A senior health boss has been quizzed on whether his current role is effective or simply a cost-cutting measure.

Jonathan Wade was appointed interim chief executive of Medway NHS Foundation Trust for six months, alongside his position in the same role at Dartford and Gravesham NHS Trust.

He replaced Jayne Black, who left after four years to become chief executive of East Sussex Healthcare NHS Trust.

But Medway councillors on the health and adult social care committee questioned the thinking behind the decision to merge the roles, asking whether his focus would be fully on problems the Towns are facing.

Cllr David Wildey (Con) said a merger between health trusts in Kent had previously been suggested and was incredibly unpopular in the Towns.

“When a merger was considered previously, probably about 10 years ago, residents were up in arms. It didn’t go down well at all,” he said.

“Any idea of a merger, I feel Medway citizens would lose out because we’ve already seen many services move out of our hospital.”

Mr Wade said: “I think a merger is very unlikely to be the recommendation. When you look across the wider NHS, it’s rare now to see those types of mergers.

“What is far more common is a group model which essentially has a shared leadership team. It could be a shared chief exec, a shared chair, or some of the key executive roles shared.

“We are looking at how best to arrange ourselves from an organisational perspective. A review is due to start next week by the integrated care board (ICB) into potential organsational structures.”

The NHS Kent and Medway ICB is the organisation which plans where NHS money is spent in order to deliver health services within its area.

Cllr Smitha Campbell (Lab) said the fact one person was acting as chief executive for two separate hospitals raised concerns about issues being forgotten.

She said: “As you can imagine, just you fulfilling the role of two chiefs has caused some concern among people.

“There will always be questions of how two roles can be fused into one without something falling by the wayside.

“I know you’ll say there will be efficiencies, but I’m curious about what the actual impact of that has been.

“We want you to be very Medway-focused and, as a committee, we want Medway to be front and centre.”

Mr Wade, who took up the role at the Gillingham hospital on April 1, said it was not easy, but he had a strong team beneath him.

He also brought more experience to the role than previous chiefs of Medway’s trust.

He said: “It’s always challenging being a chief exec of one organisation, as is spreading my time across two.

“What’s really important is that I get the right support from the teams beneath me. A deputy chief exec who is full-time at Medway started last week, moving through with the agendas I’ve set.

“I’m a reasonably experienced chief exec in the NHS and looking back across Medway’s recent history, it’s been able to attract first-time chief execs.

“There is a certain amount of knowledge and experience that I’ve already built which means I can get off to a better, much more rapid start.

“I want to make a big success of it, even if it’s just from a selfish perspective of it’s my career too, I want to do the very best.”

He went on to explain that one chief executive covering multiple hospitals was becoming more common because of a shortage of people wanting to take on the roles.

It was also due to the NHS making the decision that one experienced chief exec dividing time between a couple of hospitals was more effective than each hospital having its own less experienced chief exec.

However, Cllr George Crozer (IndGr) asked how future chiefs could get experience if there were fewer roles and whether it was just a way to save money.

He said: “You said there was a reduction in the number of people coming up and that it’s good to put an experienced chief in charge of the trust, and multiple trusts.

“But if there’s a lack of candidates, and experienced people are taking on the roles which people could come up through, isn’t that going to reduce the number of people who will be qualified?

“And is making a chief of two trusts not just a cost-saving exercise which will dilute the effect for Medway?”

But Natalie Davies, chief of staff at NHS Kent and Medway ICB, said the experienced chiefs would be training their deputies to eventually take on the role.

“If you need to grow a chief executive one of the best ways to do this would be through being a deputy to an experienced chief,” she said.

“It’s better than dropping them in as leaders and hoping they do well.

“There is a bit of a cost saving in it and in the NHS we’re always trying to drive down management costs, so we can put as much as possible into front-line care.”

Former chief exec Jayne Black’s salary was between £195,000 and £200,000 in 2023 for Medway NHS Foundation Trust.

The issues facing the trust were also discussed, including cultural problems within the organisation, with incidents of racism from members of staff, and financial pressures.

Cllr Dan McDonald said there was a problem of issues not being solved, a new chief comes in with promises to fix things, and nothing changes, and it starts again with a new chief being brought in.

He said: “A lot of these issues have appeared in the Care Quality Commission reports constantly. The attitude, the racism, the culture.

“I’ve seen since 2015 that it’s constantly a problem. We get a new person through the door and everything’s going to be magical and wonderful.

“The buck does stop with the executive and they should have been moving this faster.

“We just want to make sure people get a good service when they walk in the door. We see reviews after reviews and we just want to see an outcome.”

The committee voted to note the report and a review is underway about the future management of the Medway NHS Foundation Trust.