Last updated 15:57, Wednesday, 23 April 2008

MARIE BURNHAM: ‘People think that you are a chief executive and not a person,’ she says. ‘When people criticise the Trust and the health system I take it personally. But I have learnt to accept I should not always take criticism personally. As chief executive people will always blame you for something, but sometimes it’s not you, it’s the system. That is quite hard when you love your organisation’

SHE has a high-powered career with a six figure salary to match. But Marie Burnham is more than an impressive job title.

Some would say she is tough to work for – she sets high standards. Others say she is a woman who cares. One thing most would certainly agree on is that she is passionate about the NHS.

The boss of West Cumberland Hospital and Carlisle’s Cumberland Infirmary recently announced she is leaving to take up another post in Lancashire. It marks the end of an era, both for her and for North Cumbria Acute Hospitals Trust, of which she has been the chief executive for the past five years.

This week she spoke to The Whitehaven News about local health services, the highs and lows of being in charge, why she took on a job that many others would shrink away from, what she thinks of Cumbria and its people, and her views on the Save Our Services campaign as well as her own personal journey.

“People think that you are a chief executive and not a person,” she said. “When people criticise the Trust and the health system I take it personally. But I have learnt to accept I should not always take criticism personally. As chief executive people will always blame you for something, but sometimes it’s not you, it’s the system. That is quite hard when you love your organisation,” she said.

“When you wear a badge with chief executive on, people think you are a certain way, that you must be tough. I don’t think that any of my ‘Improving Working Lives Champions’ would think of me as hard.

“People have pre-conceived ideas about what a chief executive should be like. I do have to make tough decisions and if it’s right for patient care then I would stand by my decisions.

“I think the managers would think that I’m hard to work for but I set high standards. I do believe that staff should be led properly.”

Family means a lot to her, “I am very passionate about family values and I do see the organisation as an extended family.”

The daughter of a father who was a union activist and a mother who was a Conservative, Marie has been brought up with strong principles. “I believe passionately in the NHS and that the service should be free at the point of delivery. I think the NHS is the jewel in the government’s crown.”

She doesn’t like to see poor care, such as cancer patients waiting or patients being moved from bed to bed. “That’s what drives me to make things better.”

Marie Burnham was one of Britain’s youngest health service managers when she took over as chief executive aged 38. She was also the first female chief executive of North Cumbria Acute Hospitals Trust.

Only about a fifth of acute trusts have female chief executives. Is it tougher in such a role as a woman?

“You often have to almost demonstrate you’re better than a man to prove your worth, but I have never been made to feel like that. I think that’s because I am credible. I was the first female chief executive in Cumbria and one of the longest-serving chief executives in the county. But it’s about capability, whether you are a man or a woman.”

When she arrived she says the Trust in North Cumbria was in an “absolute mess and had to be rebuilt”.

She put in a new management structure and lifted it up from its position of a zero-star organisation.

“In 18 months it went from being among the worst performing in the country to among the top ones.” And she was extremely proud to secure that two-star rating, despite still battling with the ongoing financial burden.

“A lot of experienced chief executives would not have touched North Cumbria Acute Hospitals Trust. But naivety actually helps, sometimes. I think it has helped me to approach things differently. I do believe anything is possible.

“I knew in Cumbria that clinical standards were okay; what let it down was its leaders and managers. I needed some way to get clinicians engaged in management. As a chief executive I supported that and worked with the clinical teams.

“All I have ever wanted to do is to make a difference in Cumbria and I don’t think I have done a bad job. I am pleased with the state that the hospitals are in at the moment and I feel like I have made a positive contribution.

“I don’t regret anything I have done, even naivety has been a blessing in disguise because I can ask basic questions. Would I do anything differently? Maybe not.”

There has been controversy along the way, with the threat to West Cumberland Hospital’s maternity unit and wide concerns about the hospital being downgraded. Nowhere was the feeling more evident than on the day of The Whitehaven News’s Save Our Services march through the streets of Whitehaven in 2006. It may have been a grey December day but more than 4,000 people took to the streets to show their feelings about their health services.

From that, the Save Our Services group was formed, led by the Rector of Whitehaven, the Rev John Bannister. West Cumbrians were prepared to fight for their services and, as a result of that, a better deal was secured for the new West Cumberland Hospital.

“I understand the march and I understand the passion,” said Marie. “And I think that people should be proud because it showed that people in West Cumbria take their health care very seriously.

“What saddened me was that at no time did North Cumbria Acute Trust board attempt to slash and burn services based on money.”

In fact, she said, the Trust went out of its way to protect West Cumberland Hospital by taking the unusual step of breaking its statutory duty to financially break even. “We were not prepared to close a hospital based on money. To not break even was quite something, not many chief executives would have done that, they would have slashed and burned. But I was determined to have a hospital in West Cumbria.”

At the end of this week there is a meeting to discuss the finances for the new hospital, for which there is £300million earmarked in the ‘Energy Coast Plan’. Then, the next big issue will be its location. Marie would not be drawn on where she thinks would be the best site for the new hospital. “It will come down to patient accessibility, particularly in a blue light (emergency) situation.” But what she would say was that the current site had not been ruled out for the new build and that another point to be considered was that staff would be allowed to claim travel expenses to get to work over a substantial period of time if the new location was effectively further for them to get to.

And, the question had to be asked, is there any point in putting a new acute hospital with community beds at Lillyhall, for example, when the area is already serviced by community beds at Workington Infirmary? Surely that would then still leave none between Millom and Whitehaven?

That’s another factor to be considered, agreed Marie. She also praised Copeland Council for a good job in putting forward a list of possible locations.

Another high point for Marie is the good relationships built up between the Trust and its partners such as local MPs and the NDA and the hard work carried out together.

As for low points, the chief executive would include the equal value pay claims. Although she does not blame the unions in addressing the national policy loophole, she said it saddens her that some nurses were awarded lump sums which often meant they were earning more than some more senior nurses.

“It was difficult for nurses working hard who didn’t put a claim in and therefore didn’t benefit, I found it quite upsetting. It was like a knife into the heart of the organisation’s morale – emotionally it was a rollercoaster for staff. It should have been resolved long before my time. It went back to 1991, it should have been addressed by 1996.”

Another low point for her was that if the former Primary Care Trust had worked with her Trust the way the new current one does in combining acute and community care, then the county’s health service would have been about two years ahead of where it is now. It has taken a new Primary Care Trust to come in but now we can move forward.”

With news that Marie is leaving in July and that Trust chairman Eric Urquhart is leaving shortly, could people be forgiven for thinking that new leaders may bring further unease back for staff and the community? “Consultants, when they come in, tend to stay for life. I have spent four to five years developing senior consultants into managers so the clinical management structure is absolutely rock solid. Because of that it would take a very brave chief executive to change the structure,” said Marie.

She had to make a decision whether to continue with the Trust for another five years to see it through into Foundation Status or whether to move on. She has chosen to take the promotion to a larger Trust serving a larger population, but it was not a decision she took lightly and intends to keep a “bolt-hole” in the county.

“It was not an easy decision for me,” she said. “I didn’t realise I would enjoy being here as much as I have, I thought it would be a management posting but it’s been a personal affection to Cumbria for me.

“I was shocked by how supportive people were and I have personally enjoyed fighting Cumbria’s corner.”