Obituary: Clifford Graham

Clifford Graham, civil servant: born Liverpool 3 April 1937; Clerical Officer, Admiralty 1954-59; Executive Officer, Customs and Excise 1959-65; Higher Executive Officer, Ministry of Health 1965-68; Principal, DHSS (later Department of Health) 1969- 74, Assistant Secretary 1975-82, Under-Secretary 1983-94; called to the Bar, Gray's Inn 1969; Director, Institute of Health, King's College London 1990-94; twice married (two sons, one daughter); died Milton Clevedon, Somerset 2 July 1994.

CLIFFORD GRAHAM was one of the people who made things happen in the National Health Service and in the wider issues of a healthy community. His work with Sir Roy Griffiths led to the introduction of general management in the NHS; he collaborated with the barrister Louis Blom- Cooper in tackling problems in mental health and illness and he was chairman of Newpin, an organisation concerned with disadvantage and abuse in the family. Graham epitomised imaginative management and would not be distracted from pursuing action on policies he thought to be right; indeed he took pleasure in exploring unconventional pathways to a proper end. That he was a civil servant, and grateful to the service for the chance it gave him, makes this all the more remarkable.

Cliff Graham made his own way in life from a childhood in Liverpool that established lifetime interests in cycling and Everton Football Club, through night- school qualification as a barrister, of which he was always proud, to a career in the civil service from clerical officer in the Admiralty to Under-Secretary in the Department of Health. He was first noticed for his contribution to the Woodbine Parish Study on Estate Management in the Health Service that opened the way for his contribution to the policies on resource allocation and the development of information systems.

Then, in the early Eighties, Graham was more personally identified when he worked with Griffiths and colleagues on the NHS Management Inquiry and was promoted to Under-Secretary to see through the introduction of general management in the NHS. Change in the health service is known for the turbulence it generates, and it is therefore notable that a concept of such far-reaching consequence was introduced, despite professional opposition, but has not been seriously questioned since. Under-Secretaries see many changes in their time, but few make a difference such as Graham did.

Graham worked with Derek Rayner during his scrutinies and then during a sabbatical year with Brian Abel Smith at the London School of Economics on Consumer Satisfaction. During his time as Under-Secretary in the Mental Health Division of the department he worked closely with Blom-Cooper at the Mental Health Act Commission; he established the Special Health Authority for secure hospitals and met Jimmy Savile in their work for Broadmoor Hospital. A chance encounter led to Graham's becoming a trustee and then chairman of Newpin, which began in south London and has spread across Britain. Latterly he directed the Institute for Health at King's College, and undertook several roving commissions on a wide variety of topics such as health services in Jordan, managed care in the United States and initiatives on alternative medicines and therapies.

Those who knew him in the diverse aspects of his life all recognised his ability to get wheels turning and were grateful for the way he attacked an issue with energy and immediacy. He brought the best out of people by his encouraging and supportive approach and could talk to anyone and get them to play their part. He helped the world at large to work with the civil service and helped the civil service to concentrate on the issues that had practical consequence.

Graham loved cycling all his life. He bought a mountain bike only two years ago and often took off exploring the West Country around his house in Milton Clevedon, near Shepton Mallet. Given his notoriously bad sense of direction these forays could lead to considerably greater expenditure of energy than was at first anticipated, and arrival at some engagement only in the nick of time. His Christmas cards were always fun because he penned a few thoughts about times past and present that were sometimes illegible even for the author. He loved music, particularly opera and the English composers Elgar and Delius, whom passing locals came to know such was his preferred volume on the stereo when relaxing in a bath.

That was the contrast between a professional life of great intensity and commitment and the ability to relax at home and on holiday in Greece. It is good to think that his second wife Sarah has as her last memory of him just such a holiday - she is expecting their child in November.

Peter Simpson