Snoozing in first class in the middle of the working day, this is the new head of the NHS hired to tackle ‘inefficiency’.
Sir Jim Mackey vowed to MPs on Tuesday he would ‘pick up the pace’ of reform.
Then the newly-installed chief executive of NHS England went straight from the House of Commons to a first-class train carriage where he started watching Netflix in the middle of the afternoon before dozing off.
The Mail can reveal Sir Jim is ‘running the NHS from a train carriage’ as he commutes 1,200 miles a week between the office in London and his home in Northumberland.
He was put in charge of the health service and its 1.5million staff and £186billion budget on March 31.
The Mail’s exclusive investigation also revealed Sir Jim left his laptop unlocked when he went to the train toilet.
He openly displayed documents including one revealing details of an ‘NHS leadership’ meeting. And the health service chief slept half an hour – through an alert on his device reminding him of an online meeting.
Sir Jim, it can be revealed, knocks off early to catch the train 300 miles home, watching TV programmes on his iPad. In London, the £300,000-a-year NHS boss overnights at a private members club in Mayfair.
Former Conservative leader Sir Iain Duncan Smith said: ‘You couldn’t make it up.
‘It’s not a great lesson in efficiency when you waste so much time travelling and falling asleep. You can’t run the NHS from a train carriage. If you want to do the job properly, you’ve got to be in the office. It’s what most businesses would demand.’
But Health Secretary Wes Streeting backed his hire to lead the NHS, declaring: ‘Jim is proving to be worth his weight in gold.’
On Tuesday morning this week, Sir Jim was introduced to the Commons’ health select committee, to answer questions alongside the health secretary.
Mr Streeting told his fellow MPs: ‘We’ve got to go hard after any waste, any inefficiency,’ to which Sir Jim added: ‘We need to pick up the pace of change.’
Yet three hours later, having settled into his first-class seat on a train home to Newcastle, had lunch, and started watching Netflix drama The Diplomat, he fell into a slumber.
After waking up, he put on an interior design show, while also dealing with emails on his laptop, before going to the loo and leaving his emails unattended.
Sir Jim, a born-and-bred Geordie, declared when he took the job – replacing former NHS England chief executive Amanda Pritchard – that his ‘heart has always been in the North East’.
A proud family man and grandfather, he has started in the role by making two return trips home a week to the house he shares with his wife.
Eager to get there, on Tuesday Sir Jim caught a 2.30pm train to Newcastle. On Thursday, he quit his desk at NHS headquarters in Waterloo at 3.45pm to head to the station.
Yesterday the NHS was at great pains to stress that Sir Jim works tirelessly in his role, with one source claiming: ‘He does always work on the train. Literally doesn’t stop working. I wouldn’t say he’s a dosser.’
But the punishing commute means he would typically spend about 16 hours travelling, with at least two days a week working from his home town.
The NHS pledged that ‘after Easter’, Sir Jim was planning to work from NHS England’s satellite office Stella House, in Newcastle, on the days he is up there.
The Health Secretary said: ‘Jim is an outstanding leader with a track record of success. He was my first choice for the job of turning around the NHS, and I was delighted we persuaded him to take up the role at short notice.
‘I am introducing performance-related pay into the NHS, so pay rises for managers are a reward not a right. That cuts both ways, and I am prepared to pay for the best talent. Jim is already proving to be worth his weight in gold.’
A health department source added: ‘Anyone who has been on the receiving end of a 5am email or weekend call from Jim knows his work ethic is second to none. He is one of the most effective and well respected leaders in the NHS.’
An NHS England source claimed: ‘It isn’t a 9 to 5 job, and Jim works evenings, weekends and early mornings. He is well known to be an exceptionally hard worker.’
A spokeswoman for NHS England said: ‘Jim was appointed as NHS England Transition Chief Executive due to his vast experience, expertise and track record of delivery for patients – despite just two weeks in the job, he has already reduced the projected deficit by £4 billion and he is laser focused on improving services for patients and making major savings for taxpayers.
‘Given it is the NATIONAL health service and he is in the most senior role in the NHS, it is right that Jim spends time in London and other parts of the country to visit a range of services and staff – any personal expenses while travelling are obviously not funded by the NHS.’
The Labour government is abolishing NHS England, to streamline the health service under the management of the Department of Health. The ‘transition’ is expected to take two years, with Sir Jim due to be the helmsman until then.
He was appointed to oversee a dramatic cut in waste and inefficiency, with the Government saying it wants to axe 50 per cent of corporate management jobs and use the savings of hundreds of millions of pounds to improve frontline services.
Two months ago, the Mail revealed how Labour’s choice to be the next Independent Chief Inspector of Borders and Immigration, John Tuckett, an advocate of working from home, was allowed to be a ‘resident of Finland’ while working in the £130,000-a-year role. Within days, he was ordered to base himself in the UK.
From the Commons to the Land of Nod
By Sam Greenhill, Chief Reporter, and Inderdeep Bains, Deputy Chief Reporter
At 11.30am on Tuesday this week, senior MPs from the health select committee gathered in Room 16 of the Palace of Westminster for a special occasion. They were being introduced to the new chief of the NHS – a man on a mission to slash waste.
Sir Jim Mackey, wearing a smart suit and sky-blue tie, beamed as he was welcomed to their meeting along with Health Secretary Wes Streeting.
The duo were presented as a double-act in a new war on NHS inefficiency.
With a nod to moderniser Sir Jim, Mr Streeting told MPs the service needed ‘more “doers”’, stressing: ‘We’ve got to go hard after any waste, any inefficiency.’ Sir Jim added: ‘We need to pick up the pace of change.’
When the committee meeting finished, at 1.35pm, the man placed in charge of spearheading this crusade headed straight for King’s Cross, made himself comfortable in a first-class rail carriage – and dozed off.
Sir Jim’s campaign to save the nation’s cherished health service hundreds of millions of pounds, it seemed, could wait…well, at least until after his train had passed Peterborough.
For as the new chief executive of NHS England, the Mail reveals today, Sir Jim is running the National Health Service, at least in part, from the comfort of the London North Eastern Railway (LNER) while travelling first class up and down the east coast of the country.
This punishing commute between NHS headquarters in Waterloo and his family home in Northumberland involves a typical travel of about 1,200 miles each week.
Ordinarily, commuters are expected to journey to and from their place of work in their own time. Sir Jim, who took over as NHS England chief executive on March 31 when he replaced outgoing boss Amanda Pritchard, appears to be able to clock off from the office early to travel the 300 miles back to his family home in Northumberland.
On Thursday this week, the ‘knight of the north’, as he was dubbed in one profile, quit his desk at 3.45pm to go home.
And on Tuesday, while NHS colleagues returned to their desks after their lunch breaks, Sir Jim left even earlier.
He hopped on an Underground to King’s Cross station, caught the 2.30pm first-class LNER service to Newcastle, and then drove the final 10 miles home from the station car park, arriving in perfect time for dinner with his wife, Victoria.
All before some workers had even started their commute home.
No wonder he proclaimed when he landed the top job: ‘My heart has always been in the North East.’
In a typical week, his schedule involves a gruelling 16 hours or so of travel, the Mail has estimated. That is quite a chunk of time when you imagine the demands of managing an organisation of 1.5million people with a budget of £186billion – more than the gross domestic product of Morocco or Kuwait.
While such a burden might be eased by travelling in first class, the Mail can reveal Sir Jim has another reason to be cheerful during his sojourns to the capital. When staying overnight in London, he has been spotted at the exclusive Lansdowne Club in Mayfair’s Berkeley Square.
Just around the corner from The Ritz, opulently-decorated bedrooms at the Lansdowne cost between £295 and £495 a night – on top of an annual membership fee of £1,500. The posh club boasts an art deco swimming pool, a piano bar and fine dining, with members bound by a strict smart dress code.
It is understood that Sir Jim – who earns more than £300,000 per year and wears a Swiss-made £2,000 Longines Master watch – only charges the taxpayer the equivalent of a ‘standard’ hotel rate, and personally funds ‘any additional cost’ from any stays at the club.
The full costs of his first-class rail travel are, however, borne by taxpayers. Prices on the Newcastle route vary from £200 and £390 return, which would work out to more than £20,000 over a year. Standard class tickets are around half the price. The NHS source insisted they ‘always try to ensure the train prices are as low as possible, booking them as far in advance as possible’.
Yesterday, the NHS was at great pains to stress that Sir Jim works while on the train. A source claimed: ‘He does always work on the train. Literally doesn’t stop working, basically. I wouldn’t say he’s a dosser.’
On Tuesday, the Mail checked on Sir Jim as he made his way home. His train departed King’s Cross promptly at 2.30pm, and he tucked into a lunch served by a first-class steward.
Then he took out his laptop computer and a large-screen iPad with its own stand, arranging them side-by-side on his table.
Swiping through his apps until he found Netflix, the NHS’s new boss started playing an episode of The Diplomat, a Netflix drama series about a new US ambassador tasked with defusing political crises.
Whether the thriller’s plot resembled any of the diplomatic challenges Sir Jim has been grappling with, in his first fortnight running the health service, is not something he would necessarily have noticed – because he slept through most of it.
The LNER Azuma service had just departed its first stop, Peterborough, and as the train gathered speed, the soothing rhythm of the rails worked its magic on tired minds up and down first-class Carriage L, which was about half-full.
In 58-year-old Sir Jim’s window seat, he nodded off at 3.23pm. It was just three hours after he had told MPs the health service could be improved if its bosses ‘pick up the pace’.
As the Netflix show played on, unwatched, he was still slumbering when his iPad flashed up an alert reminder of a meeting.
Visible to any member of the public walking along the train aisle, the message revealed the virtual meeting would be held over the Microsoft Teams video app and was scheduled to start at 3.30pm.
Alas, this time came and went as Sir Jim gave every impression of being soundly asleep. He remained motionless for almost half an hour in total as the green English countryside flashed by his window. It was not until 3.51pm, when the meeting was presumably well under way, that his eyes flickered open again. Taking a sip of water, he began texting someone on his phone. Perhaps the meeting was not one that had required his attendance.
At 4.01pm, Sir Jim gave his attention to emails on his laptop computer while his iPad played on next to him.
The Diplomat had finished, but like any well-prepared commuter, he simply delved into one of his other streaming apps, pressing play on an episode of Designing the Hebrides, an interior design show about tradespeople on the remote Scottish islands ‘using their craft skills, energy and creativity to perform a series of makeovers’.
The man tasked with giving the NHS its own makeover spent most of the next hour tapping away on his laptop, apparently dealing with emails.
There were no phonecalls during the journey – which even with Sir Jim’s soft Geordie accent might easily have been overheard by other passengers – but just before 5pm, a call of nature compelled him to leave his seat for the bathroom at the end of the carriage.
He left his laptop and iPad unattended for three minutes, without putting them into ‘lock screen’ mode, meaning that in theory anyone would have been able to sit down at his computer and browse the emails of the chief executive of the NHS without needing to enter a password.
Some 10 minutes later, as the train zoomed past Newton Aycliffe in County Durham, Sir Jim turned off Designing the Hebrides and brought up a document on his iPad entitled ‘NHS Leadership meeting’. For anyone seated nearby, or passing along the train corridor, the agenda of this important-sounding meeting was easily visible.
The LNER service pulled into Durham station, with majestic views of its famous cathedral bathed in the evening sunlight. Then, as it neared Sir Jim’s final stop, he packed up his stuff and was first in the queue at the doors to disembark the train as it clattered over the Tyne railway bridge and into Newcastle station.
He seemed eager to return to his £780,000 detached home on one of the most exclusive residential estates in the North East. He paid a parking ticket – the station car park charges £40 for two days – and hopped into his SUV for the 23-minute drive to his four-bedroom bungalow complete with a garden office and double garage.
His wife, Lady Mackey, offers a curated glimpse into their affluent lifestyle through her public Instagram account. Her frequent posts feature trips to The Ivy, high-end designer handbags and pristine home interiors in images that would not look out of place in the pages of a luxury lifestyle magazine.
The account also features the NHS boss’s life beyond his beloved North East with his regular trips to his holiday home in the Algarve.
Sir Jim began his career as a qualified accountant before joining the NHS in 1990. Over the years he steadily climbed the ranks, earning a reputation for strong leadership and financial acumen.
His celebrated contribution to healthcare was formally recognised in 2019 when he was knighted in the New Year’s Honours list for his services to the NHS.
From 2002 to 2023, he served as chief executive of Northumbria Healthcare NHS Foundation Trust, making him one of the longest-serving hospital chiefs with his tenure an undeniable success.
In 2016, it received the highest ratings of all trusts from the Care Quality Commission with the regulator awarding 20 core services the top rating, the most ever given to a single trust to date.
During the Covid pandemic, as hospitals across the country grappled with a dire shortage of PPE, Sir Jim took decisive action. He established a factory in Northumberland producing vital equipment including masks, theatre gowns and scrubs. The operation was quickly scaled up to supply hospitals nationwide.
Proud Geordie Sir Jim has long had his sights set on the top job at the NHS, having put himself in the frame to succeed Sir Simon Stevens (now Lord Stevens) in 2021 but was ruled out of the race then.
In fairness to Sir Jim, it must be pointed out that he is in the unique position of being the ‘transition’ or ‘transformation’ boss of NHS England – the ‘arms-length’ management organisation which is due to be abolished within the next two years as part of the Labour government’s reforms.
When his appointment was announced, Sir Jim told colleagues: ‘I have been asked by Government if I would lead the NHS through its transition from the current crisis to getting back on its feet, as transition CEO of NHS England, on a secondment basis with immediate effect.
‘You will know that my heart has always been in the North East, and I am enjoying working with you all here in Newcastle.
‘So this has given me quite a lot of heartache and I hope that you understand that I feel that I really cannot reject such a request. I also feel a deep sense of duty to help however I can, to get the NHS nationally back on a more stable footing.’
Last night the NHS insisted Sir Jim’s travel arrangements did not affect his ability to do the job properly, with a source stressing: ‘He is working from the train, and doing conference calls when he needs to from the train. Basically, he is from Newcastle, lives in Newcastle and has family commitments in Newcastle. So that is where he lives.
‘Now he’s taken on this role, he does have to travel to London. It is absolutely necessary to travel to London for meetings with ministers, some of Jim’s executive team and for appearances at key conferences and parliamentary committees.’
Health secretary Mr Streeting, meanwhile, told the Mail: ‘Jim is an outstanding leader with a track record of success. He was my first choice for the job of turning around the NHS, and I was delighted we persuaded him to take up the role at short notice. Jim is already proving to be worth his weight in gold.’
A source at the department added: ‘Anyone who has been on the receiving end of a 5am email or weekend call from Jim knows his work ethic is second to none.’
Insiders have said he is expected to take a firm line ‘on wasteful spending’ in his new tenure, drawing on his financial nous and no-nonsense approach.
He previously took a similar secondment in 2015, leading the now-defunct NHS Improvement for two years. During his tenure, Sir Jim was said to have been known to be tough on trusts that did not deliver on their financial targets.
He has featured regularly in the Health Service Journal’s ‘HSJ100’ list of the most influential people in health, landing in the top 10 several times over the past decade.
Last night a spokesman for NHSE said: ‘Jim was appointed as NHS England Transition Chief Executive due to his vast experience, expertise and track record of delivery for patients – despite just two weeks in the job, he has already reduced the projected deficit by £4 billion and he is laser focused on improving services for patients and making major savings for taxpayers.
‘Given it is the NATIONAL health service and he is in the most senior role in the NHS, it is right that Jim spends time in London and other parts of the country to visit a range of services and staff – any personal expenses while travelling are obviously not funded by the NHS.’
