Monday, September 28, 2009

Friend of Simplicity - Ken Dainton

Today I have immense pleasure in publishing my latest ‘Friend of Simplicity’ interview with Ken Dainton.

Ken is a personal friend (he was best man for my marriage to Annie) and has been a professional management colleague in healthcare for over 25 years.
In 1983 I moved 300 miles from my home locality as a (relatively) young and inexperienced manager to a big challenge in a new job in the National Health Service (NHS). I found myself in Torbay, Devon, England – a place where I knew no one.

The first person to make me feel welcome at work in Devon was Ken who at the time was the Administrator (which in those days (all but) meant CEO) of Torbay Hospital which has over 500 beds. Ken was very helpful to me from day one in all sorts of ways. He gave me great support and advice in a completely new locality where frankly, I felt completely lost.

I unashamedly ‘used’ Ken as my 'informal mentor' in those days and actually I still do.

As far as I’m concerned Ken is the best Chief Executive the NHS has never had.

Hundreds – possibly thousands - of people in the NHS have influenced me during my long healthcare management career. Ken – through his wisdom, guidance, experience and kindness has influenced more than most.

I hope you enjoy reading the interview and please respond with questions and/or comments for Ken.

Trevor: Welcome Ken - Please give a brief history of your career.

Ken: Very boring and conventional I'm afraid. I joined the Bath Hospitals straight from school on their local training scheme for administration back in the swinging sixties. We were expected and encouraged to obtain the Institute of Hospital Administrators qualification and leave for higher things. This I did, working in Wiltshire before coming to Devon 36 years ago. I have been rooted to this delightful spot ever since but fortunate to have enjoyed a variety of jobs including planning, HR, and operational management both within the hospital setting and in the community. I retired four years ago but returned on a part time basis. Work is now my hobby.

Trevor: Can you pick a couple of excellent leaders you have worked for and tell me what it was that made them better leaders than the average manager?

Ken: Unfortunately I can only think of one that I have worked for (perhaps that says something more about me than them!) but there are several others that I have worked with who I would single out. The qualities that stand out are integrity; good communication skills; vision; a pragmatic approach and ability to secure alliances; and the personal credibility (ability/knowledge/understanding/judgment/objectiveness) that breeds confidence in colleagues.

Trevor: I’m interested to hear your opinions about the UK National Health Service particularly in the light of the current debate regarding universal healthcare in the US.

Ken: I've lived in the States for short periods and what stood out for me was the number of people working well into their old age, some of them very frail, in order to pay their healthcare bills. The anxiety that was generated was palpable. For a civilised society with top class acute facilities it is barbaric. The NHS offers free at point of delivery, comprehensive, cradle to grave, non judgmental care. But those strengths are also its main weakness in that it tries to do everything for everybody (often backed up by legal action) and thereby creates an impossible funding and ethical dilemma.
It seems to me that the ideal system would be the best bits of both-one with minimum bureaucracy, that incentivises innovation, encourages self help and reliance, and is explicit in what it services it provides.

Trevor: What’s your opinion of doctors being involved in management?

Ken: The first thing to say is that not all doctors want to be involved in management. I can understand that because it’s not what they trained for and doctoring is tough enough without any further distractions. However they can't then complain if issues are not addressed to their satisfaction.
The second thing to say is that a common misconception of doctors is that management is about sitting behind a desk, dealing with finances or commanding a bunch of recalcitrant staff. Its not. It’s about shaping the strategy; establishing the agenda; setting priorities; keeping maverick colleagues on side; and advancing the clinical capacity and skills of the organisation. It is vital that doctors play a full and leading role.

Healthcare is a dynamic business, there is a political dimension (both local and national) and teamwork is essential to reconcile the many and various competing demands. Without clinical leadership the organisation will flounder.

Trevor: Can a manager from any organisation manage a large hospital? – What are the unique issues in hospital management?

Ken: I see no reason why managers should not be recruited from outside the NHS provided they have the personal attributes necessary. However, there is a steep learning curve that needs to be climbed very rapidly. There is a multiplicity of professions, specialist interests and power bases. Understanding the connections, motivations and dynamics is quite tricky. Learning who the movers and shakers are, both people and positions, is crucial. Taking advice from seasoned operators and tapping into the organisational memory is a key skill.

As with any new recruit the early, honeymoon period is crucial in gaining credibility and it is even more important for external appointees.

Trevor: Looking back on your career can you identify some of the big differences in management say 30 years ago compared to 2009?

Ken: Looking back some of the decision making processes were pathetic. On the other hand we were much more liberated from the vast weight of rules/regulations/legislation that there is today. Thirty years ago there was more thinking-on-ones-feet and initiative. These days the NHS is far more risk averse and there seems to be a written protocol to follow for every little issue. Management can easily deteriorate into a tick box culture and this drives increasing specialisation.

Gone are the days when a young manager could be a jack-of-all-trades (master of none) and learn by taking a chance and making mistakes.

Gone are also the days of the "public service" ethic. There are still pockets of altruism but society has changed.
The other obvious difference is that there is no longer a defined career ladder to climb. These days it is more of a flexible climbing frame to scramble across both within and outside the service. Trevor:

What advice would you give to young managers just entering their management career?

Ken: Healthcare is a fascinating subject so:

*Take a professional pride in all that you do.
*Respect, and learn from, all other professions.
*Seize opportunities to develop.
*Listen to what patients, their carers and front line staff are saying.

Trevor: Are you optimistic about the future of healthcare management here in the UK?

Ken: I am a natural optimist. I am confident that the NHS has a future and there will therefore always be a need for good management. The top guys though will need a much tougher skin, have to be more politically and publicly astute and find a way of imposing that public service ethic on an increasingly strident audience.

Trevor: Brilliant - thanks Ken – keep taking the pills my friend!


Dave Wheeler said...


A most excellent interview indeed! Ken's point that that recruiting managers outside of the field is an interesting and excellent one. Many public school districts have in the past have hired retired military officers with good to great results in most cases.

Looks as if you had the benefit of having a great mentor!

Dan Gunter said...

Nothing like giving a shout-out for a mentor that positively influenced (influences) your career and in turn multiple aspects of your life. Sounds like Ken's the kind of mentor that is so rare (if not missing entirely) for far too many people.

Great interview. I always enjoy reading these.

Trevor Gay said...

Thanks Dave and Dan - very kind comments from you both.

Ken is indeed a brilliant mentor and he is far too modest to say as much - so I say it for him!

Ken will reply in due course I'm sure.

J.KANNAN said...


At the outset I would like to classify this interview with Ken Dainton as an "Exotic" one.

1. It is indeed quite amazing to note that you have a long lasting friendship with Ken apart from being a True Mentor of yours.-Keep it Up Trevor. And you in turn keep your Mentor in high esteem referring to his wisdom,,guidance, experience, kindness etc.that have influenced you most.I am personally thrilled to know this.

2.A clean and highly appreciative track record of study, career and growth. A true worker can never retire that's why Ken still continue to work, indeed and excellent attitude to be followed.

3.An apt answer from ken. Its rather difficult to pick, choose and name of people(Leaders) who have made work as their hobby and was a cause of support and growth of others. I do agree with Ken.

4. For your question on opinions about UK, NHS, Ken has answered openly and frankly without any fear and favouritism which is a rare phenomena, according to me.

5.As rightly mentioned by Ken doctoring undoubtedly is a tough job with out any other detraction and divertions., but requires to play a vital role keeping in mind various aspects brought out by Ken, and I really like this and would like to classify as "Excellent advice".

6."Personal attribute necessary" are key words used by Ken followed by sharp learning curve.....................................................
A truly justifiable answer.

7.Yes. Time is a big factor in identifying the difference in management of organisations and Ken has explained in spic & span in crisp.

8.Great advice to young Managers by Ken and a very good and essential to be a really good and worthwhile Managers.

9.Natural optimism is one the finer and great qualities in a person and Ken has expressed it in then beginning of his answer with good tips.

Trevor, really brilliant questions equated with brilliant answers from Ken.

With Beast Regards to You & ken.


Mark JF said...

I very much agree with the comment that the NHS needs to be, "...explicit in what services it provides." Implicit in this is the recognition that we need to have a debate about what the NHS does NOT do. All too often, politicians and commentators come up with the usual bland statements about the universality of the system. But, as Ken points out, this creates a massive funding issue.

We need to start the difficult process of debating what the NHS can't do and what it can do but for a charge. And then start the extremely difficult task of implementing it.

Scott Peters said...


Great interview. A great mentor to boot! As I was reading the interview, a professor came to mind that mentored me during college. The professor provided a unique way to look at problems to develop solutions. The professor also understood the dynamics of politics, grants, and funds to support his labs. Even though he had to work in a very organized "system", he never let the "system" affect his passion and dedication to research.

Ken seems to have a wonderful balance about him...something JK touched on. What's most interesting about Ken is that he understands the landscapes of yesterday and today, and while he doesn't try to reconcile them, he places great value on what a manager needs to be successful in today's environment.

You have continually surrounded yourself with good, caring people. Nice to share in some of the seeds of your success!

Trevor Gay said...

JK, Mark and Scott- thanks so much for your comments.

I've been on the road - or to be more accurate - on the trains for 8 of the last 9 days and the next two weeks looks pretty much the same as I travel round England working - but hey - sleep is over rated :-)

Ken will respond in due course but thanks for the kind things you say about him - he is indeed a great mentor and a great friend. A real source of wisdom.

JOHN O'LEARY said...

Another good interview, Trevor! And except for the food trains are the best way to travel.

Trevor Gay said...

John - I agree about trains - I am very impressed with rail travel in the UK - much better than the image often portrayed in my personal experience. And the food is definitely better than a few years ago - particularly on Virgin Trains - there is no surprise in that of course with Sir Richard in charge :-)

Ken Dainton said...

Many thanks for the responses.I am amazed at the interest & embarrassed/flattered by them.

One, of course,still goes on learning & I wish I knew then what I know now & was able to put into practice.

I find it fascinating being in this position now watching the mistakes which senior people make,albeit with the best of intentions.

Why don't we/they learn by talking to those who have gone before?

Is it arrogance,insecurity,lack of thought or organisation or maybe lack of time? A mixture I guess.

Thanks again to all who have made comments - I value them.