International Festival of Public Health


Tribute to Aidan Halligan

International Festival of Public Health, Manchester

July 1st 2016

Ian Jacobs, President & Vice Chancellor, UNSW Sydney

It is a great privilege to have this opportunity to say a few words in memory of my friend and colleague Aidan Halligan a man I admired so much. It feels particularly apt to be speaking about Aidan in Manchester where he made an enormous contribution in the last 18 months of his life.

Aidan died suddenly from heart disease just over a year ago on April 27th 2015 age just 57 years. A premature and terribly sad loss to his wife Carol and the three daughters he was so proud of Molly, Becky and Daisy and of a great man who gave so much to everyone he encountered. He was a powerful, inspiring speaker and a compassionate caring man who achieved an enormous amount and had a big big impact on everyone he worked with. After his death there were numerous obituaries and tributes from NHS and academic colleagues, and in the media including for example the Guardian, BMJ and Irish Post, which I have drawn from in preparing this tribute.

Aidan was born in Dublin and qualified in medicine at Trinity College Dublin, in 1984. He progressed quickly in his chosen specialty of Obstetrics and Gynaecology being appointed lecturer at Leicester University in 1993, and just 4 years later in 1997 became the youngest Professor in his speciality of foetal and maternal medicine.

By all accounts he was a compassionate caring clinician but his real contribution came through his willingness to challenge the status quo in the NHS and in healthcare broadly. His charismatic, engaging and innovative approach to healthcare quickly gained the attention of the NHS leadership. The story I heard was that a Minister of Health came on a planned visit to Leicester Infirmary for a 3 hour programme at the end of which Aidan was scheduled to speak at a 30 minute session. The earlier sessions over ran so Aidan only had 3 minutes left. He gave such a passionate and clever 3 minute talk about patient safety that within days he was offered a job in the Department of Health. Even if not quite accurate this story gives a sense of the way Aidan worked and he did take a role at the DoH spending the next few years In Whitehall as Director of Clinical Governance for the NHS from 1999-2006 and then also Deputy Chief Medical Officer for England from 2003, under Liam Donaldson. He helped establish consistent standards of care across the English NHS but he also realised that the constraints, compromises, pragmatism and sometimes hypocrisy of life as a senior civil servant were not for him. Aidan needed a role where he could innovate and reach out to people in a different way.

He went on to set up an innovative training establishment in Leicestershire, Elision Health where surgical and multidisciplinary teams could develop their skills. In 2007, he took on a role as director of education at University College London Hospitals (UCLH), where he commissioned a novel education centre, focused on the science of human factors, in health care which sought to understand how people behave and interact in a range of situations. It was at UCLH where I was Director of the Biomedical Research Centre and then Dean of Medicine at UCL that I first encountered Aidan. I was deeply impressed by the way he was prepared to challenge the way health care staff however senior behaved towards patients and to each other. He addressed deep seated issues of intimidation and bullying in an incredibly skillful and determined way. It was clear to me that this was a man who cared passionately about the wellbeing of others and was prepared to act in a principled way however challenging that may be.

Aidan was also a wonderful mentor, advisor and confidante. So many people who have met him report chats over coffee with him which have influenced their plans and careers. That was certainly the case for me and I will always be grateful for his listening, his sound advice and the confidence he gave me to pursue what I felt was right. His ideas, often unconventional were inspiring, his analysis of people, their behaviour and their motivations was insightful and his advice was thoughtful, persuasive and caring. Importantly he would give time to people at all stages of their career from the youngest student to the most senior clinician or academic. He read widely and he memorably always carried a notepad on which he wrote down anything interesting he heard or read - so you always knew whether you had said anything remotely valuable when you met with him!

Aidan was deeply affected and concerned for the plight of the disadvantaged in our society. In 2009 he was deeply affected by the death of a homeless man outside UCLH. I remember him telling me about this over a coffee, explaining that the NHS was failing the homeless and explaining his thoughts on how this could be addressed. Most people would have left it at that but Aidan put his ideas in to action. He worked with Nigel Hewett to set up a specialist homeless team to address the system failure and profound injustice in the way homeless people were treated by the NHS. He set up an independent charity, Pathway, in 2010, to address this problem. There are now Pathway teams in many hospitals across the UK and thousands of homeless people have received better care as a result of his vision and action.

At the same time he was chief of safety for Brighton and Sussex University Hospitals from 2008-13 during which time he appointed the first-ever independent patient safety ombudsman, with a whistleblowing remit. That role gave him the opportunity to visit Camp Bastion field hospital in Afghanistan, which at the time was the busiest and clinically most challenged A&E in the world. H observed the multinational hospital team led by British regular soldiers and NHS doctors and nurses in the army reserve force. The experience of seeing well led teams, with a holistic patient focus, performing well in extraordinary circumstances, left him convinced that lessons could be learnt for the NHS. He went on to establish an NHS Staff College at the UCLH Education Centre in 2010 to apply the best of military leadership training in the NHS for clinicians and managers to improve NHS care. Through that initiative Aidan helped many clinicians and NHS managers to create safer and more effective ways for health workers to work together, in an environment in which they could recognise and learn from mistakes.

I moved on from UCLH to Manchester in 2011 and kept in touch with Aidan - for me our 2 monthly chats over lunch or coffee were key opportunities to reflect on what I was doing and seek the advice of an outstanding colleague and friend who I knew would hold me to the highest standards, probe with astute questions and usually give me unexpected insights and solutions to problems. So I was delighted when in 2013 he contacted me to ask if I was interested in Manchester Academic Health Science Centre being the lead organisation for a community action programme through which he wanted to reach the most underprivileged in society and improve their healthcare and quality of life - you may enjoy this mind map Aidan made to explain his vision and plan in 2013. That programme in 2014 became Well North, and we secured a combination of local and Public Health England funding to run it across many areas in the north of England. Aidan approached this in his characteristically dynamic, quirky, charismatic and engaging way - reaching out directly to people in the most deprived communities, helping them to voice what matters to them and, with the support of their community, taking action to address those concerns. He inspired many others and the work he led in the last 18 months of his life continues as a tribute to all he stood for.

So I have told you about Aidan as a Prof of Obstetrics and Gynaecology, as head of clinical governance and deputy CMO of the NHS, as the leader of an innovative health education centre, as creator of NHS for the homeless, as founder of NHS staff college and as Director of Wellbeing - but none of that quite gets across the quality of Aidan as an outstanding, wonderful, caring human being. He had an inspirational quality in his presence, his words, his thoughts, in the way he so clearly cared about others and particularly those who suffered or were disadvantaged which was unique and powerful. Those who worked closely with him were I know as devastated to hear of his death as were Shahina Mohamed, Peter Noble and myself who heard the news just 3 months after moving from Manchester to our new roles in Sydney. We had a sense that a unique and powerful force for good had been lost and that his loss was genuinely irreplaceable. Above all else Aidan taught us that the most important aspect of truly great leadership is a 'moral compass'. All that we can do now is to try to emulate in a small way the care, compassion and quality that Aidan brought to his life and work.

In his last email to us his friends in Sydney, sent to Peter Noble when the funding for WellNorth was confirmed in March 2015 just a few weeks before his death, Aidan wrote typically with three exhortations:

"First, go where no-one else goes;

Second say what is unacceptable;

and third show how it might be done".

He went on "those three statements often engage an audience who are sceptical, as it seems to reflect what everyone thinks but nobody says in relation to difficult social and health reform".

Aidan made lots of notes and often quoted them, so I am going to finish my tribute by quoting the moving words of John Walsh, Practice Manager at the York Street Homeless Health Service written soon after Aidan's death:

"Someone once said that if we stand on the shoulders of giants we can see for miles. Aidan was a giant. He called us – beckoned us – to come and see what he saw. Many of us did. He showed us how cities and services working together can make a difference. How caring pathways can be built for the most vulnerable of our people. And perhaps most importantly that we can be the writers and makers of our dreams. Goodbye Aidan and thank you for everything. We will continue that fight for social justice, kind care and being who we are at our best. That is your legacy and message. We want it be ours too".

Thank you Aidan for everything you taught me personally and so many others, for your passion, vision, generosity of spirit and for everything you did for the homeless and under privileged in society. Your work lives on in the UK and around the world through all of us who have been inspired by you and share your commitment to social justice.

Professor Aidan Halligan was the Director of Well North, a Public Health England programme to improve health and wellbeing across the North of England. He was also Principal of the NHS Staff College for leadership development and Chairman of Pathway, a charity that has developed health services for the homeless within the NHS.

He became a professor in foetal and maternal medicine in Leicester before taking on a national role as the first
NHS Director of Clinical Governance. He went on to become Deputy Chief Medical Officer for England, with
responsibility for issues of clinical governance, patient safety and quality of care across the NHS in England.

Tragically, Aidan passed away suddenly at the age of 57. Below is a link to an obituary for Aidan which featured
in The Guardian.
http://www.theguardian.com/society/2015/jun/19/aidan-halligan