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Um I want to thank Martin and the committee um for asking me to come along and speak today. Um Martin said, we're talking about inspiring leadership. And what I thought I would do is look at some of the qualities that I think we all are learning each and every day. Uh And the very first quality I want to look at is that of respect. So what you'll see here is um myself when I was first commissioned as a Royal Army Medical Corps, reservist. Uh and the chapter, my right is my father. And the very first thing he said to me as a senior officer in the Royal Army Medical Corps was some, you must earn the respect of your rank, never demand it. And so what I want to do is just go through some of the salient things around leadership. And during this, you may see examples from your own units of good leadership. You may see examples where maybe it's challenging leadership, but each and every one of us are leaders. Now we live in a world that's difficult at this present time. We talked about it at the conference earlier today. Some would say that our NHS has run a drift that we are disconnected that were coming out of the pandemic and all of the difficulties that have arisen with that. We also have a media where every day we see the negatives, we see what's wrong with our system. We heard meow earlier saying we do really good things but there's so much noise, the noise of negativity, the noise of medical negligence, the noise of duty of candor, all of the things each day, the waiting lists are continuing to rise, the difficulties in our workforce, the lack of diversity, bullying, harassment, all of that in the mix and sometimes it can be really difficult to see. We know that our current NHS is no longer fit for purpose because we have a changing population, the elderly are getting older, which is a success of the NHS in many ways. But with that comes a challenge to the NHS. We have a depleted workforce. We have heard some amazing talks today about advances in treatment and therapies, robots, artificial intelligence, really expensive drugs. We still in this day, 2023 have massive health inequalities throughout the UK and Ireland. And the way we were organized in 1948 seemed the right thing to do for the free at the point of entry health service is no longer fit for purpose. And so in terms of the leadership at this present time, as we go through, I wanted to look at, inspire and look at some of the qualities that I've learned and assignments said sometimes the hard way and some of the lessons I've learned in my journey through to date. So I think first of all, it is important to say that it is not higher article and it is not aged dependent because I am older than someone else. I am by default, a better leader that is certainly not the case. And there's a leader here that I learned from on a weekly basis. And that is your presidente or your last presidente of a Saint Martin King. Martin King came as a sick former student to a crisp course as a casualty, he was made up as a casualty and now he teaches on the very course he came as a sick former and he is a leader of surgery in this country. So leadership and respect work both ways in terms of the eye of inspire initiative. It is really important that as leaders, we take initiative, some people make things happen, some watch what happened and yet some people wonder what happened. And so we've got to use initiative and in northern Ireland at the minute, we're trying to use all we can for the worst waiting lists in the UK, for a workforce depleted for political instability, you've got to keep using your initiative. And one of those ways of doing that is to constantly try and think outside the box. So one of the difficulties we have is no money in the health service. Belfast trust have come out with a memorandum that says, look, we'll give you one drink, but we're not giving you more than one drink and you must bring your own cup. So the difficulty with that is how do you think outside the box, one cup per person, bring your own cup will give you a drink. No one mentioned what size the cup was to be. So we're thinking outside the box, when we go on to end, we think of that ability to negotiate. How often do we see leaders saying just do it because I'm the boss. We need to learn the art of negotiation. And that is one of the things in the political role that I've had over the last 5, 10 years that has really sunk in that ability to negotiate that ability to bring out the best and uh to share, learn thinking but not to play the rank game. And within Northern Ireland, we were very proud and honored to be part of a Bengo, a report into how do we transform our health and social care going forward? Um And, and the difficulty for us is sometimes you've got to seek forgiveness rather than permission. And if you aren't hearing the word, no, occasionally, then you're not asking enough or asking for enough. And certainly negotiation is very, very common in Northern Ireland. It's an active part of life in Northern Ireland where in constant negotiation, but it is really important that everyone believes they benefit in the role of leadership. The third of support. And that comes in two ways. You must be a mentor. You heard it from Rohan Parks earlier about the benefit of being a mentor. He is one of my mentors and has always been one of my mentors and we strive to follow one step behind our mentors as he said earlier on. And it is therefore important that we work with in a compassionate leadership role. I'm a massive fan of Michael West and the work that he is doing on compassionate collective leadership, it is not the hierarchy, it is not to do what I say just because you have to do it and don't ask questions that we all embrace. We each have talents. As Linda has said, everyone in this room has talents in abundance and more, but they're quite often suppressed in terms of support as well. It's really important to know that as a leader, you have support Simon's eloquently said about the leader looking over his shoulder and no one's behind him, getting out of the trench and going up the field and there's not a single person with them. So it is really important um that there's a degree of support. So this isn't the latest boy band called Take that. Um This is actually us doing a press conference after a major decision in Northern Ireland politics. And you can see Martin King in the back and various other people that you'll be familiar with. But that is the support that I need each and every day as a director of surgery in Northern Ireland, the support of your team that work with you in any one occasion. And one of the things most said today, and I think he demonstrated many of the qualities we strive for is the support of our family's quite often we pay lip service to that or they come last in our line of priorities. However, support is a negative thing that's creeping into the health service and that is professional jealousy and toxic culture. And I think we have to strive as surgeons to make sure we call out the toxic culture. The professional jealousy and difficult for us in Northern Ireland was we actually had to produce a document called hashtag dear colleague to look at a set of principles between interaction with primary and secondary care. Can you imagine that the caring profession had to come up with principles of how to respect and be nice to each other. How often do you hear that was an inappropriate referral that useless gp, useless. Never saw the patient. How often do we do that in our day to day business? And I think the P is professional. We are professional individuals. It's really difficult. I make that mistake every day about the boundaries of professionalism. But I think we've got to have that respect and remember every professionals trying to do the best they can. And sometimes we get involved in other people's circuses, don't we? We get linked in the things that are actually not going to change for us are not going to make the situation better. And I think it's important that we just try to refocus in on what our ability is. This to me is the most important and that is integrity. Uh And Steven Cov is a well known keynote speaker on leadership from America and he describes in the speed of trust that the active building credibility is two things, character and competency, the character based on integrity and intentions, that integrity, that honesty, that trust you come and talk to me about your problem. It isn't going to be spread throughout the theater by the next day, it isn't going to be told to the next colleague as soon as they come in or wait to hear what he told me or wait to hear what he told me. It is that integrity that you're trustworthy and that all we do is trustworthy because despite the sensationalism, we hear in the press, 99.99% of us go in to do a very good day's work in a system that sometimes makes that very difficult. There are very few rogue doctors in our society, very very few. And I think we have to remember that integrity resilience. I'm embarrassed to talk about resilience when we have heard from mo earlier on because that is rebuilt, resilience and much, much more in a lived experience. But the pandemic taught us all to have resilience. I've had my fair share of mental health problems and stress in a career in surgery. The competition to be the best, the competition to get the next interview, the next job, the next paper, the next posting, the next professorship and we do need that resilience. And certainly in the pandemic when surgeons ended up with change, not the routine, the chaos, the standing down of surgery resilience was needed more than ever. And I think we all need to remember that we are all swans in the lake, the legs are going very quickly under the water, but we look elegant. Every surgeon, every consultant, every role model, we are swans in the leg to test my resilience as a large man. Uh I have done the rate alpine twice. So carting this large load up the called the lab Annette the highest pass in the Alps um takes a lot of resilience. Um I probably was a stone lighter by the time I reached it, but it takes a lot of resilience to do that. And we are resilient individuals. Most said that earlier, we have had to be resilient to get to where we are. Excellence is the final, inspire, excellent. Everything we do as leaders, we must strive for excellence. We owe it to our patient's. They must get the best of us at all times, whether that is as a system, which is clearly the difficulty at the minute or as a clinician, that excellence goes to the formation of surgical hubs, interventions, etcetera. And my final two slides talk about some of the lessons. The good surgeon knows how to operate, better surgeon knows how to, when to operate. And the best surgeon knows when not to operate. I'm going to change that to leader. And the second issue is that remember to be raised to treat the janitor with the same respect as Simonson, the chief executive officer. And finally, if you wonder what this is all about, why am I going through surgery? Remember Pericles? Because it's not what you leave behind. It's not what's written on the stone monument. It's not what badges or ranks or collections or degrees you get, but what's woven into the lives of others. This conference has filled me with energy because I know even the darkest night will end and the sun will rise. Thank you.