's one thing Ms Chapman learned from Tesco, it is how not to employ more staff than is needed.
Goodbye to the past
'I can look you straight in the eye, and say that the years of simply hiring more doctors and nurses has now ended,' she said.
'I do believe we have the capacity in the system to provide a first-class NHS service.
'We've got to move away from the overall growth story. Today the story should be about improving service.'
But can she really do that with the same or fewer staff?
'In the past year, just 2,300 forced redundancies were made, and 82 per cent were non-clinical. If I am to be responsive, these sorts of cuts have to happen. When you go through any period of change, you must learn new things, and this is what I'm having to learn now.'
Under tight new recruitment rules, Ms Chapman said managers have been instructed to 'seek vacancy freezes, and redeploy existing staff wherever they can'.
'What I can say is that the past 10 years of capacity building has provided the groundwork to enable myself and my team to embark upon the next era of the health service to use this built-up capacity to enable staff to provide more value.'
Despite such pressure, there are compensations. 'I'm doing a job I really want to do. Seeing staff help people makes doing a tough job so much more worthwhile,' she said. 'We have many people that want to make the NHS better. It's almost a privilege to enable this to happen.'
This interview was first published in HR magazine.
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