I agree with much of what is said, but have a couple of points to make that have to be overcome, the first two of which are in the article, but I think are very difficult to change:
1 - reducing and removing red tape / controls is a lot more difficult than increasing it and goes against much of the comment / media that will accompany it;
2 - we have a situation today whenever something goes wrong that something must be done and in particular that we must introduce "John Smith's Law". Getting around those is almost impossible;
3 - The biggest issue to me is the ever increasing centralization of the British [especially English] state. The centre can't control much of what it is trying to control and that leads to the use of targets / red tape, etc. Why can't the centre realize that it can't control everything efficiently?
4 - It sounds politically great to announce more doctors, more Bobbies on the beat, etc. This is often at the expense of admin staff and leads to doctors and police dealing with the sort of admin that they shouldn't be.
My recent favourite political news item was the massive increase in consultancy fees paid by government. Why? They said they would decease Civil Service staff numbers. They achieved that target, but only in a way that cost them substantially more. It shows how such targets and political actions are leading to the wrong outcome and backs up this article completely.
"The risk that something bad will happen because of too little compliance needs to weighed against the risk of a public servant following the rules to the letter yet failing to add value to those citizens they’re meant to serve."
This also plays into something Sam talks about in his book - the nature of the English press, meaning that even for local projects, like the Camden thing, all the downside risks lie with the central government, who will take a painful public beating from the Daily Mail if anything whatsoever goes wrong.
(In fact, I'd lay money on the Camden Family Group Counselling policy being abandoned eventually under these circumstances - something goes wrong; Daily Mail uses it as a stick to beat the government; government introduce rules to ensure it "never happens again".)
One that is touched on but perhaps not fully explored is that of risk and the attendant problem of potential legal liability and compensation. That I see as another significant driver (along with the desire to command and control) here. Defensiveness and protection from legal liability (for the organisation and in some cases for the individuals involved) underly many of the behaviours seen every day in the UK and which are highlighted in the article. Unless and until that can be addressed in a sensible way, empowerment and a refocus away from compliance and regulation is probably just a pipe dream.
There have been reports of a no-fault approach to compensation for clinical negligence in the NHS. That won’t necessarily read across into other sectors. Additionally it won’t necessarily do away with defensiveness as there would still be a cost involved that management would seek to minimise by controls.
I agree with much of this. A couple of observations:
1. One driver of disempowerment in the public sector is that managers and leaders are very often weak. Weak managers and leaders are rarely self-confident enough to use empowerment and prefer compliance. And one crucial reason why public sector managers and leaders are often weak, is that they’re badly paid, and so it’s difficult to recruit and retain top flight people. Of course money isn’t everything, but its also not nothing, and the blunt truth is that managers who can earn 250 or 350k easily in the private sector are not often going to be willing to work for 100 to 150k in the public sector
2. The tensions between front line senior leaders and management team can often be very challenging and get in the way of empowerment. And it’s by no means all one way: I remember a (female) Trust CEO telling the story of being taken for a walk by a senior consultant, a few months into her job. He put his arm around her shoulders and said: “Look my dear, the thing you must understand is that if you do something we don’t like, we shall simply ignore you. Because you will be here for two or three years, and we will be here for all our working lives.”
Managers and senior leaders need to be empowered before they can be expected to empower the people that they manage and lead. Most politicians have talked down the civil service for many years, that eventually has an impact.
The goal outlined here is admirable but I would suggest the NHS's nature as a politically-run service means this kind of devolution is unlikely to ever succeed. Politicians experimented with making the NHS operationally independent; since then Conservative ministers have been trying to claw back power.
Ultimately, when something goes wrong in the health service the health secretary feels accountable and wants to pull levers to fix that (whether it be Martha's law, 40,000k extra appointments, etc). That creates exactly the kind of pull to the top that is referenced here. A trust answers to the integrated care board (which are increasingly becoming another layer of performance management, not able to focus on the long-term as intended), which then answers to the NHS England regional team, to the national team and ultimately to the department of health. With that kind of political control in place, and a culture of top-down compliance targets, it's difficult to see much changing.
Some great ideas and I liked the different and varied examples. Probably I am getting too old for this (my career was late 70's to a few years ago). The word 'empowerment' was devalued by all the rubbish that was imposed on us in the late 90's. I forget the name of the scheme but I do remember getting back to my desk after another interminable meeting to find a note from my highly respected senior manager "I empower you to [do a shed load of work]."
Further, pay is low and has been falling for decades. In order to compensate, staff are now allowed /encouraged to develop their own careers with no regard for the organisation or even the hours at which the organisation is nominally open to the public. I agree that many / the great majority want to do a good job (though I have met those who transferred from the private sector and were appalled) but finding and developing leadership and defeating 'jobsworths' is a massive task. Undoubtedly moving / eliminating some of the top down targeting will help but given that there has now been a generation of senior management that has no expertise in the sectors they are managing - see prisons, tax and now Grenfell I fear that rebuilding is going to be more like starting again.
I remember a hands on domineering Director of our department being replaced, late 90’s, by one who stressed empowering us. Neither made any significant difference as far as i was aware. The autocrat had the advantage of many years in post and was actually feared as well as respected by some. His successor was seen as someone just climbing the greasy pole and wouldn’t be around for long. The department was forever changing its name and responsibilities usually as a means of getting rid of people through reorganisations, ie making them redundant.
One of the things that’s worth acknowledging is that, within the NHS, we have the tools to do this and they are very well established. Improvement capability is present, to a greater or lesser extent, in all NHS organisations. These are the processes that identify problems, devolve potential solutions to the lowest level and then build testable propositions around change. The challenge is that we don’t systematically use what we know works.
Love this. Like Sam, I spend a lot of time looking at the "gnarliest" issues that could make a massive for the many, such as healthcare, affordable housing, education and more.
The idea of shifting responsibility and leadership to one along the lines of what Dan talks about is absolutely in line with what I have seen working in commercial businesses from the small to the very large and global.
I also appreciate the work that Ms Mazzucatto and her growing org at UCL do to bring focus to the idea of being "mission-driven", something we now see in the current UK government.
One caution is that the gap between academia and real world leadership is one that it is important to bridge. Working with those who work in that space actively to support mission-driven change is something I would encourage academics and poilicy thinkers to do more.
PS I am very much open to offering my support in any way I can to such conversations (and, for clarity as I work with the private sector as much of my client base), my work around such complex issues is always pro bono.
Oh, and I'd love to attend the event on the 11th, but am off at that time to attend another event along similar lines, ie looking at big picture issues and ways to approach addressing them ;)
Interesting-it’s just not compliance in the NHS but targets over the last 15 years (but in fact always there to some extent) to achieve savings - savings or “cash releasing” cuts that were never designed to improve just to remove. It’s why the NHS is in an appalling state. As these saving were achieved with no assessment of the impact - I suppose the compliance was there to make the savings occur. It’s harmed most of the NHS but has virtually destroyed mental health care…. As it was an easy target with fewer control processes over spend.
I completely get the benefits of system change but as a teacher working in the world as it is with little opportunity to be a system changer my only option is as 'canny outlaw'. That means following the word but not the spirit of the rules in favour of harder to measure outcomes like better resilience and tolerance that go beyond these system compliance metrics like higher grades. It's hardly sustainable so here's hoping the system changes come soon
Very interesting! It's really good that you're drawing on so many examples from outside high-income countries in the West: I hope that's becoming normal for researchers.
As an NGO campaigner, until about ten years ago I was guilty of thinking about problems of governance and public management in lower-income countries as if they were categorically different than those in the UK and much simpler, being chiefly caused by unethical behaviour (= corruption), or lack of "capacity." I had lived for years before that in a middle-income country, so I should have known better. Events in the UK in the last few years finally put paid to the last traces of that prejudice.
Excellent piece, but I'm not optimistic. It looks as though the new government is going for more compliance, more regulation, more 'independent' regulators with even more powers.
Interesting. My first thought was that it might be useful to hunt up the works of Braverman and have another look at them. My second was that the NHS example begs the question of wether the authors friends wife did find better more effective treatment outside of the NHS and what the reason for this was. Was it really to do with more empowerment? My third thought is that it is interesting that this was published on the same day that the report on the Grenfell disaster was in the newspapers headlines, and Royal mail was announcing that some letters would no longer be delivered on saturday. Examples at either end of the spectrum, but both evidence that since the eighties there has been a seismic shift in the nature of public services, with ever diminishing public accountability.
Important ideas I think. You referred to the easy to measure targets of McDonald’s. I remember back in the day when having worked on a burger production line in a restaurant was considered nearly a right of passage that would equip one for later employment because of the easy to understand targets. I wonder how many civil servants were shaped by this type of work during their college and university years.
I agree with much of what is said, but have a couple of points to make that have to be overcome, the first two of which are in the article, but I think are very difficult to change:
1 - reducing and removing red tape / controls is a lot more difficult than increasing it and goes against much of the comment / media that will accompany it;
2 - we have a situation today whenever something goes wrong that something must be done and in particular that we must introduce "John Smith's Law". Getting around those is almost impossible;
3 - The biggest issue to me is the ever increasing centralization of the British [especially English] state. The centre can't control much of what it is trying to control and that leads to the use of targets / red tape, etc. Why can't the centre realize that it can't control everything efficiently?
4 - It sounds politically great to announce more doctors, more Bobbies on the beat, etc. This is often at the expense of admin staff and leads to doctors and police dealing with the sort of admin that they shouldn't be.
My recent favourite political news item was the massive increase in consultancy fees paid by government. Why? They said they would decease Civil Service staff numbers. They achieved that target, but only in a way that cost them substantially more. It shows how such targets and political actions are leading to the wrong outcome and backs up this article completely.
And on the last point the most recent controversial appointments for training the civil service staff?
"The risk that something bad will happen because of too little compliance needs to weighed against the risk of a public servant following the rules to the letter yet failing to add value to those citizens they’re meant to serve."
This also plays into something Sam talks about in his book - the nature of the English press, meaning that even for local projects, like the Camden thing, all the downside risks lie with the central government, who will take a painful public beating from the Daily Mail if anything whatsoever goes wrong.
(In fact, I'd lay money on the Camden Family Group Counselling policy being abandoned eventually under these circumstances - something goes wrong; Daily Mail uses it as a stick to beat the government; government introduce rules to ensure it "never happens again".)
The article makes many valid points.
One that is touched on but perhaps not fully explored is that of risk and the attendant problem of potential legal liability and compensation. That I see as another significant driver (along with the desire to command and control) here. Defensiveness and protection from legal liability (for the organisation and in some cases for the individuals involved) underly many of the behaviours seen every day in the UK and which are highlighted in the article. Unless and until that can be addressed in a sensible way, empowerment and a refocus away from compliance and regulation is probably just a pipe dream.
There have been reports of a no-fault approach to compensation for clinical negligence in the NHS. That won’t necessarily read across into other sectors. Additionally it won’t necessarily do away with defensiveness as there would still be a cost involved that management would seek to minimise by controls.
I agree with much of this. A couple of observations:
1. One driver of disempowerment in the public sector is that managers and leaders are very often weak. Weak managers and leaders are rarely self-confident enough to use empowerment and prefer compliance. And one crucial reason why public sector managers and leaders are often weak, is that they’re badly paid, and so it’s difficult to recruit and retain top flight people. Of course money isn’t everything, but its also not nothing, and the blunt truth is that managers who can earn 250 or 350k easily in the private sector are not often going to be willing to work for 100 to 150k in the public sector
2. The tensions between front line senior leaders and management team can often be very challenging and get in the way of empowerment. And it’s by no means all one way: I remember a (female) Trust CEO telling the story of being taken for a walk by a senior consultant, a few months into her job. He put his arm around her shoulders and said: “Look my dear, the thing you must understand is that if you do something we don’t like, we shall simply ignore you. Because you will be here for two or three years, and we will be here for all our working lives.”
Managers and senior leaders need to be empowered before they can be expected to empower the people that they manage and lead. Most politicians have talked down the civil service for many years, that eventually has an impact.
The goal outlined here is admirable but I would suggest the NHS's nature as a politically-run service means this kind of devolution is unlikely to ever succeed. Politicians experimented with making the NHS operationally independent; since then Conservative ministers have been trying to claw back power.
Ultimately, when something goes wrong in the health service the health secretary feels accountable and wants to pull levers to fix that (whether it be Martha's law, 40,000k extra appointments, etc). That creates exactly the kind of pull to the top that is referenced here. A trust answers to the integrated care board (which are increasingly becoming another layer of performance management, not able to focus on the long-term as intended), which then answers to the NHS England regional team, to the national team and ultimately to the department of health. With that kind of political control in place, and a culture of top-down compliance targets, it's difficult to see much changing.
Some great ideas and I liked the different and varied examples. Probably I am getting too old for this (my career was late 70's to a few years ago). The word 'empowerment' was devalued by all the rubbish that was imposed on us in the late 90's. I forget the name of the scheme but I do remember getting back to my desk after another interminable meeting to find a note from my highly respected senior manager "I empower you to [do a shed load of work]."
Further, pay is low and has been falling for decades. In order to compensate, staff are now allowed /encouraged to develop their own careers with no regard for the organisation or even the hours at which the organisation is nominally open to the public. I agree that many / the great majority want to do a good job (though I have met those who transferred from the private sector and were appalled) but finding and developing leadership and defeating 'jobsworths' is a massive task. Undoubtedly moving / eliminating some of the top down targeting will help but given that there has now been a generation of senior management that has no expertise in the sectors they are managing - see prisons, tax and now Grenfell I fear that rebuilding is going to be more like starting again.
I remember a hands on domineering Director of our department being replaced, late 90’s, by one who stressed empowering us. Neither made any significant difference as far as i was aware. The autocrat had the advantage of many years in post and was actually feared as well as respected by some. His successor was seen as someone just climbing the greasy pole and wouldn’t be around for long. The department was forever changing its name and responsibilities usually as a means of getting rid of people through reorganisations, ie making them redundant.
One of the things that’s worth acknowledging is that, within the NHS, we have the tools to do this and they are very well established. Improvement capability is present, to a greater or lesser extent, in all NHS organisations. These are the processes that identify problems, devolve potential solutions to the lowest level and then build testable propositions around change. The challenge is that we don’t systematically use what we know works.
Love this. Like Sam, I spend a lot of time looking at the "gnarliest" issues that could make a massive for the many, such as healthcare, affordable housing, education and more.
The idea of shifting responsibility and leadership to one along the lines of what Dan talks about is absolutely in line with what I have seen working in commercial businesses from the small to the very large and global.
I also appreciate the work that Ms Mazzucatto and her growing org at UCL do to bring focus to the idea of being "mission-driven", something we now see in the current UK government.
One caution is that the gap between academia and real world leadership is one that it is important to bridge. Working with those who work in that space actively to support mission-driven change is something I would encourage academics and poilicy thinkers to do more.
PS I am very much open to offering my support in any way I can to such conversations (and, for clarity as I work with the private sector as much of my client base), my work around such complex issues is always pro bono.
Oh, and I'd love to attend the event on the 11th, but am off at that time to attend another event along similar lines, ie looking at big picture issues and ways to approach addressing them ;)
Yes. Trick will be to move away from counting things so much, find other ways of measuring success.
Interesting-it’s just not compliance in the NHS but targets over the last 15 years (but in fact always there to some extent) to achieve savings - savings or “cash releasing” cuts that were never designed to improve just to remove. It’s why the NHS is in an appalling state. As these saving were achieved with no assessment of the impact - I suppose the compliance was there to make the savings occur. It’s harmed most of the NHS but has virtually destroyed mental health care…. As it was an easy target with fewer control processes over spend.
I completely get the benefits of system change but as a teacher working in the world as it is with little opportunity to be a system changer my only option is as 'canny outlaw'. That means following the word but not the spirit of the rules in favour of harder to measure outcomes like better resilience and tolerance that go beyond these system compliance metrics like higher grades. It's hardly sustainable so here's hoping the system changes come soon
Very interesting! It's really good that you're drawing on so many examples from outside high-income countries in the West: I hope that's becoming normal for researchers.
As an NGO campaigner, until about ten years ago I was guilty of thinking about problems of governance and public management in lower-income countries as if they were categorically different than those in the UK and much simpler, being chiefly caused by unethical behaviour (= corruption), or lack of "capacity." I had lived for years before that in a middle-income country, so I should have known better. Events in the UK in the last few years finally put paid to the last traces of that prejudice.
Great article, so hopeful.
Excellent piece, but I'm not optimistic. It looks as though the new government is going for more compliance, more regulation, more 'independent' regulators with even more powers.
Interesting. My first thought was that it might be useful to hunt up the works of Braverman and have another look at them. My second was that the NHS example begs the question of wether the authors friends wife did find better more effective treatment outside of the NHS and what the reason for this was. Was it really to do with more empowerment? My third thought is that it is interesting that this was published on the same day that the report on the Grenfell disaster was in the newspapers headlines, and Royal mail was announcing that some letters would no longer be delivered on saturday. Examples at either end of the spectrum, but both evidence that since the eighties there has been a seismic shift in the nature of public services, with ever diminishing public accountability.
Important ideas I think. You referred to the easy to measure targets of McDonald’s. I remember back in the day when having worked on a burger production line in a restaurant was considered nearly a right of passage that would equip one for later employment because of the easy to understand targets. I wonder how many civil servants were shaped by this type of work during their college and university years.