Posted on 8 February 2018
Alan Maynard was a giant in the field of health economics, and one of the University of York’s most influential social scientists.
His ideas inspired numerous major NHS reforms in the 1990s and 2000s and helped shift the focus of health policy making towards quality and outcomes as well as costs and activity.
He helped put health economics on the map – developing it from an arcane sub-specialty in the 1970s to a thriving profession today, with health economic ideas and evidence now deeply embedded in health policy making institutions and processes around the world. He also helped to plan and to manage local NHS services, playing a leading role in the NHS in York since the 1980s.
Alan arrived at York as a graduate student in economics in 1967, returning as a lecturer in 1971. With only brief diversions to the University of Exeter and the Nuffield Trust, he remained an immensely valued member of the University of York until his death in 2018: over fifty years of sharing research ideas, inspiring students and staff, engaging policy makers and using economic ideas to improve health and health care.
In 1978 he created York’s MSc in health economics, which has since trained over 750 health economists, now infiltrating governments, universities, pharmaceutical companies and health care organisations around the world. Many have benefited from his teaching – not just economists, but health service managers and clinicians too; all have been informed, entertained and challenged to think critically about how best to improve health.
In 1983 Alan founded the Centre for Health Economics (CHE), where he was Director until 1995. CHE has had a major influence on health policy and the development of health economics, and continues to flourish. He was founding editor of Health Economics, now a leading journal in the field, and later had a hand in creating two other thriving institutions: the York Health Economics Consortium and the Centre for Reviews and Dissemination.
Alan’s role in cultivating health economics talent among many hundreds of students and researchers is a huge part of his legacy. But he also made a difference outside the academic ‘ivory tower’, in the messy real world of the NHS.
He worked with many doctors, particularly enjoying debate with those he viewed as ‘medical mavericks’, including Archie Cochrane, Brendan Devlin, Kenneth Calman and Iain Chalmers. He worked for decades in the local NHS – including 12 years as Chair of York Hospitals NHS Trust, and latterly as Chair of the York Clinical Commissioning Group.
The approach Alan took in working with NHS staff was to challenge, to encourage critical thinking and also to support and nurture – he ‘walked alongside NHS managers’, in good times and bad.
Alan is perhaps best known for his unflinching approach to tackling policy makers who he believed to be paying insufficient attention to the creation and use of evidence. He persisted in confusing them with facts. Translating knowledge into policy change, as he described it himself, requires craftiness and tenacity – both of which he possessed in spades.
He was determined to improve policy debate by clarifying ill-defined policy problems, highlighting solutions that were ‘faith-based’, and fearlessly pointing out when people were ‘talking tosh’.
Despite this bluntness, he was always invited back into the world of policy debate – his insight, wisdom and authenticity were valued, and he was liked even by those who disagreed with him. As Morris Barer and Bob Evans pointed out, “if you want to tell powerful people things that they do not want to hear, you had better be entertaining as well as clever”.
Alan was a great communicator, writing in academic journals, but also reaching wider audiences – for many years via a column in the Health Services Journal, and more recently through blogs and Twitter, which he embraced with gusto and enjoyed immensely, even throughout his illness.
But for those of us who were privileged to know him well, our memories are of a person of immense warmth, kindness and generosity of spirit. This extended to everyone - junior and senior – without hesitation. Alan’s Twitter feed is now full of admiration and affection from all kinds of people – students he has helped and inspired, researchers he has supported and mentored, and others who only met him fleetingly but found themselves deep in memorable conversation.
We remember also his genuine humility - reading a draft of Maynard Matters, the book written by colleagues to celebrate him and his work, he commented, "Who, me...?". And we remember the simple fun of being with Alan – his mischief, his humour and his refusal to take life too seriously.
How, then, should we follow in Alan’s footsteps, and honour his memory? He would want us to carry on doing high quality research that informs and challenges health policy and to communicate and engage with the messy real world of policy development and health care practice. He would want us to be bold, to tackle muddled thinking and to prick pomposity. He would want us to nurture future generations of health economists and to be curious and critical friends to those in other health-related disciplines. And he would most certainly want us to have fun doing it.