FabStuff Podcast

Dr T Porrett
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Interviews with leading figures from health and social care

  1. Episode 14 Dr Charlotte Refsum - Tony Blair Institute

    DEC 6

    Episode 14 Dr Charlotte Refsum - Tony Blair Institute

    Niall Dickson CBE and Roy Lilley with their latest guest Dr Charlotte Refsum  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 Charlotte 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!  Send us a text

    36 min
  2. Episode 13 Rob Webster CBE

    NOV 15

    Episode 13 Rob Webster CBE

    Niall Dickson CBE and Roy Lilley with their latest guest Rob Webster CBE  For this next edition of In The Loop podcast Niall and Roy come together with Rob Webster one of the most prominent NHS managers and a huge advocate of integration. Rob heads up the West Yorkshire and Harrogate Health and Care Partnership an integrated care system.  And like every other system in the country he is grappling with a huge financial challenge, a big reorganisation, redundancies and staff threatening industrial action. So how is he managing as he faces a 45% reduction is his workforce and key staff in an angry mood?  Rob reveals this is the most frustrating period in his 36 year career with enormous pressure on everyone and he admits it is causing harm to his staff.  But he insists it will not distract from the work. While he acknowledges the difficult financial position, he says the transition is incredibly difficult, supports the aims of the reorganisation and believes that close working relationships between health, local authorities and the third sector can and will deliver meaningful change.   He says the NHS must put its people first and argues that staff have quite rightly become dissatisfied and that the job of NHS leaders is to do something about this. He notes how painful it has been to see the attrition of standards over the past fifteen years but suggests this can be a period where the NHS has to recover and transform services. Niall and Roy remain concerned about what can be achieved given all the headwinds but here again is a leader who says they can make progress. This podcast was recorded before the government announced the go-ahead for widespread redundancies in ICBs and NHSE.  Speaking at a Providers conference on 12th November the Secretary of State said;  ‘...Funding arrangements [for voluntary redundancies] have been agreed with HM Treasury and will be from within the existing funding settlement. We will not be cutting any investment to the NHS frontline. Further detail will come forward in the coming weeks.’ It is widely anticipated that NHS organisations will be permitted to overspend budgets in the current year and the amounts reclaimed over subsequent years through efficiency savings.   Send us a text

    41 min
  3. Episode 12 Sarah Woolnough

    NOV 1

    Episode 12 Sarah Woolnough

    In their latest podcast Niall and Roy engage with Sarah Woolnough the Chief Executive of The King’s Fund, one of the country’s leading health think tanks. In a frank discussion, Sarah defends the role of think tanks and laments the government’s failure to embrace public health and prevention in its first year in office.  She is highly critical too of the decision to kick the social care can down the road and says the Fund is now exploring radically different ways it could be funded, including social insurance. She is no fan either of the current reorganisation, arguing that she would have done it differently and quoting NHS leaders warning that it is already a major distraction. And she calls on the government to be honest about what it can and cannot be achieve within current funding constraints. Sarah reveals one of the most powerful moments she has had since joining the Fund: listening to leaders revealing the moral injury they have felt for not being totally transparent about their financial position for fear of being placed under greater performance scrutiny.  And while she wishes pharmaceutical bosses better understood NHS funding challenges she understands their ‘immense frustration and anger’ because they feel the government has led them up the garden path. Send us a text

    46 min
  4. Sir Jim Mackey, chief executive NHS England

    OCT 13

    Sir Jim Mackey, chief executive NHS England

    EXCLUSIVE Sir Jim Mackey, Chief Executive  NHS England in conversation with Niall Dickson & Roy Lilley ... in a frank interview Sir Jim talks about the difficulties he is facing and the fact taking on what he thought would be the job and how it's actually worked out, are two very different things! In this wide ranging conversation he accepts the pending redundancies are a cause for great concern and says that he does not anticipate any compulsory redundancies although the time scales are still uncertain. Managing the complexity of reorganisation, the pressures to deliver waiting lists and the Ten Year Plan are all on his 'to-do-list'. Listen to how he prioritises and how he sees the future. Send us a text

    45 min
  5. Episode 10 - Claire Murdoch

    SEP 21

    Episode 10 - Claire Murdoch

    In their latest venture In the Loop, Niall and Roy turn to mental health and conduct the first interview with Claire Murdoch,  NHS England’s outgoing mental health director since she dramatically resigned earlier this month after nearly ten years on the job.    In the podcast, Claire says she quit because she felt she no longer had political support and reveals her dismay at the failure of the new government to maintain the share of NHS spend on mental health.  In a strong defence of what has been achieved on her watch, including more than doubling the number of professional staff working in child and adolescent services, much improved access for young people, despite a huge increase in demand, and great progress on a nationwide roll out of mental health support in schools.  Looking forward, she says the share of NHS spend has been phenomenally helpful and must be protected and that as far as she is concerned it was ‘job begun not job done’.  But this discussion also reflects the reality of mental health care in England today with services desperately struggling to meet the explosion in demand and with patients of all ages unable to access the support and treatment they need. Send us a text

    36 min
  6. Episode 9 Dame Jennifer Dixon

    SEP 11

    Episode 9 Dame Jennifer Dixon

    The latest podcast from Niall and Roy sees a somewhat different take on the current state of the NHS from Dame Jennifer Dixon, the longstanding and respected Chief Executive of the Health Foundation.  Jennifer, who once practised in paediatrics before moving into public health, accuses the government of being disrespectful and menacing in its approach as it seeks to reform the service and argues that the system needs to use its principal asset which is human capital.  She also questions whether it will be possible to deliver all that is being promised, arguing that while technology will help it is possible to be unrealistic about what it will achieve. Dame Jennifer also questions whether the current approach to prevention will work suggesting that there is a limit to how much the NHS can do given its funding constraints and she warns that if autonomous Integrated Care Boards could go upstream and spend funds in that way it could be at the expense of basic services. She says that while we are not there yet, if improvements don’t come fast enough, we may get into a situation where we need to look at getting much more money into the system from some other routes. On her own profession, she says she understands why young doctors are angry but reveals how she saw at one hospital how disrespectful they were to their chief medical officer, switching off their online cameras and putting barbed comments in the chat box.  Jennifer calls for much more practical support for resident doctors but predicts that technology will mean more tasks will be protocolised and that as a result in the future there may be a need for fewer physicians, with those who are there working at the top of their licences.  The next five years she says will be the most critical in the NHS’s existence. Send us a text

    35 min
  7. Lord Darzi

    AUG 29

    Lord Darzi

    In their latest podcast Niall and Roy have a fascinating exchange with Professor Lord  Darzi, the eminent surgeon and former government minister whose independent investigation earlier this year laid bare an NHS that is failing at so many levels and which has lost public confidence. In the podcast, Ara Darzi reveals how shocked he was to find that staffing was not the issue, but that instead there had been a serious crash in productivity.  Nor was funding the issue. He says money has been wasted over the last fifteen years. Instead, he argues that the answers lie in empowering local leaders and grabbing the huge opportunities for innovation from the digital revolution.  He predicts that AI will transform clinical practice and slash the current administrative burden. But none of this will work unless the NHS receives capital investment, and he adds that the neglected area of social care must be tackled.  Send us a text

    34 min
  8. Episode 7 in conversation with Professor Tas Qureshi

    JUL 29

    Episode 7 in conversation with Professor Tas Qureshi

    In this episode of their Podcast In the Loop Niall and Roy step on to new ground in a fascinating discussion with Professor Tas Qureshi. a General and Gastro-intestinal Surgeon at Poole Hospital in Dorset. But Tas has another role – he has made a number of trips to Gaza as a volunteer, giving up his free time to support his fellow surgeons there as they deal with the most horrifying of trauma injuries, as well as helping to train staff in the treatment of cancer.   This is a personal story, not a political statement but by telling it Tas hopes to highlight the plight of all those who are suffering, including so many children. In doing so he gives us a mental picture of what it is like to operate, medically and in every other way, in a war zone.  You will have seen many terrible pictures of the suffering in Gaza, but this account, with words only, is in some ways more illuminating, more powerful.  He reveals the impossible choices he and his colleagues face of which child to treat and which ones must be left to die, sometimes in agony, the so called safe houses which are not safe from bombs and bullets, and the resilience of humans in the face of impossible odds.  Many UK doctors do incredibly valuable pro bonowork, but Tas is one of a smaller band who are also prepared to risk their lives to relieve suffering. And like Tas, they are not keen to promote themselves, but are keen to tell the story of what they have witnessed.  Send us a text

    30 min
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Interviews with leading figures from health and social care

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  • Creator
    Dr T Porrett
  • Years Active
    2K
  • Episodes
    14
  • Rating
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    © 2025 FabStuff Podcast
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