Can The Public Sector Leopard Change Its Spots?

Can the public sector changeI went to an event very recently where a number of public sector and not for profit organisations were shouting very loudly about the joined up way in which they were working together and the great benefits that were being delivered to their customers.

On the face of it, this was exciting news but was everything as it seems? I can hear readers now thinking ‘he is going to have a go at the NHS’. Well in a way you would be right and in a way wrong. It is brilliant that service deliverers can improve and extend the range of services and observe genuine results.

So where is the problem? Well, the biggest one comes when someone reminds us that ultimately these organisations are spending our money. One of the people present who commissions services provided compelling evidence that these services were being effective. Commissioners have predictions for future service demand. This helps to ensure the amount and type of services required are actually there. The commissioner stated that demand was increasing much less than predicted which implies that prevention is working.

Well, that’s that then? Not quite. A gentleman asks politely but in a very ‘civil servant’ type of manner, what evidence he can put on the table at a meeting he is going to attend the next day. He wants facts (and lots of them) as do his colleagues (anyone with the word ‘Manager’ in their job title). We have a whole raft of people whose job it is to justify and account for spending.

The organisations are delivering new or altered services (great) but underneath they are fundamentally the same. This is a little like saying that a supermarket chain is changing and supporting the environment whilst all it is doing is stocking some local potatoes and getting rid of some plastic packaging.

We should remove whole swathes of middle management. We could then fund many more services if we could only change the way in which these organisations work. The public only turn their attention to accountability when the services they seek are not there. When GP visits are easy to make, when libraries are still there and functioning well, when refuse collections do not result in piles of waste on the street, we are all happy.

For a small example of how this can work see my article Ban The Boss – see the BBC’s Business Doctor at work. Its an hour long programme but well worth it.


Does It Have To Be Like This?

Alternative thinkingDoes It Have To Be Like This?

Let’s face it. There is a lot going on right now both here in the UK and in the wider world. It would be very easy to be dissatisfied with everything and say that the Government, Rescue Services etc could be doing better. Why is our internet not faster, why is there not a bus when I want one?

There might be things wrong with these aspects of life but why are things as they are, and could things be improved? The snow got me thinking this morning. How do people drive long distances to get medical help in very snowy places? The answer is, they often don’t. The key word here is drive.

The issue is getting medical attention. If we focus on driving then we come up with suggestions like 4 wheel drive ambulances which would be very expensive when you have a system such as we do in the UK.

If you are setting up a system from scratch then why drive long distances to a patient and then a long distance to a hospital. We could have some 4 wheel drive vehicles together with emergency/trauma doctors that are based nearer to patients and could get there quicker to stabilise a seriously ill patient. What if they need to get to a hospital? Well, let’s have more air ambulances and less road based ones.

You can see where this is going! Focus on the problem and find a good solution, don’t simply take what is there and fudge it. This might work for a while but is not likely to work for the remainder of our lifetime.

As well as applying this type of thinking to social issues we can also use a different approach to many business issues. A good example of this is the use of telephones in Africa. Many countries did not have a large number of telephones because of the cost and the need for wires and telegraph poles.

But much of Africa is flat and the signal from a mobile phone mast can travel a long way. If the cost structure is right then mobile phones become affordable even in the most remote of communities. Charging is also simple due to solar power.

Imagine if this had been a business. Your helpful business adviser could have suggested that you wait for the cost of installing telephone lines to fall and then install a system at that point. But your competitors have gone mobile (high speed, data, the whole shebang), they have leapfrogged you, left you behind.

So have a think about what your issues really are and if there are better ways to solve them. Look for the difference that makes the difference.

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