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The Health Goat

Nick Robinson | 09:01 UK time, Thursday, 4 October 2007

The man they call the Health Goat in Whitehall has been dragged into the electoral bear pit today. That man is Professor Lord Darzi - a man who's already got more than his fair share of titles and jobs. He's a top surgeon and professor two days a week and the man Gordon Brown brought into the government to head up an inquiry into the NHS four days a week. That's where his latest title comes from. GOAT is the acronym for Government Of All the Talents.

Lord DarziA few weeks ago I observed Darzi as he performed high tech keyhole surgery to remove a gall bladder. His talents there are not in question. As he openly acknowledges what is open to doubt is whether he can transfer that talent to the world of politics.

The decision to become a minister was, he told me, the hardest of his life. It took him two meetings with Gordon Brown and two weeks of worry before he bowed to the pressure to become a minister and not merely an expert adviser.

Both the timing of his interim review - brought forward to allow an election to be called - and his view that "the days of the district general hospital are at an end" (which, he insists he meant only in relation to big cities like London) have ensured that he faces a tough first day in the political spotlight.

You can see why Brown wanted his man. The government has lost the trust of health service staff and desperately wants to regain it. Darzi has a track record of engaging with the staff in the hospitals he works in.

When fellow surgeons at his hospital complained that the porters always brought the patients to surgery late, he decided to become a porter for a day to see how things looked from their perspective. He recalls one colleague who knew about his disguise, calling to warn him that one of the porters was operating on his patients. The serious lesson he learnt was that no-one looked him in the eye when he was a porter so it was no wonder they didn't feel part of the team.

Whilst holding up a lady’s gall bladder for me to see on his new high definition monitor Darzi told me that Eden's decision to invade Suez was probably taken because his gall bladder op went wrong. The illness that resulted impeded his judgement. When I suggest that this proves that politics and surgery don't mix he laughed. I wonder if the Health Goat would laugh today.

UPDATE: In response to comments about the exact date of the announcement. I have replied here.


I'm not sure you can say the interim review has been 'brought forward' so categorically, Nick. The review was announced in the Commons by Alan Johnson on 4 July. Look it up in Hansard... he said: 'Professor Darzi will complete an initial assessment in three months' time.' 4 July plus three months is 4 October. Exactly, to the very day.

  • 2.
  • At 10:35 AM on 04 Oct 2007,
  • karin wrote:

If Brown expects to win back the trust of NHS workers then he should start with giving them a decent pay rise. He should also stop the centralisation of hospital services. NHS workers in scotland were given a 2.5 percent pay rise. Workers in England were given a measly 1.9 percent due to the increase being staged. This is in effect a wage cut as the rise is below the rate of inflation. The NHS is funded on the good will of staff who frequently work late without extra pay. Well Brown has now completely lost that goodwill. Has Brown ever worked late to save someones life? How would people feel if NHS workers clocked off exactly when they were supposed to in the middle of an operation because they are not being paid for staying. Does anyone know how it feels to know you are being taken advantage of but there is nothing you can do about it because its someones life and not a load of meaningless facts and figures you are dealing with.

  • 3.
  • At 10:37 AM on 04 Oct 2007,
  • Malcolm James wrote:

Nice of you to give the Professor a positive report on his surgical skills, Nick. I think peer appraisal is here to stay. Perhaps he should reward you with one of those titles you so covet, or maybe you should stick to politics.

  • 4.
  • At 10:41 AM on 04 Oct 2007,
  • Derek wrote:

The enquiry was into the English NHS Nick. Is it not time that this was made clear in articles?
Gordon Brown has overall responsibility for the English NHS, not the Scottish NHS, which is the responsibility of the Scottish SNP government!

  • 5.
  • At 10:43 AM on 04 Oct 2007,
  • John Delaney wrote:

I have just read something about a political football by Andrew Lansley the guy who says his part can save the NHS don't make me laugh lansley your party caused the problems and the labour party tried to solve it with money and hey ho the trust managers etc should never have been given the money as they caused the problems.

So no political party apart from the tories is allowed to talk about the NHS and anything else do us a favour mate get lost.

  • 6.
  • At 10:45 AM on 04 Oct 2007,
  • J Michael wrote:

"NHS staff don't trust the government"--that's an excuse for not doing what needs to be done, yet getting paid anyway?

Time to release power from Politician to masses. let them have choice, give NHS competition -- seems people sitting inside NHS are too complacent to take any change.

  • 8.
  • At 10:56 AM on 04 Oct 2007,
  • John H. wrote:

If this were the PM blog, we would expect Nick to respond to Simon's comment (currently @ 1). Does that sort of thing happen here? It would be interesting to read.

All the doctors I know think that this man is the wrong man to do any review. They also know that far from being outside politics that he is an inner-circle Brownite.

NHS workers say that the Government is destroying the NHS.

  • 10.
  • At 11:07 AM on 04 Oct 2007,
  • Dr Krishn Shah wrote:

I'm a medical doctor myself (locally trained but can't get a job).

Firstly I should tell you the operation you describe (Laparoscopic Cholecystectomy) is a simple (relatively) procedure carried out thousands of times annually by 99% of all general surgeons.

Please don't get me wrong he's highly respected in the profession. However, just because of this don't try to make out that his views will reflect those of the profession.

You obviously think he's a great guy.
Aaawwhh he spent a day as a porter. It was because the porter felt unappreciated that patients were taken down late. NO. Poor coordination and communication, lack of porters, general chaos on the ward
due to a lack of senior nursing staff available to go down with the patient are the real reasons.

He's a long time servant of the Labour party, a Labour Lord no less. All this deep introspection prior to taking the job is odd since he's produced reports for the government before. Will the review reflect Professor Darzi's political or professional assessment. A combination of both I suspect.

Gordon Brown in his speech last week clearly set out what he wanted. A health service "personal to all" whatever that means. He pre-empted the "biggest review of NHS services ever". How can the review recommend any other approach now the PM's set his own vision?

  • 11.
  • At 11:07 AM on 04 Oct 2007,
  • Madasafish wrote:

Central reviews are very interesting but a complete waste of space.. like most central planning and control.


Well to anyone (but a politician ).. it is blindingly obvious that ANY NHS hospital or Trust which does not do the BASICS.. like wash ahnds or clean wards...

is run by people who should be fired ... at once.

The fact that after 10 years of central planning it still goes on says all about the uselessness of central planning and NHS management.

I have a simple solution.

Pay management by results. A sliding scale of deductions from salary for MRSA/dirt etc for NHS Chairman and the Heads of hospitals.

After 2 months .. I suspect a lot of resignations an dlots of improvements.

All the rest if politico spin.

  • 12.
  • At 11:13 AM on 04 Oct 2007,
  • jim brant wrote:

"... the timing of his interim review - brought forward to allow an election to be called..."

A statement of fact, or an opinion? It sounds like the former, but surely it's not? As I understand it, the report was expected next week - and if it had been delivered then would it have prevented an election in November? I do wish you wouldn't drop these bits of poison into your reports, without at least some indication of the evidence and reasoning behind them.

  • 13.
  • At 11:14 AM on 04 Oct 2007,
  • Foucault wrote:


In all decent relationships there are those things that one you have done- a bit like splitting the atom in two- which are, in effect, 'a point of no return'.

New Labour has broken the trust between them and the workers of the NHS. They want to re-establish that trust. Dave Cameron will do that for them. That's the simple truth, these are the undisputed facts of this case.

  • 14.
  • At 11:15 AM on 04 Oct 2007,
  • Mike wrote:

Some gall, some bladder...

  • 15.
  • At 11:18 AM on 04 Oct 2007,
  • Robert Crosby wrote:

More sweeping opinion passed off as fact, Mr Robinson? How on earth can you say, "The government has lost the trust of health service staff and desperately wants to regain it... " and expect not to be challenged? As a trade unionist in the public sector, I recognise that there are concerns amongst staff regarding both management issues and current pay settlements. However, you have typically gone over the top and suggested that this amounts to something even more serious. I'm beginning to find some of your commentaries underwhelming to say the least.

  • 16.
  • At 11:23 AM on 04 Oct 2007,
  • Lesley wrote:

Well let's hope our 'goat' can do something about the cleanliness of our hospitals. Leeds General Infirmary is a dirty disgrace and an insult to it's patients and the tax payer. At least Gordon has had the good sense to engage someone who knows what he's talking about and who seems genuinely passionate and interested, Porter story is a fine example. Get rid of some of the huge numbers in management and train the ones left in business management and accounting. Increase the number of nursing staff and let's have some actual nursing back on the wards, instead of paperwork. Good luck to the guy.

  • 17.
  • At 11:32 AM on 04 Oct 2007,
  • Gordon McIntyre wrote:

"The government has lost the trust of health service staff and desperately wants to regain it"

A pretty sweeping statement to be reported as a fact is it not?

Are you saying that health service staff would not vote for Labour in any upcoming poll?

There is a difference between staff expressing concerns about pay and conditions and a loss of trust.

Wow, another lame initiative from Gordon Brown where he tries to restore credibility in an NHS that he has helped to dismantle and destroy.

  • 19.
  • At 11:49 AM on 04 Oct 2007,
  • Dectora wrote:

Sweeping statements are Nick's forte. He of course has interviewed every single NHS employee, hasn't he? How large was the sample on which he was drawing?
All public servants grumble, it goes with the job. But try another health system some time, Nick. I'd love to see Nick after a week in a French teaching hospital, when he discovers that clinical staff vanish to their private lives as dusk falls. And French health workers don't trust their govenment, either. Perhaps Foucault could enlarge on this.

  • 20.
  • At 11:51 AM on 04 Oct 2007,
  • John Delaney Torquay wrote:

Come on then lets have it what is the average wage of an NHS nurse because the ones I speak to can't understand what all the fuss is about.

  • 21.
  • At 11:53 AM on 04 Oct 2007,
  • Dave wrote:

In item 14, Gordon McIntyre wrote ""The government has lost the trust of health service staff and desperately wants to regain it". A pretty sweeping statement to be reported as a fact is it not?" Sorry Gordon - a blog is opinion, not fact. Nick's comments (along with every other news story on this and every other news media and blogging website) is opinion, an argument based on evidence and shaped by the writer's perceptions and values. Nick's entitled to his opinions about Lord Darzi as I am about your kneejerk reaction (and as you are about mine). The only difference here is that he gets paid to write his...

  • 22.
  • At 12:01 PM on 04 Oct 2007,
  • Nevil Phillips wrote:

The daft thing about the appointment of Lord Darzi (as any practising GP will tell you) is that he is a surgeon and a professor in a teaching hospital - he spends his days in an operating theatre or a lecture auditorium; about as far away from the experience of a provincial GP's surgery as one can possibly get.

Accordingly, his contact with and understanding of the role and daily professional life of GPs will be no greater than any other (non-medical) minister. It would have made so much more sense if Mr. Brown has seen fit to appoint a practising primary care physician as a minister - then, at least, the public and the GPs would have some faith that all of their interests were weighed in the balance and an informed and practical view would be taken of the changes (if any) that are necessary.

As it is, the NHS review (insofar as it concerns the public and their relationship with GPs) will be yet another exercise which is conducted too remotely from the problem and by an individual whom, while talented, is not properly suited to the task.

It is no wonder that GPs, as the people who are in the front line of the Government's suggested reforms, feel marginalised and un-consulted.

It will also be no wonder if the public ends up disappointed with the review for the same reason - that it is effected by the wrong person in the wrong way; like a review of a Ford Mondeo by a Formula 1 champion.

  • 23.
  • At 12:05 PM on 04 Oct 2007,
  • Phil Johnson wrote:

He may be an excellent surgeon and very talented, but that is likley to give him a less than useful perspective on General Practice, or hospital infections! If we belive that this is an attempt to bring "impartial experts" in, we must have believed in the WMD and everything else that this government stands for.

  • 24.
  • At 12:06 PM on 04 Oct 2007,
  • Jeremy wrote:

By manipulating statistics over ten years, by spending taxpayers money without caring about value for money, by deceiving the electorate, Labour has lost the confidence of NHS staff.
Mr Brown would appear to be using Mr Darzi as a "human shield" to give him some protection in time for the election. As with the troops in Iraq this is one more example of cynical manipulation of peoples lives for a political end.

Nick - Derek is right. Since this deals with the English NHS that's the description that should be used.

What does it say about the government that it now need to co-opt trusted people to use a human shields against an angry health service and public ?

  • 26.
  • At 12:08 PM on 04 Oct 2007,
  • michael berry wrote:

brown using people again in this weeks politics, did he learn from tuesday? seems not. if this review came out early or not is not the point but what is that goverment reviews take up to a year normally and the blogger on here quoting hansdard on 4th july makes me wonder if brown has been thinking of a snap poll longer then we throught

i can't wait for the polls today or tomorrow and brown will suddenly see a reverse gear

  • 27.
  • At 12:43 PM on 04 Oct 2007,
  • Alick Munro wrote:

NHS GPs (I'm one myself) don't think a full time surgeon knows much about what goes on in a GP surgery.
So we don't think Prof Darzi's remedy of polycliics is at all relevant to the problems we face.
But the government thinks it can save money by having GP surgeries go the way of sub-post offices, and they've brought in Prof Darzi and renamed him Lord Denham to be their front man.
The difference is, patients who can barely require a local service, and they do need to see doctors and practice nurses face to face on average four times/year - much more for the infirm. And they get to know and trust their own local doctor or else they move on. The mutual understanding of the relationship saves an awful lot of effort for both parties.
Polyclinics are likely to be staffed by rapidly changing salaried GPs - a bit like out-patient clinics, I'm sad to say. Is this what the public really want?

Alick Munro

  • 28.
  • At 03:38 PM on 04 Oct 2007,
  • John Galpin wrote:

Judging from the amount of bile being spilt the prognosis doesn't look good.

  • 29.
  • At 04:11 PM on 04 Oct 2007,
  • Peter, Fife wrote:

4 Oct 07, 09:01 AM
"...Both the timing of his interim review - brought forward to allow an
election to be called - and his view that "the days of the district
general hospital are at an end" (which, he insists he meant only in
relation to big cities like London) have ensured that he faces a tough
first day in the political spotlight.."

Alan Johnson

4 July 2007 : Column 962
".Professor Darzi will complete an initial assessment in three months'
time to inform the comprehensive spending review. He will produce his
full report in the new year, setting out a new vision for a 21st-century
NHS, coinciding with the 60th anniversary celebrations."

Do you wish to borrow my calculator?
Add three months to 4th of July 2007

  • 30.
  • At 07:32 PM on 04 Oct 2007,
  • Foucault wrote:

In response to your comments 'Dectora' the evidence-base is vry well established that since coming into power trust between the general public and this Government has statisitcally fallen.

New Labour has, by its own admission, not 'listened to the views of its staff when implementing change and recognises that many of them are feeling fatigued'.

Of course, facts are tough when you believe in total spin! Now let me go find my WMD...oh they do not exist. Oh well, we will invade Iraq anyhow!! Come on wake up!!


Did you go to the 'opening' in Basildon? If you did I hoped you asked Brown why he was 'opening' something that was already open.

  • 32.
  • At 12:01 PM on 05 Oct 2007,
  • Duncan wrote:

Don't mention PFI! I did it once but I think I got away with it!

The Darzi interim review was, as you say, always planned for October but it was to have been delivered next week in Parliament. At the beginning of this week it was brought forward to get it out of the way before any possible election announcement.

  • 34.
  • At 10:43 AM on 06 Oct 2007,
  • Philip Bannister wrote:

Who was this patient being operated on by a government surgeon with a BBC political editor watching?

  • 35.
  • At 06:16 PM on 06 Oct 2007,
  • Peter, Fife wrote:

Could you please supply details of dates which were set for delivery of this review other than "October" and "three months"
Links to these references would also be appreciated?

Having read your blog and the text of interview with Lord Darzi I am left with the impression that he is a liar; could you assist with clarification?

Hi-tech keyhole surgery is increadible difficuly. fair play to the man.

  • 37.
  • At 05:04 PM on 16 Oct 2007,
  • David Smith wrote:

What we need here is a Health Minister with 'hands on experience' rather than someone who's only capability is sticking plasters on.

Trouble is there are far too many government adviser's zapping at the expenses... they are not giving 'freebies' with added expenses on top.

Isn't anyone in this government capable of thinking for themselves?

It's a bit like asking a plumber to do a heart by pass, mind you the other 'Not for for purpose guy' didn't do much good come to think and he was a Doctor.

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