HE rose from a labourer toiling in a Lanarkshire steel works to the top tables of international firms with turnovers of hundreds of millions of pounds.
But after becoming the new chairman of NHS Lothian at the age of 64, Leith-born Brian Houston believes he is facing one of the biggest challenges of his professional life.
Mr Houston, also a non-executive director of Hibs, said that since landing the role in April, he has had his head buried in mountains of papers, reports and meeting minutes.
Yet he feels he has still only “dipped his toe” in the scale and complexity of the issues that will come across his desk over the next four years, with the health board facing an unprecedented surge in elderly patient numbers in coming decades, not to mention the fallout from the waiting times and bullying scandals which have yet to be fully resolved.
Although new to the health service, he told the Evening News in his first interview as chairman that he is already clear that it is not just the NHS that will have to change to deal with the challenges.
He said: “It’s not just about creating a better NHS Lothian, it’s about creating a radically different model of what public health and the delivery of health to address it means.
“It’s about mobilising almost the entirety of society to adopt a completely different approach to how we keep ourselves healthy. If we don’t do that the system will fall over. It’s not sustainable given changing demographics and population growths. They are pretty self-evident trends.
“If we don’t now start worrying about how we start at least to make some of these major paradigm shifts in the whole environment that we operate in we’ll wake up in five years’ time and find that it’s all passed us by and the thing’s falling over.
“I’ve worked in and for organisations of the same scale in terms of balance sheet and numbers of employees [as NHS Lothian] but the difference here is you are in the public domain, so you are not simply talking about a market or customer base you’re having to deal with, you’re talking about an entire community. We’re dealing with the physical and mental totality of human beings, which is just about the most complex thing there is on the planet.
“It’s a global situation. I can’t think of another industry that has a greater complexity and potentially a greater urgency in terms of the time factor to change it.”
Mr Houston moved from Leith to the West of Scotland as a five-year-old, went to school at a comprehensive in Glasgow’s Southside before leaving at the age of 16 to take his first full-time job in a Motherwell steel works.
He worked as a cost clerk, bricklayer and general labourer at various steel production plants throughout Lanarkshire, before enrolling in a night school class to study accountancy.
After qualifying aged 21, he worked for a decade in financial jobs for a series of Scottish companies, before becoming managing director of small distribution companies “by accident rather than design”.
Mr Houston took a job with PA Consultancy, a management consultancy firm, driving change in organisations across industry, spending the last decade of 22 years there as its chairman and chief executive of European operations.
“Retiring” at 51, he went on to become a non-executive and chairman on a series of boards for manufacturing companies, an interim managing director three times for companies in the offshore oil and engineering industries and served on the board for VisitScotland for eight years.
It might sound like a meteoric rise through hard work and a touch of good fortune, but life has not always been blessed.
His second of four children died from a rare form of cancer four years ago, having spent months in St John’s Hospital and the Western General Hospital.
While reluctant to discuss the tragedy at length, he spoke about it briefly at his first NHS Lothian board meeting and admits the “life-changing personal situation” is likely to have played a part in his desire to become involved in the health service.
He said: “I suspect that subconsciously it’s one of the reasons I felt quite good about coming into the NHS and hopefully help do something to aid in its development.
“I didn’t in the aftermath of my daughter’s death turn around and think ‘in her memory I must get into that’, it was nothing even approaching that. But I suspect it’s tucked away at the back of your mind and part of a set of things that came together to make me pleased to be taking this on.”
Although he has so far spent his short time with NHS Lothian behind a desk or in meeting rooms, he said he is keen to become a roving chairman, shunning his office in the board’s plush headquarters at Waverley Gate for buildings throughout the health board’s estate.
Next month, he plans to embark on a tour of NHS facilities to meet with staff and patients, but is already convinced the organisation he heads is in far better health than he expected.
He paid tribute to the “remarkable” job performed by chief executive Tim Davison and his team in a short space of time to turn the health board around since the “dark days” of the waiting times scandal.
“I did a bit of research into the background of what the NHS set-up was and particularly the recent background to NHS Lothian,” he said. “Of course, you immediately come up with all the most recent very negative media coverage around the whole waiting lists saga.
“I suppose without having really considered it in any depth I came along with a preconception that it was a place swimming in problems and was partially arrogant to think the reason for me being appointed was to come along and rescue them from this morass. When I got here I found it was very far from the truth.
“I expect to spend the majority of my time walking the floors and being in different places. For example I’ve asked the site director of St John’s Hospital to find me a hot desk from July 1 and I’ll base myself there for two or three weeks. After that, I’ll spend some time somewhere else. Hopefully I’ll get a better view of the grassroots of the organisation and how things actually work.”