CONSETT, UNITED KINGDOM - APRIL 1: The new chief executive of NHS, Simon Stevens (C) talks to staff at at Shotley Bridge Hospital in County Durham on April 1, 2014 in Consett, England. The new boss of the NHS also visited Shotley Bridge Hospital, the Consett Medical Centre and International Centre for Life in Newcastle on his first day in the job. (Photo by Owen Humphreys - WPA Pool/Getty Images)
NHS chief Simon Stevens with health staff in County Durham

When Simon Stevens spent his first day as NHS England’s chief executive at the small hospital near Darlington where he began his career 25 years ago, he sent a clear signal.

After a 10-year absence, working in US healthcare, he was coming home, to the service that had shaped his professional life since he joined as a graduate trainee.

Unusually for an ambitious Oxford graduate, Mr Stevens set his sights on a career in unglamorous NHS management, rather than the fast-track civil service or the City after “big bang”. The reason may lie in his upbringing.

The eldest of three boys, Mr Stevens, now 47, was born on a Birmingham council estate, but this apparent parable in social mobility masks a family background that endowed him with considerable social and intellectual capital.

His father Laurence was a Baptist minister who became chaplain and religious education teacher at St Bartholomew’s School in Newbury, Berkshire, to which young Simon progressed in 1977. St Bart’s had begun to turn from a grammar school to a comprehensive only two years earlier. It retained the academic aura and traditions of its previously selective intake and 15th century foundation.

John King taught Mr Stevens history and spotted him as Oxbridge material by the age of 14. He remembers a “brilliant” young man, never afraid to challenge received wisdom or put forward his own ideas, with a special fondness for the Stuart period.

“You could pick him out as a leader,” recalls Mr King, who says the Stevens family instilled strong values based on the importance of public service. At Oxford, Mr Stevens was part of a distinguished cohort, some of whom later won political fame. Michael Gove and Boris Johnson were contemporaries.

He enjoyed a relationship of mutual admiration with the future London mayor, says Anthony Frieze, a college contemporary and fellow student politician. He recalls Mr Stevens lending “radical cred” to the Old Etonian’s tilt for the Oxford Union presidency.

The fact that Mr Stevens – known at university as a leftwinger – built an alliance with the poshest of Tories, says much about his career-long ability to form relationships that transcend ideological differences.

As a student he was already the pragmatic, cross-aisle figure who served Tony Blair and into whose hands David Cameron has now entrusted the politically fraught task of keeping the NHS on the road until the election and beyond.

In 1987, after treading a careful path between his own leftwing conscience and the need to win over the Conservatives whose support was required to clinch victory, he won the presidency of the Oxford Union himself.

His term of office is remembered for a particular coup: his decision to invite Gerry Adams, the Sinn Féin president who was persona non grata for the British establishment, to speak in a Union debate on terrorism. While contemporaries viewed the invitation as an act of courage, the resulting furore did nothing to hurt Mr Stevens’ university profile.

Upon graduation, fellow students recall he was already set on working for the health service. Acceptance to the NHS management training scheme led on to a series of jobs, from cottage hospital to big London teaching institution.

His entry into the world of Westminster came when Alan Milburn, later to become health secretary, summoned the bright young NHS manager to an interview in the Commons tea room in 1997. Even 17 years on, Mr Milburn recalls the meeting in detail. “He was high-energy and he could straddle the worlds of policy and politics which is highly unusual. Within 10 minutes I knew, ‘This guy gets it,’ ” says the former cabinet minister

Mr Stevens was a key architect, along with Mr Milburn and Mr Blair – to whom he went on to serve as health adviser – of the reforms that for the first time broke up the NHS monolith, introducing privately run treatment centres to offer choice to patients and a dose of competitive ginger to the wider health service.

Although their legacy is disputed, and many early contracts were poorly constructed, Mr Stevens’ record won him a post at UnitedHealth Group, a medical insurance company with a dominant presence across the US.

Those who have studied his pro­gress have been struck by his ability to grasp the im­pact of social and demographic changes – in particular the opportunities offered by the burgeoning middle classes in nations such as India and China.

He has also been allowed the freedom to think about the future as head of UnitedHealth’s own think-tank, the Center for Health Reform and Modernisation. Its goal, one friend says, “was to produce evidence that could help inform policy – analysing why [for example] healthcare in the US was expensive”.

Through the prism of a moneymaking organisation, Mr Stevens has also grappled successfully with some of the challenges the NHS must confront if it is to survive: better care for the elderly with chronic conditions, avoiding expensive hospital admissions by treating people in the community, and improving preventive care.

Will it be enough to sustain the NHS?

On his appointment, Sir Malcolm Grant, chairman of NHS England, hailed Mr Stevens as “the best in the world”. Whether he lives up to that designation may determine not just his own career prospects but the shape of the health service for decades to come.

Curriculum vitae

● Born 1966, Birmingham. Married with two children.

● Education: St Bartholomew’s comprehensive school; Balliol College, Oxford; Strathclyde University; and Columbia University School of Public Health

● NHS career: Joined the graduate scheme in 1988 and held various front-line posts until 1997.

● Government career: From 1997 to 2004, policy adviser to Alan Milburn and then Tony Blair.

● US career: Joined UnitedHealth in 2004, becoming CEO of its $30bn Medicare company, before becoming president of its Global Health arm.

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