Two opposing views

One reason why the NHS is loses money.

A few weeks sago, I was at a lecture given by Sir Alex Ferguson. It was excellent – he was amusing but humble – thoughtful yet single-minded. He told stories of his background – of the good times and the bad.

But one thing he said stayed with me. He told how, if he had any doubt about a player, he had to resolve it before he went to bed. Once the decision was made, it was cast in stone – irrevocable. He would never change his mind.

Later, I was talking to an Executive with the Health Board.

“You know, life used to be quite simple” he mused. “I made my decisions and we got on with the job. Then Government wanted to know what we were doing, and all decisions had to go before them. I found that this meant I could take longer to make a decision – I agonised over it – before it went for approval. Then, so often, it would come back rejected, and we’d have to start again. It was so frustrating and time-wasting.”

I bet it was. I’m sure that it costs money too. Having senior management go back to the drawing board – what is more expensive than that?

Sir Alex Ferguson would never have put up with it. But that is why he is where he is, and the Health Service is where it is. Processes are no longer fully owned by the Health Service– which suggests to me that it can no longer control the outcome. Now just think about that for a minute.  It is all very well saying processes don’t matter – it’s outcomes that count: but surely for any outcome, there must be ownership of the process?

“The Origins of Consciousness”,, explains why this system does not work: why the Health Executive takes longer: why the decision was deemed inappropriate. To make an appropriate and effective decision, spontaneity and instinct are essential. It is an engrossing book  – humble and informative – which allows a different perspective on out problems.

Surrendering control of your processes cannot bring about a happy outcome. If you give away the keys to your house, you cannot expect to rule the roost.  We are bending over backwards to achieve cooperation – at the cost of efficiency.

If managers take responsibility for their decisions, a happier, more cost-effective and efficient workforce would result.        Government should not requires oversight at this level unless the wrong person not been hired. In which case there is an answer.

We need to see where we are going. A view helps us know what we need – how to prepare.

At the moment, that Vision is missing – obliterated by targets and policies.

And people running round in ever decreasing circles.

© Linda Jane McLean

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