In The Loop: the BIG Questions

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In this podcast series, Roy and Niall leverage their extensive experience in health and social care to engage in insightful conversations with influential figures. They explore the sector's critical issues and challenges, cutting through political rhetoric and hype. Each episode offers a deep dive into the realities of healthcare, providing listeners with a clear understanding of the complexities involved. Who is Niall? Niall Dickson CBE is a prominent health and social care figure. He has held several key positions, including Chief Executive of the NHS Confederation, Chief Executive and Registrar of the General Medical Council, and Chief Executive of The King’s Fund. He has also worked as a journalist for the BBC and was awarded a CBE for his services to patient safety Who is Roy? Roy Lilley is a health policy analyst, writer, broadcaster, and commentator on the National Health Service (NHS) and social issues. He has held various influential roles, including vice-chairman of West Surrey and North East Hampshire Health Authority and chairman of the Homewood NHS Trust. Roy is also known for his popular eLetter, which reaches around 300,000 health and care managers, and for founding the Academy of Fabulous Stuff, a repository of best practices in the NHS.

Episodes

  1. FEB 4

    Tom Dolphin chair of the BMA council.

    The British Medical Association are never far away from the headlines but what is their real game? In their latest In the Loop podcast, Niall and Roy have an in depth discussion with Dr Tom Dolphin the BMA chair who leads one of the most powerful trade unions in the country, if not the most powerful. In a revealing exchange Tom reflects on the growing militancy of doctors and their willingness to strike, as well as the changes affecting General Practice which for some GPs is making their lives less satisfying and more transactional. But he insists the partnership model, in which GPs run their own businesses, can survive if it is properly supported, in spite of many younger doctors choosing to take on salaried roles.  Tom also doubts the value of revalidation, the system that requires doctors to show they are competent and up to date and he blames the NHS for making doctors undergo pointless statutory training as part of that process.  And he is deeply concerned at so called ‘doctor substitution’, whereby tasks once performed by doctors are being carried out by professionals with new roles such as Physician Assistants, and he reveals talks are underway with the Royal College of Nursing about the expanding roles of Clinical Nurse Specialists.   As the seemingly existential duel with the UK government goes on, this is a chance to hear the leader of Britain’s doctors as he reflects on the battles ahead for the BMA, but also to hear his take on the wider and fundamental challenges facing the medical profession. Tom insists the BMA and the UK government are aligned in their ambition for the NHS, but there is little sign in this exchange that the union will back down. Indeed he issues a warning that if things don’t go their way, further strikes are possible from other doctors including consultants, the most senior doctors on the front line.

    41 min
  2. JAN 4

    David Gregson, Founder of BeeWell.

    In the Loop – the BIG Questions  Niall Dickson CBE and Roy Lilley with their latest guest David Gregson founder of BeeWell   To start 2026 Niall and Roy make a departure from their usual management and political interviews and explore the worrying state of our young people.  The awful reality that youngsters in the UK appear to be unhappier than nearly all their European counterparts.    Their first guest of the New Year is David Gregson an entrepreneur and philanthropist has embarked on an ambitious and innovative programme called Beewell. Its aim is to improve the wellbeing of young people throughout the country, starting in Greater Manchester and a few other areas of England. Working with the Mayor Andy Burnham along with schools, local authorise and the NHS, the Beewell approach s already claiming to have made a significant impact, affecting the lives of thousands of school children.    But can this programme, which demands action and a mind-shift from statutory and voluntary services, really be the catalyst to change the prospects of the next, generation? The current position is dire. In a fascinating exchange, David Gregson points to weaker family relationships, restrictions on child freedom, and the fact that adults often no longer understand the world in which their youngsters live. He applauds moves by the UK government to raise the profile of youngsters’ wellbeing and its support for idea of conducting surveys in every school but wants them to go further and faster.

    41 min
  3. 12/03/2025

    Dr Charlotte Refsum, Director of Health Policy at the Tony Blair Institute.

    In their latest In The Loop podcast Niall and Roy lock horns with Dr Charlotte Refsum Director of Health Policy at the Tony Blair Institute. In a frank discussion Chalotte a former GP  reveals how the former Prime Minister is still closely involved in policy development and she lays out the stark choices facing the NHS if it is to survive in the face of the enormous challenges it currently faces.      Charlotte is a former GP who has specialised in health policy. She worked for the consultancy firm KMPG and has been involved in supporting change in 25 countries.  She contributed to the government’s NHS plan and has worked with Sir Patrick Vallance and Sir John Bell on technology and how the arrival of the AI era will transform health and care. In the podcast Charlotte defends the Institute’s links with big tech companies and non- democratic governments and insists she and her colleagues have editorial independence and have never felt under any pressure to write anything or hold a view because of those relationships or funding.  What follows is a frank assessment of the current government’s strategy but hard questions about what will be needed to implement the changes needed and whether the absolute priority, which concentrates so much of its resources on older people with long term conditions, is justified.  Charlotte suggests the current budget may be all we can afford, and in her view the NHS needs to find ways of living within its means. That will involve thinking like an insurer, assessing future risks and taking prevention much more seriously. And there is also  talk of copayments for some new treatments for those who can afford it and the need for the NHS to start decommissioning some services if it is to embrace the technological revolution that is underway.  And she suggests we need a revolution in primary care.  As for the professions, she suggests the impact on doctors and others is uncertain but will be profound.  One of the changes she identifies is how new technology will continue to undermine the asymmetry of information that underpins the professions and how it will become easier and cheaper for people to seek advice from elsewhere. But she adds, that does not mean a dystopian future where we send out someone with an NVQ and an iPad to get and manage complex cases!

    36 min

About

In this podcast series, Roy and Niall leverage their extensive experience in health and social care to engage in insightful conversations with influential figures. They explore the sector's critical issues and challenges, cutting through political rhetoric and hype. Each episode offers a deep dive into the realities of healthcare, providing listeners with a clear understanding of the complexities involved. Who is Niall? Niall Dickson CBE is a prominent health and social care figure. He has held several key positions, including Chief Executive of the NHS Confederation, Chief Executive and Registrar of the General Medical Council, and Chief Executive of The King’s Fund. He has also worked as a journalist for the BBC and was awarded a CBE for his services to patient safety Who is Roy? Roy Lilley is a health policy analyst, writer, broadcaster, and commentator on the National Health Service (NHS) and social issues. He has held various influential roles, including vice-chairman of West Surrey and North East Hampshire Health Authority and chairman of the Homewood NHS Trust. Roy is also known for his popular eLetter, which reaches around 300,000 health and care managers, and for founding the Academy of Fabulous Stuff, a repository of best practices in the NHS.

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