Looking to the future
Despite a career that has afforded her great experience of the inner workings of the NHS across the whole of the UK, the BDA’s new director for Scotland acknowledges that her new role is unlike anything she has ever done before.
Born and raised in Paisley, Pat studied modern history and political science at Dundee University before joining the NHS graduate management training scheme in 1979.
The two–year training programme took her to Edinburgh, Glasgow and Dundee but her first role after the scheme was at Yorkhill Children’s Hospital. From there she worked in Tayside before moving to Argyll and Clyde and then Forth Valley, where she took on the role of hospital manager at the Stirling Royal Infirmary.
Her next role was at the University of Stirling where she was taken on as a research fellow, and subsequently senior lecturer, spending the next six years setting up an MBA programme for doctors and dentists in association with the BMA. Pat then moved on to join the Scottish Government as a policy advisor in what was her biggest exposure to primary care – including primary care dentistry – so far. She led the national task force on the development of primary care trusts (PCTs) in Scotland, which brought about the introduction of PCTs. The outcome of the taskforce was the government white paper in 1996 called Designed to Care.
Pat explained: “It was a very challenging role because primary care had never really worked in organisations before. They had all been independent of each other and now they were being organised into primary care trusts who would manage them and their services on a grander scale. So that was a big change for them.”
The changes involved included to the budgets, so where previously services were funded on a practice level, they were now going to be funded through PCTs. Pat continued: “So that was a big change and there was a lot of opposition within the professions and within the NHS generally.
“It was quite an interesting job though and I had an all–Scotland remit. My job was to make sure every health board was ready for the changes and we put a lot of organisational development money into promoting and helping the changes to take place.”
After her role with the Scottish Government, Pat was appointed as the director of clinical service development at Argyll and Clyde. She said: “It was my job to improve and develop services, introduce quality initiatives and reconfigure services.
“It was a politically contentious job, lots of public consultation, lots of political opposition, lots of public involvement – trying to help the public understand why these changes would help provide a better service, rather than a reduced service.”
From Argyll and Clyde, she joined NHS Greater Glasgow and Clyde where she became the director of planning in North Glasgow University Hospitals Trust before moving to join consultancy firm Tribal in 2006. Although based nominally in Scotland, this new role took Pat all over the UK, from the south east of England to Northern Ireland.
Her main duties involved mainly working with acute trusts that were financially challenged. She explained: “What you tend to find is that if an organisation has financial problems, it has other problems. That financial deficit is the manifestation of a whole lot of other things that are going on. So trusts that are in financial difficulty have often got clinical problems, management problems and patient care problems as well as other issues.
“So it was my job to go in with a team and help them put together a recovery plan and try and turn it round.”
After four years, Pat decided to set up her own business and launched Kilpatrick Consulting, targeting much the same areas as her previous role. Again, she worked mainly with acute trusts in the north west of England and Northern Ireland, where she also worked with the department of health. During this time she was appointed as the acting director of surgery for Pennine Acute Hospitals NHS Trust. She said: “I went down to help them sort out their surgical service and, at that time the director left, so they asked me to stay on and become the interim director. That was interesting. They had a big financial deficit and it required us to restructure all the surgical services. It was good for me because it took me back from working at a strategic level to looking at the detail in an operational division, with lots of staff and clinical issues.”
The role also provided her with experience of working in a big organisation again – experience that would prove useful for her next role at the BDA.
Pat explained that when she saw the post advertised she saw it as an interesting new challenge in a brand new role. She said: “I thought that this was another opportunity to do something different in a different type of organisation, with different stakeholders, representing different people – I am no longer with a private company and it is no longer about winning new business. It is also no longer about working for the NHS and the constraints of the NHS management system.”
And, during the interview process, Pat briefly came face–to–face with her predecessor, Andrew Lamb, who was involved with the first stage of the interview process. She paid tribute to the work that he had spearheaded over the last decade, with regards to the salaried services contract – which is finally nearing conclusion – the manifesto document for the last election and his work looking at services for the older patient, to name but a few.
She said: “I think Andrew’s career and successes speak for themselves. He came across as a quiet and unassuming man but he worked tirelessly in pursuit of the issues and the challenges of the job.
“I think he had a very reflective style and it was very successful and effective.It’s no surprise that people still talk affectionately about him.”
Pat has identified that her first priority in the role is to renew contacts that Andrew had built up over his career in dentistry and latterly in the BDA. She said: “It is my job to get out and create my own opportunity to understand the industry better, while at the same time raising the profile of the BDA as much as I can by talking to people, going to LDC meetings, conferences and trying to engage with dentists in whatever forum they are in.”
As well as the new salaried services contract, one of the main challenges facing Pat are the problems with duplicate registrations affecting more than 7,000 NHS list numbers and the attempted clawback of more than £3.5 million in funds by PSD.
She said: “Dentists are quite rightly very unhappy and we have made a legal challenge under the terms of the regulations. If it goes ahead, then dentists will have to trawl back over all their records to validate it all and say which registrations are correct or not.
“I think it is a big administrative nightmare for PSD, and to some extent we are sympathetic to that, but on the other side of the coin it is a big nightmare for our members.”
Despite all this, Pat remains very positive for the future of dentistry, both NHS and private, in Scotland. She said: “I think we are quite fortunate in Scotland because the Scottish Government is deeply committed to NHS dentistry. I don’t get any sense that there is any question over that.
“It has invested significant amounts of money promoting access and access is now very good. People don’t have the same sort of difficulties that they had five years ago getting registered.”
She continued: “For me it is all about the members. My job is to make sure that we promote dentistry and the needs and aspirations of dentists in Scotland.
“We need to make sure that we do our very best to make sure that the lives of dentists are manageable and that the resources are there for them to do the best for their patients.”