John was born in 1943 at the height of the Second Word War. He was an only child and grew up in Kidsgrove where his father was the vicar of the local parish church. As a teenager he wasn’t greatly interested in studying, much more interested in playing cricket! So when a chance meeting at a school careers fair brought him a job offer, he promptly left school at 17 and went to work at Crewe Memorial Hospital as a junior clerk.
He moved though a number of jobs in the North Midlands and Yorkshire before joining the recently created National Training Scheme (now GMTS) as an in-service trainee. His first job after leaving the Scheme was as Hospital Administrator at Durham County Hospital. It was here that he first developed his interest in using data to improve services. He employed the regional mainframe computer to reschedule admissions to make more beds available for urgent admissions – a remarkable achievement in the late 1960’s. His boss at his next job in West Cumberland encouraged him to work closely with consultants which he very much enjoyed. So when an opportunity came in 1971 to combine his love of data and working with doctors, he took it with enthusiasm. That meant a relocation south to Birmingham to the Queen Elizabeth Hospital (now UHB).
The 2 years John spent there provided much of the material for his first book ‘Hospital Beds’ which was eventually published in 1982. The 1974 NHS Reorganisation saw John appointed as District Administrator in East Birmingham where he had a second new hospital to commission, the first being West Cumberland Infirmary. But he found that the move back into mainstream hospital management did not have appeal it once did which is why in 1978 he found himself at the Health Services Management Centre at the University of Birmingham.
Thus began the second phase of John’s NHS career, that of a ‘placebo academic’ as he liked to call it. Initially he obtained the funding for a post concerned with clinicians in management. This quickly turned into a research project on routine data and mental hospital performance and also a place on a committee investigating Orthopaedic waiting times. 40 years on those two topics are still as relevant as ever considering the current state of the NHS waiting lists and the recent Winterbourne View scandal.
That research project gained John a PhD and the Orthopaedic work led in 2 directions. Firstly, there was the development of the first ever national performance indicators covering the major hospital specialties in 1982 which gave rise to the unit name Inter-Authority Comparisons Consultancy (IACC). John had used computer power before to bring data to life but this time he harnessed the graphical display capabilities of the new microcomputers to good effect. This was innovative at the time and had a far reaching impact across the NHS. The Department of Health eventually employed John and his team to develop a graphical display for their own performance indicators until the mid 1990’s.
Secondly, it led to the work on reducing waiting lists that he is possibly most widely known for. The first problem he tackled was getting the topic on the political agenda. Until the mid 1980’s hospital waiting lists were regarded as a political hot potato, to be avoided at all costs. John used his flair for making an impact with data to produce, in conjunction with the College of Health, a series of maps showing the variation in waiting time across England. This sparked a debate which led to the first national Waiting List Initiative in 1987.
Initially in the West Midlands region and then across the whole of England, he and the team he gathered around him focused on reducing waiting times rather than purely waiting list numbers. John argued strongly that it was the time patients waited that mattered more than how many were in the queue in front of them. That focus on individuals was a strong driver. His second book ‘Why are we waiting’ published in 1987 featured a lady he referred to as Mrs G. Many thought this a literary device but Mrs Goodwin was a real person, his real life neighbour. The impact he and his team had is hard to underestimate. At the start there were over 250,000 patients waiting over a year for surgery in England, 5 years later this was dramatically reduced. Never again were NHS waiting lists regarded as something that couldn’t be tackled. It provided the foundation upon which all the current targets are based.
The 5 years he spent working on reducing waiting time across the NHS had 2 consequences. There was the very public falling out with the Department of Health over their waiting list policy – don’t believe everything you read in Hansard – but there was also his third book ‘Private Eye’ which explored the grey area of the NHS and private practice. He teamed up with Channel 4’s Dispatches programme to produce a TV documentary and an accompanying booklet on this subject. The work was credited with being one of the chief factors leading to the revision of the consultant's contract.
John’s research and consultancy work resulted in over 100 publications including three books, two of which gained the Baxter prize for European healthcare literature. He was also awarded the Naughton Dunn medal for distinction in orthopaedic surgery for his work on reducing waiting times, the award I think that he was most proud of. And towards the end of his career, he was awarded an Honorary Professorship from the University of Birmingham, a real achievement for someone another University had described as ‘educationally subnormal’!
As in any career, John received encouragement and, in some case, financial support, from a number of individuals from that anonymous administrator who persuaded John to join the NHS in the first place through to Professor Derek Williams who took him on at HSMC in 1978. He was also helped by circumstances. The NTS was originally envisaged as a scheme for graduates only but widened their remit to include in-service trainees just at the right time for him. The 1974 Reorganisation placed restrictions on jobs so John could not return to his beloved Cumbria as he wanted to. John succeeded in part because of these factors but mostly due to his drive, enthusiasm and passion for patient care.
He leaves behind his wife Val, his childhood sweetheart that he married in 1967, his three children Chris, Paul and Becky and 6 grandchildren. Then of course there are his surviving colleagues at IACC, HSMC and those he inspired in turn across the wider NHS.
Mike Davidge, Director of NHS Elect
John used his flair for making an impact with data to produce, in conjunction with the College of Health, a series of maps showing the variation in waiting time across England.Mike Davidge