Osiris Training

There are those who tried to convince us that improved efficiency would be enough to deliver the budget saving in the public sector. They were wrong and we now see rationing in the form of increased waiting times in the NHS, tighter eligibility criteria in social services and service reductions as libraries, day centres and swimming pools are closed. Now some people are claiming improved customer care is the answer. All we need to do is get better at identifying and delivering what our customers want. If we simply listen more we would waste a lot less time and money on providing service that people don’t want and we would have fewer complaints. Of course good customer care makes good business sense. Of course the public sector wants to shake off the take it or leave image of old. And of course doctors and social workers are keen to distance themselves from the professional knows best culture. So yes we need to get better at listening to people and finding out how they want their services delivered.

 Only it’s not quite as straightforward as that in the public sector. Just for a moment let’s pretend the private sector has sorted this problem, that the utilities, the banks and the train operators have developed sophisticated and effective ways of listening to their customers and adapting their services in response. That call centres are a fast and easy way to do business, that computers don’t automatically generate threatening standard letters and that the member of staff at the other end of the phone doesn’t keep repeating “but the screen is telling me”. How does this solve the problem of getting a home help to help you into bed when you want as opposed to when they are available? How does this help you deal with opposition from neighbours to opening a home for people with learning difficulties? And how does this work when local people voice their opposition to plans to close their local hospital or library or day centre or want their bins emptied weekly?

So customer care alone is not enough especially when times are tough.  

Blair McPherson is a writer and commentator on equality and management in the public sector his latest book is Equipping managers for an uncertain future. For more information visit www.blairmcpherson.co.uk

You lie in your own mess. You are cold. You are hungry and confused. You can’t remember whether you have taken your pills. You feel ashamed, lonely and frightened. It will be hours before someone will let themselves in to wash and feed you before rushing off to their next client. No time to chat, probably no conversation at all, only the TV for company.

I speak of the failure of community care when I describe the collapse of care at home.

The savage cuts in social care funding will mean hospital beds are blocked as people cannot be discharged home due to lack of support services. Blocked hospital beds means longer waiting times for others to get into hospital for their operations. Some will be forced into residential care not because they need it but because community services are not there and families cannot fill such a gaping hole. Those who end up in a home may not be any more fortunate as local authorities try to force care home fees down to make their reduced budget stretch and financially struggling homes cut back on food and staff pay. Whatever happened to joined up thinking? Whatever happened to living longer is something for society to celebrate? Whatever happened to old age should be enjoyed not endured? 

Community care has failed older people not because people didn’t want it, not because it wasn’t preferable to institutional care, not because it didn’t have the support of the professionals but because you and I decided (or others on our behalf) that we couldn’t afford to treat older people well.

Blair McPherson author of An Elephant in the Room –an equality and diversity training manual published by www.russellhouse.co.uk

Three quarters of the NHS work force is female, half of GPs are women but commissioning is mans work. A report in the Health Service Journal (HSJ) has revealed that the majority of newly set up clinical commissioning groups are led by men. Women make up only 15 per cent of chairs or leads at the 285 commissioning groups.

A similar situation exists in Local Authorities women make up 70% of the Local Authority workforce but only 21% of chief executives and only 30% of senior managers.

In the private sector the statistics are even more depressing. A recent report by management consultants Deloitts found that 20% of companies in the FTSE 100 had no women on their board. Most revealing in terms of the commitment to change is the fact that the proportion of women on boards has only increased from 5% to 9% in ten years.

The Public Sector may be further ahead in making a reality of equal opportunity rhetoric but these statistics show that there is a problem with management culture across all sectors.

The management culture at Gatwick Airport as revealed in the TV documentary Inside Gatwick may give us an insight into how those top 100 organisations are really run and don’t forget the Public sector is always being compared to successful private sector organisations.

Just because public sector managers would be much more careful about making comments about female staff that doesn’t mean that they don’t share some of their views on how staff should be managed.

Plenty of Public Sector managers would introduce Gatwick’s much feared 12 o’clock meetings if they could get away with it. “Someone will get shouted at, you just hope it’s not you”. Cut to meeting. A small room is crowded with managers all standing up. There are no chairs because this will be a short meeting and senior managers don’t want people to be comfortable. In front of colleagues the senior manager picks who he thinks is to blame and demands to know what went wrong.

Here is another example of macho management that not only turns women off but supports the glass ceiling.

Following the sudden departure of the head of marketing an interim specialist has been drafted in. He introduces himself to the management group by telling them things will have to change there is no room for failure and then proceeds to detail their failings to date. He informs the audience that the previous strategy for increasing sales was completely wrong, a strategy they had spent the past 18 months selling to staff, their managers and partner agencies. 

The material in this documentary is shockingly familiar to anyone in the Public Sector, frequent restructuring, a climate of fear and blame, major shifts in strategy, senior managers sudden departure and the drafting in of interim managers.

Could it be that the reasons why progress remains depressingly slow in public and private sectors is the persistence of a macho management culture. Could it be that in a climate of brutal budget cuts it is all to easy for the management culture to become one which uses fear and blame to motivate people, where success is measured in the short term, and competition takes president over cooperation. Could it be that despite commissioning being a new activity in the NHS the harsh financial climate means the same type of managers with the same type of leadership style are sort.

Blair McPherson author of Equipping managers for an uncertain future and People management in a harsh financial climate both published by www.russellhouse.co.uk

You would have thought leadership was all about owning decisions wouldn’t you. You’re in charge you make the decisions. Some of those decisions may be unpopular or controversial but you stand by your reasoning. Both James Murdock and Theresa May, one as a leader of a large news agency the other of a large government department have said it wasn’t me who made the decision. Both claimed they did not authorise the actions of their staff and are as shocked and surprised as the rest of us at what was going on. Of course we don’t believe them.

 The person at the top of a large organisation can’t be involved in every decision. The trend towards reducing management posts and increasing spans of responsibility means those in charge have to delegate more. Sometimes things will go wrong and questions will be asked. The first question should be what was the thinking behind this decision the second is, was it made in good faith? Did the person who made the decision do so in the belief that this is what their boss wanted?

 A good lieutenant can read their leaders mind and doesn’t need to wait to be told what to do. This is convenient because the boss sometimes wants things to be done but due to the sensitive nature of the decision doesn’t want to be associated with it. In a political environment the political leader goes one step further and wants to be able to “truthfully” say I knew nothing about this. American Presidents have coined the phrase plausible deniability to cover this position. In these circumstances plausible simply means there is no written record, no incriminating emails, no taped phone conversation to link the leader to the decision.  

In some local authorities off the record conversations may take place between the leader and the chief executive or the chief executive and one of their directors. Such a director might have a word with one of their senior managers. Is this beginning to sound like a scene from The Godfather?

The thing is unless you are directly involved you don’t know how much of this is going on. We only find out when something goes wrong that can’t be hushed up with an early retirement or quiet departure with a generous package.

It would appear that effective leadership doesn’t require owning decisions just not getting caught. 

Blair McPherson author of Equipping managers for an uncertain future and People management in a harsh financial climate both published by www.russellhouse.co.uk

The public have increasingly being using the courts to fights cuts. The latest example was the ruling that the Isle of Wight’s plans to cut social services were unlawful. This comes few days after a similar decision against Sefton council and whilst the courts are hearing the case against Brent councils decision to close six libraries. It would be a mistake to consider these decisions victories for the public over the local government. At best these are postponements not reversals. They are decisions based on a failure to consult in a meaningful way they are not decisions that mean the cuts will not take place. A more through consultation will happen, some changes will be made to the original plan but services will still be reduced, libraries will continue to close. This tactic was extensively used to try and stop the closure of local authority run older person homes. There are now very few local authority run Homes.

A judicial review ensures maximum scrutiny of the decision making process it is time consuming, expensive in legal fees for the local authority and doesn’t change the fact that a budget reduction means cuts will have to take place. Saving one area of service will inevitable be at the expense of another. What this means is that an unelected, organised, articulate pressure group can use the courts to keep their library open at the expense of someone else’s day centre. Better that councils are held accountable by the electorate as a whole through the ballot box.

Perhaps there is a better argument for the use of judicial reviews to challenge the decision to close a local hospital since the NHS is not locally politically accountable. The outcome may be a postponement, a commitment to review the plan and to consult more widely but the end result is likely to be the same.

Blair McPherson former director of community services and author of People manage

When Charles Dickens wrote Oliver Twist his aim was to show life as it was in the backstreets of a great capital city. He wished to confront his readers with a world of street gangs, prostitution and homeless children. He wanted to show it was all too easy for a young innocent to be sucked into a brutal world of crime, of casual violence and exploitation.  He wanted people to understand life below the poverty line breeds intense loyalties and dangerous allegiances.

I watched Top Boy (channel 4) the story of a young boy living in the inner city trying to avoid being taken into care and finding himself sucked into a world of street gangs, crime, casual violence and exploitation. A view of modern day life which is far from glamorous despite the flash cars, clothes and night clubs of the drug dealers. Gang loyalties are intense .The worst crime is to be a “snake”, disloyal to the gang “your new family”. It is a violent world where the need to kill someone is accepted as occasionally unavoidable just as the likely hood of you or your friends being killed is inevitable.

Oliver Twist didn’t represent how most Victorians lived any more that Top Boy reflects how most of us live but it is difficult to maintain that we have made great strides as a society when life for the underclass is so horrifically similar.

www.blairmcpherson.co.uk

It is time we recognised that leaving patients starving, thirsty or in pain (Patients Association report into hospital care) isn’t about identifying wicked, callous or indifferent individuals but about the culture within the NHS. A culture that gives surgeons a higher status than geriatricians, intensive care nurses a higher status than nurses on general wards because general wards are full of older people. You wouldn’t have to remind a pediatric nurse to ensure a child ate and drank and who would leave a child crying in pain? But apparently it is different for an elderly person with dementia. This is about clinical care being higher status than physical care, this is about the way resources are allocated. This is about an NHS that views older patients as the unattractive, unglamorous, unrewarding end of health care. Ultimately it is a failure of leadership since the culture of any organisation is determined by its leaders.

Blair McPherson author of equipping managers for an uncertain future and An Elephant in the Room- an equality and diversity training manual both published by www.russellhouse.co.uk