I'm usually in the office by 8.30am and try to leave by 6.30pm, but I’ve always got my BlackBerry with me, even on holiday. My job falls roughly into two parts. First, I’m responsible for the healthcare of the 256,000 people who live in Walsall. As a Primary Care Trust (PCT),we have a budget of £385m to purchase services from healthcare organisations. That works out at around £1m a day, or £40,000 for each hour of the day. The figures may sound daunting but a considerable part of the money is pre-spent.

Second, we run a provider service. We provide all the community care services in Walsall, from district nurses to health visitors. We also provide the learning disabilities service, in partnership with the local authority, and we’re responsible for the mental health service.

For the last ten years, the NHS has had record additional funding – about 10% growth year on year. In real terms, the expenditure of the NHS has risen by over a third, which is pretty impressive. A large part of what we’ve done, particularly around waiting times and targets, has been bought with that development money.

Considering such a rise in expenditure, it’s frustrating when the press concentrate on the things that go wrong in the health service. People always call cheap shots: you could have done this better, you should have spent the money on a hip operation. We did a really brilliant thing last year by becoming the first PCT to sponsor a stand at a football club. The Txt 64446 health stand at Walsall FC costs £20,000 for a season ticket, and those who register receive health messages. We have a target audience of more than a million people because there’s a market at the ground on a Sunday; anyone in advertising would confirm it’s a pretty good hit. Yet a local TV station did a really unpleasant piece, showing a picture of 20 defibrillating machines and suggesting that we could have spent the money on those instead.

There’s always a lag between what we’re trying to do and people’s understanding of it. Part of that lag is due to the way in which the media manages health stories. Hospital closures, for example, are always presented as bad news, despite the fact that a lot of them actually deserve to be closed.

I’ve got a saying by Liam Donaldson, Chief Medical Officer, pinned to my wall: “Every chief executive officer of a public sector body believes that somewhere out there is a bullet with their name on it. They think it’s only a matter of when, not whether, it will start to move towards them.”

Sometimes it’s a matter of finding ways to help people understand our role: we’re the third largest employer in the borough and as such we need to create a separation between provider and commissioner.