A woman in a male domain, the head of NHS Estates has had to work hard to earn respect. Now the most powerful woman in construction, it is her job to ensure that the health building budget of £1.8bn a year is spent efficiently.
Fixing you with her green eyes and analysing your handwriting, Kate Priestley could be doing the interviewing herself. But that is what you would expect from a former psychiatric social worker who oversees the procurement of £1.8bn of health building work every year, and who is now asking some tough questions of the construction industry.

  Priestley still practises graphology, the study of handwriting, in her spare time. As a social worker, she would use it to assess whether patients might be dangerous. Although it is just a hobby, Priestley still studies the handwriting of correspondents. There is no pattern among contractors’ writing, by the way: some are aggressive; some are surprisingly laid back, she says.

More and more contractors are likely to be getting in touch with Priestley over the coming months as she emerges as a central figure in the government’s drive to reform the way it does business. She already sits on a taskforce, led by Treasury official Steve Robson, that is monitoring the Egan process. And, following the Ministry of Defence’s move to prime contracting, she has the job of making the NHS the next public sector client to cut waste and costs by implementing Egan.

NHS Estates has a strategic role in the building and maintenance of the UK’s £76bn of health assets. It “advises” health trusts and authorities on how best to manage their estate and how to procure billions of pounds of new private finance initiative projects – not that the trusts will have much choice about whether or not they follow it.

The proposal is to simplify and streamline procurement by bundling the NHS’ work into a series of £25m-plus packages, to be let to six contractors in three-to-five-year deals. The system will then cascade down to the regional level, which will also be let in repeat packages, until the whole of the NHS’ construction work is organised in this way.

At the same time, NHS Estates is aiming to upgrade the standard of its advice on the PFI and other areas of procurement by advertising, probably in September, for lawyers and accountants to strengthen its skills base. The idea is to engage them on a repeat basis to provide continuity of advice.

Since her appointment in February, and especially since she unveiled NHS Estates’ plans to adopt Rethinking Construction, Priestley has gained plenty of respect from the industry – respect that was not so forthcoming before her £1.8bn yearly spend made her easily the most important woman in construction.

“It’s surprising how interested in you people become when they find out how much money you’ve got to spend,” she says. “Contractors now treat me with a certain amount of respect; perhaps because I am so rare.”

Pushing through change

Priestley has already started the change process by meeting with large private sector clients, such as Tesco, BAA and Marks & Spencer, that are also trying to cut costs through repeat work with contractors. These firms are likely to be used to persuade NHS managers of the case for change.

The stakes could hardly be higher. “A 30% saving, which the Egan report makes us think we can achieve, would be huge, with us spending so much,” she says.

Despite the hostility many in the health service feel towards the PFI, Priestley’s own position is resolutely pragmatic: “I don’t care how the money is raised – I just want to ensure it is spent properly,” she says. However, she counters a recent National Audit Office report that said the first PFI hospital deal, at Dartford in Kent, may end up being no cheaper than a publicly funded scheme: “The PFI hospital programme needs to be taken as a whole. Anything examined on a one-off basis can look less value for money – it’s the totality, across the spending programme that counts.”

It’s surprising how interested in you people become when they find out how much money you’ve got to spend

It’s a man’s world …

From her vantage point as a woman in a senior position, Priestley can see the faults in this male-dominated industry. “One problem in the NHS’ dealings with the construction industry has been the tendency for them, and us, to revert to type. So, they become macho and aggressive, and our managers and medical people become defensive if something goes wrong. The only way to get around that is a partnership approach, which is what we are working towards.”

She also foresees many more women moving into senior positions in the near future, bringing with them more up-to-date approaches and skills. “I think women will come into their own more because of new ways of working in construction. Their ability to do more than one job at once and their conciliatory approach will all help. Men become so competitive that it can disrupt the whole process. I can’t see many boardrooms in construction remaining so male-dominated either, because it is such a waste of female talent.”

NHS Estates’ own board has changed since Priestley took over, with more of a mixture of men and women. She says the quality of decision-making has already improved. Carillion group business development director Shonagh Hay, one of the few other senior women in construction, has seen Priestley in meetings with contractors. She says: “I find Kate very direct, but she’s also very warm – just the type of person needed to carry through the changes needed in this industry. In meetings, she’s obviously in control. She’s quite a tiny person, but she’s very big in stature.”

Some senior officials, however, ensconced in their safe, male-dominated world are more cynical. One says of her: “What are you interviewing her for? She’s got a reputation for being ambitious and outgoing, but that talk about men and construction is just her being provocative and high-profile, trying to get the headlines. What’s the point of trying to make NHS Estates less male-dominated? It’s a building agency – what do you expect?”

Not your typical mandarin

Priestley knows that she is an outsider.

She points out that her background – she was educated at a grammar school before NHS training as a psychiatric social worker – is not typical of a high-ranking official. Most mandarins, she says, are male, middle- or upper-class and Oxbridge-educated.

Not that she is entirely blameless when it comes to stereotyping. One reason she left psychiatry was that she began to believe that “every youth has behavioural problems; every old person has senile dementia”.

Priestley loves her job. She relishes its variety and its international dimension. The day after our interview she was due to fly to Cuba to attend a conference on the 2000 bug – NHS Estates is providing technical advice to the NHS and monitoring its attempts to reduce the impact of IT failure. She says that, because the NHS is an integrated network, Britain is better prepared for the millennium bug than any other country in the world.

If she can convince NHS managers of this, she will have done much more than helped construction become more efficient. Her 30% saving amounts to £540m – enough to give every nurse and midwife in the country an extra £1500 a year, or build five more district general hospitals.

Personal effects

Age 49 Who’s who in your family? One grown-up son. Where do you live? Hexham, Northumberland, but I have a flat in Leeds where NHS Estates is based. What do you do to unwind? I don’t have time for hobbies or much of a home life, although I enjoy cooking. What’s your favourite building? The Hagia Sophia in Istanbul. What book are you reading? The Alphabet Versus the Goddess by Leonard Shlain. What has been your greatest achievement? Abseiling down a 100 ft viaduct. What is your biggest weakness? Food! What do you think of Casualty? I prefer ER, or should I say George Clooney.