A stellar career in digital wasn’t enough to land Joe McDonald an interview for the national CCIO job. So why was he passed over? He has his suspicions

Sailing out of Mesolongi at dawn is one of my wife’s favourite bits of the 300-mile yacht delivery trip from Corfu to Epidavros. There is a spectacular view of the sunrise over the mile long channel between the quaint old town quay and the sea. Giant loggerhead turtles intermittently pop their chunky heads up in the still of the morning, sending golden circles rippling across the otherwise glassy sea.

My wife sees none of this however, because her favourite thing about Mesolongi is the size of the quay which allows us the luxury of mooring the yacht with its side, rather than its stern, against the quay. This means getting the boat out the following morning can be done single-handedly, and she gets to stay in bed for several hours, waking to the comforting thrum of the diesel engine or the singing of the wind in the sails. My wife spent years trying to get back to sleep after I woke her before dawn so I could ‘commute’ from Newcastle to London in pursuit of a dream, an NHS enabled by IT. She needs her sleep.

Quietly as I can, I slip bow and stern lines, shove the bow out, push the throttle gently forward and pull away from the quay. Using my phone and Bluetooth headphones, I can listen to Radio 4 without waking the sleeping beauty.

The big news today is that the Garrick Club has, after many years of dogged resistance, decided to admit women members. Earth shattering, evidently. I hear a member of the patriarchy complaining that the country and the club has gone to the dogs by admitting the “wrong kind of people”. The establishment is rocked.

My watch pings as we gently advance up the narrow channel to the sea. I have email.

Culture of fear

“Dear Joe, thank you, blah, not shortlisted, blah, many applicants, specific criteria, no feedback possible, blah blah…”. So I won’t be the next national CCIO. Not even interviewed. Disappointed, I look for the signature, while keeping one eye on the channel markers as we approach the open sea. There is no signature, it’s sent from a team inbox. No one to talk to. No one brave enough to tell me I’m too old or too mouthy or the wrong kind of person. And there we have the culture of NHS IT: fear is keeping the ‘wrong kind of people’ out.

Heading into the Gulf of Corinth my disappointment becomes anger. I didn’t expect to get the job, but I should be on the shortlist of any genuine competition. I know I’m supposed to slip quietly into retirement, but you know what? People slipping quietly away is what keeps poor organisational cultures alive. Look at the Garrick, it took the ‘wrong kind of people’ to shake off its demons. Look at the contaminated blood scandal, the ‘right kind of people’ were all over that.

So, why did I think I would get an interview? Well let me do something very uncomfortable and tell you. Aside from 40 years clinical practice:

I was clinical lead for mental health IT during NPfIT and mental health has been paperless for 10 years.

I was founding director of the very successful shared care record, Great North Care Record.

I was a founder member and five times elected chairman of the Digital Health CCIO Network taking it from a handful of members to 6000-plus.

I was appointed visiting professor of health informatics practice at Newcastle University.

I helped write the first CCIO Handbook.

I am medical director at three successful health tech SMEs.

I was one of the first ever CCIOs in the country at the award-winning Cumbria, Northumberland, Tyne and Wear Foundation NHS Trust IT department.

I have led more national UX surveys of NHS EPRs than anyone else in the world.

Been there, done it, got the tee shirt and still only 62, with fire in my belly and gas in the tank.

Worse than sour grapes

But what do I know? Am I guilty of sour grapes? You bet. A sore loser? Indubitably. But it’s worse than that. I encouraged many of you to apply for the national CCIO role. I’m now wondering if the process is the familiar window dressing before an in-crowd placenik gets a tap on the shoulder. It’s an important job, there should be a proper competition. Enough.

I hear sleeping beauty, stirring down below. The kettle whistles, I stop the engine and unfurl the foresail; with the wind behind us maybe we can fly effortlessly down to Corinth by sunset.

She’s awake now so I fire up the HiFi and, not for first time in my CCIO journey, I play New Dawn Fades by Joy Division. A pod of dolphins appear on the bow as they often do in response to music in these parts. I’m brought a cup of coffee at the helm, and I tell her that I’m now history, apparently. “Their loss, pet” she says, her arm gesturing at the sun and sea. “But why would you care about any of that when we have all this?”

But that’s the problem. I do care. I still do.

Professor Joe McDonald is a former NHS consultant psychiatrist, trust medical director, chairman of CCIO Network and founder of the Great North Care Record. He is currently working as peripatetic medical director for a number of SME health tech companies, including Sleepstation, SARDJV and Parsek.