Christine McLaughlin has her work cut out, as Scotland's co-director of population health. The country has notorious health challenges: its life expectancy is the lowest in western Europe, and there are stark inequalities between its most and least deprived areas.
But despite the scale of the challenge – or perhaps because of it – this is McLaughlin's dream job. Here, she tells CSW what her role entails, what she feels most strongly about, and how she got here.
Could you tell us what you do? How does your role fit into the bigger picture of the health sector?
I’m co-director of population health and I sit within the Scottish Government Health and Social Care Directorate. We have a portfolio of reform for health and care, which includes things like improving waiting times and early discharges for the year ahead, through to developing our population health framework, which sets out our approach to improving the health and wellbeing of the population and reducing health inequalities. I also head up all of our digital and innovation initiatives, which include programmes to help people with type 2 diabetes, stroke patients and babies born with rare genetic conditions. There are two additional programmes looking at how a person’s genetics might affect how they respond to certain drugs.
"The pandemic helped us to build strong relationships across the four nations. We worked hand-in-hand every day throughout that time"
Once they’ve been fully tested, my co-director and I assess whether the programmes are ready to adopt and scale across the whole of the country. Digital innovation is a big part of the plan to reform health services. I’m also responsible for overseeing our longer-term service renewal work across health and care, which is a 10-year plan for how we want to improve services. And I head up all our work on things like screening, vaccinations and pandemic preparedness for the future.
How do you collaborate with Whitehall?
I’m very used to working across the four nations – diseases don’t respect geographical boundaries! All our population health work, like the alcohol, tobacco and obesity agendas, operate across the UK and so do our health protection services.
The pandemic helped us to build strong relationships across the four nations. We worked hand-in-hand every day throughout that time. I was responsible for Test and Protect which is our version of Test and Trace. And there were UK-wide services on testing for Covid, of course.
What was your first job in government? Did you have a smooth career path?
I came through a finance route – I started off my career as a finance trainee in the NHS, in Glasgow Royal Infirmary, and then I joined the Scottish Government as deputy director of finance for the NHS in 2010.
When I started my career, the top government job that I was aiming for was director of finance for the NHS. And I got to that point, but then I got breast cancer and I decided to take a career break in December 2019. That was two months before the pandemic.
During Covid, there was a call-out for people who wanted to come back, and I volunteered to do that – initially the job I went back for was to set up a field hospital. I was happy to help wherever help was needed, and that’s what took me into the world of public health. I ended up running the Test and Protect programme for two years, and that’s how I’ve found myself doing the job I’m doing, which I absolutely love. There’s a fabulous range and freedom in what I do now. I’ve ended up in a place I didn’t expect to be, but I’m really enjoying it.
What do you need to do your job well?
A clear purpose, a really strong team and trusted relationships. For me, a strong team is a motivated team, doing the best job they can do, and that comes from a real understanding of what we’re trying to achieve – the value and impact of what we’re doing. They need to understand what good execution looks like from the start.
Trusted relationships throughout the system are really important in my role, whether that’s across the four nations, the Scottish Government or the NHS health and care system.
You can argue that Scotland is a good size – the number of people who are leaders within the system allows you to work directly with people. I work directly with all the NHS chief executives, and all the directors of population health. The numbers are such that you can get to know people and build strong relationships quite easily.
I’ve also got the benefit that I worked in the NHS before working in government, so I do understand that sector. Government and the NHS have different priorities and they operate differently, so I’m at an advantage having worked in both.
"It was quite a terrifying time. The pressure to have the hospital ready was intense"
What is your proudest achievement to date?
It’s got to be the job I went back for during the pandemic. I got a call on a Saturday to say, “Will you help us build a 1,000-bed field hospital in three weeks?” So that’s what I came back into government to do.
The Scottish Exhibition Centre in Glasgow was converted into a field hospital, and I was part of that team. I oversaw all the finance, procurement and governance to get it set up – it was called the NHS Louisa Jordan hospital. I stayed with it for the next year and we used it for outpatient clinics, and then we converted it into a mass vaccination centre for a year. Thankfully, we didn’t need to use it as a hospital because the NHS was able to cope with patients in our existing hospitals, so eventually we decommissioned it and we turned it back into a concert venue.
It was quite a terrifying time. The pressure to have the hospital ready was intense. At the same time, the spirit of the people involved was amazing. We had people turning up every day to volunteer: joiners, engineers; all sorts of people asking if they could help with what we were doing. The sense of everybody working together as a community was outstanding. It shows what you can do if you all work together – a lot of learning came out of it. That’s what I’m proudest of – it wasn’t just about the pandemic and setting up the hospital, it was also the way people came together.
“There was a lot of focus on getting the pandas to mate, but they were upset by the noise from the construction site”
What is the most bizarre thing to happen to you at work?
Most civil servants will have stories that they can’t really talk about – working in health protection and infectious diseases, there are bizarre things that happen all the time!
But the one I would pick out is from my finance role, when I ended up working on a solution to re-home the two giant pandas from Edinburgh Zoo. There was an old hospital site behind the zoo and the land was being sold, so I was responsible for the capital side of it.
As it happens, it was mating season for the pandas. There was a lot of focus on getting them to successfully mate, but they were upset by all the noise from the construction site. So we had to move them to the other end of the zoo, and I was involved in the logistics of trying to make that happen.
The good news is the pandas were successfully moved – but unfortunately they didn’t mate. They’ve now gone back to China.
What would you be if not a civil servant?
I thought I would be a chef initially! I studied kitchen management at university and I worked in a top hotel in Glasgow as a student. I loved working in a kitchen and I thought that’s where my career would take me. So if I wasn’t doing this, I think I might be doing hotel catering.
I found out about NHS training schemes after I left university and they had a good reputation. So that’s what took me into finance. I didn’t ever feel that certainty about what I wanted to do, so I switched around a bit until I settled into what I do now. But they are all good skills to have – cooking and money management are both very useful. I still really enjoy cooking at home – I do it to de-stress.
"All my best examples in the work I’ve done are about multi-disciplinary working"
What is the best piece of professional advice you’ve been given?
A key one for me would be that if you’re a really good leader, you are comfortable to admit that you don’t have all the answers. Your job is to navigate through complex situations and listen to other people and, fundamentally, to stay true to your values. That’s something I come back to when things are tough.
I think it’s so important to have integrity and to feel like I can be open and honest with people, and give people a sense that I’m open to conversation.
What do you feel most passionately about in your role?
I feel passionately about the whole agenda. One thing that I’ve come to understand much more about in this role is the impact of health inequalities and the need to be thinking about that in everything we do. So when we’re developing policy and we’re thinking about implementation, it’s not just about getting to a bottom line position, but thinking about the impact on the people who are in most need of the work you’re doing.
I’m also very aware, from the population health work that I do, about the key factors that impact on ill health generally. The fact that being healthy is so much to do with factors in your life overall, and that only 20% of those factors are related strictly to the things we do in the NHS. The other 80% of the reasons people end up with disease – the key factors relating to obesity, stress, alcohol and other dependencies – are about things like financial security, education, housing and good work.
The King’s Fund [think tank] have done a lot of important work on the evidence for this in their study into the pillars of population health. If we really want to improve the health of the population, it’s not just about what we do in health and care; it’s about the work we do on the economy, education and housing. This is the basis of the work we’re going to be publishing for our population health framework.
We’re also collaborating with [influential researcher] Michael Marmot in three areas in Scotland, looking at community planning at a very local level to reduce health inequalities. To achieve this means working across the NHS and local government as well as central government and the voluntary sector. It’s a really interesting and important piece of work.
If you could wave a magic wand over the civil service, what would you change?
I’m very grounded in reality – I’m not really into magical thinking! The key thing for me in all of this is the importance of multi-disciplinary teams. I got that from working in the NHS, who do it really well.
I think it’s crucial in government to be able to work alongside people with policy expertise, delivery expertise, analytics expertise and digital expertise. We should all be working together from the outset to develop policy and strategy, and then engaging with the system on how you might implement something. The more we can do that, the better job we will do. All my best examples in the work I’ve done are about multi-disciplinary working.
I do think we learned a lot during Covid because we didn’t have time to do it any other way. We had to have everyone working together at the outset, and everyone in that situation brings a different skill set and a different range of experience. I’m starting to see more and more of that, but being much more deliberate about it would be a good thing.
This interview first appeared in the summer 2025 edition of the Civil Service World Magazine, which you can read here