The NHS ‘Blame Game’ and How to Change it


Over the past year, Radix has held a number of events and published a policy paper looking at possible reforms to the NHS: to localise decision-making and reduce bureaucracy.

Against the background of Covid, the NHS’s command and control systems appear to have held up well, but how has it felt to those inside the system?  How is morale on the frontline and what happens when things go wrong?  Who takes the blame and what impact does the fear of litigation have on how decisions are made?

To mark the launch of his book, Letters to a Young Doctor, leading Orthopaedic and spinal surgeon and former President of the Oxford Union, Prof Hilali Noordeen, will be conversation with Prof Stephen Smith, Chair of the East Kent Hospitals Trust, which has been at the sharp end of the response to Covid and its new variants.  Together, they will provide very different perspectives on how the NHS is coping with the crisis, and how events are viewed from the top down and the bottom up.

Their discussion will be led by Denis Campbell, the health policy editor for the Guardian and the Observer, and one of the most respected journalists in the field.

  • Panelist

    Prof Hilali Noordeen

    Prof Noordeen is the author of Letters to a Young Doctor, which is published on 25th February. Prof Noordeen was appointed as a consultant Orthopaedic and spinal surgeon at The Royal National Orthopaedic Hospital and Great Ormond Street Children’s Hospital in 1995. He trained in spinal surgery in Minneapolis and Seattle, USA and is a Professor in spinal surgery, KUM, National University of Malaysia, and an Associate Professor at University College London (UCL). Professor Noordeen is the author of several articles in peer reviewed journals and chapters in books. Letters to a Young Doctor is his response to his son’s enquiry about pursuing a career in medicine. It is meditation on the practice of modern medicine and a manual that aims to identify the profession’s problems, while prescribing possible solutions.

  • Panelist

    Prof Stephen Smith

    Professor Stephen K Smith is a clinician scientist having held senior positions in Academic Medicine and the NHS at the University of Cambridge, Imperial College, London and most recently the University of Melbourne. He currently serves as Chair of the East Kent Hospitals Trust, on various health and health technology Boards and as a Trustee of Pancreatic Cancer UK. Prof Smith led the formation of the UK’s first Academic Health Science Centre at Imperial College Healthcare NHS Trust and was its first CEO. A gynaecologist by training, he has published over 230 papers on reproductive medicine and cancer. He was awarded his Doctor of Science in 2001 for his work in Cambridge on the complex gene pathways that regulate the growth of blood vessels in reproductive tissue. He has served on the Boards of Great Ormond Street Hospital, the Imperial College Healthcare NHS Trust, the National Healthcare Group, Singapore and the Royal Melbourne Hospital, Melbourne, Australia. He was founder/director of GNI Group Plc that achieved IPO on the TSE in 2007.

  • Chair

    Denis Campbell

    Denis Campbell is health policy editor for the Guardian and the Observer. He has written about the NHS, public health and medicine since 2007 and shares health-writing duties with Sarah Boseley, the health editor.


Online Event


Tuesday 23rd February 2021, 6:00 pm - 7:00 pm

Additional Details

UCAS has received a record number of medical school applications this year (on the government’s website). But up to 1 in 10 of those entering medical school in the United Kingdom will drop out either during or just after completing their degree, and only a third of doctors who have successfully completed the foundation training choose to go straight into specialty training, according to the latest available data. This is the highest percentage it has ever been.

So, when Nordeen’s fifteen-year-old son asks his opinion on pursuing a career in medicine, the question provokes a period of deep reflection and the decision to write this book. As a consultant orthopaedic and spinal surgeon at the Royal National Orthopaedic Hospital, Great Ormond Street Children’s Hospital and other leading London hospitals, Noordeen endeavours to explore his son’s concerns at a primary level. But what advice can he offer a teenager poised to devote himself to years of study, followed by a career punctuated alternately by uncertainty and prestige?

Why does anyone leave medicine? How may we prevent this? A way to reaching a remedy is to understand the cause. Most undertake a study of medicine in order to deliver care. The main reason for leaving medicine is a disillusionment that arises from a failure to meet expectation. A triumph of reality over hope. The first part of the challenge therefore, and the primary purpose of this book, is to engage this reader in the understanding of the practice of medicine as it currently is, so that expectations can be more realistic. However, students and young doctors will persevere with hope and aspiration to mould medicine to adhere to their respective expectations. The secondary challenge is to prescribe a way to manage their consequent disappointment, or alienation. This starts with the premise that change or equilibrium can only be achieved by an introspective method that is both individual and collective, of like-minded individuals.

Letters to a Young Doctor is both meditation on the practice of modern medicine and a manual that aims to identify the profession’s problems, while prescribing possible solutions.

Available for advance purchase now for despatch for 25/2/21

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