Osiris Training

So which are you a sucker or a rip off merchant? Did you lead your organisation into a Private Finance Initiative that looked attractive at the time or did you negotiate the deal that means the money will keep rolling in for decades? Did you resolve the problem of updating the organisations IT systems or were you the one who sold them a Rolls Royce when all they wanted was a mini, did you find the away of cutting over heads rather than services or did you win the lucrative contract with the punitive get out clause to provide support services?

These days being the chief executive of a public sector organisation means collaborating with the private sector. Collaboration has both negative and positive connotations. Collaboration between public sector organisation and with the voluntary sector is seen positively but collaboration with the private sector is viewed with suspicion. According to a recent survey by the management consultancy Hay Group whilst public sector leaders predict an increase in public –private collaboration they oppose and even resent the trend. In their report “Relationship Counselling” they record the concerns of senior managers about the effect such increased collaboration will have on public services and that senior managers refute claims that the private sector can deliver public services more effectively. There is a strong feeling in some parts of the public sector that collaboration with the private sector is a necessary evil. Those who have worked their way up through the public sector are very uncomfortable about doing deals with the private sector. Past experience has left many senior managers feeling that slick private sector operators have taken advantage of public sector organisations, that members have been seduced by glossy presentations and the promise of painless budget savings and officers have been out manoeuvred by cleaver sales techniques and smart lawyers.

It is not inevitable that the predatory private sector will rip off the naive public sector but a long term relationship will require both sectors to put aside their prejudices and find ways of collaborating which allow for profit and social benefits.

In the past social services have tried to frame contracts with the private sector to reflect public sector values whilst accepting that companies need to make a reasonable profits. Local Authorities view themselves as model employers with favourable pay and conditions, opportunities for staff development and a commitment to equal opportunities. They have however found that they can’t tell private sector companies what they should pay their staff or who they should employ. They have had more success in offering financial incentives to employers who invest in staff development. The idea is that contracts allow for premium payments for organisations that for example have over 50% of their staff with an NVQ in care. The argument is that not only does this help skill up the local workforce but means staff turnover is lower thus allowing for more consistency in care from better trained staff. The two biggest complaints from service users are the high turnover of staff and the lack of experience of staff resulting in personal care being provided by a succession of inexperienced strangers Of course this only worked whilst the premium was financially attractive once local authorities decided they could only afford the basics then they had no leverage.

This experience has convinced many that only financial incentives will make private sector organisations adopt public sector values. 

Blair McPherson author of Equipping managers for an uncertain future published by www.russellhouse.co.uk

There are too many generals in the army, too many rear admirals in the navy and too many vice marshals in the air force according to the ministry of defence. As the armed forces have shrunk in size senior officer posts have not been reduced proportionately resulting in top heavy armed forces. The ministry of defence has announced a cull of senior posts as well as more junior officers. The unprecedented scale of the cuts is necessary to balance the budget. This same argument has already been made in the NHS, Local Government and the Civil Service. The public sector is over managed, top heavy and has become bloated. Whether you accept the argument that compared to the private sector the public sector has historically been top heavy there is no doubt that mergers, service reductions and out sourcing have resulted in fewer staff and the need for fewer managers. But how many fewer managers?  

My personal experience as a Director in a large local authority is that the current harsh financial climate is seen as an opportunity to bring the public sector in line with perceived slimmer more efficient private sector management structures. Much of this seems to be based on anecdotal evidence gained at the bar and golf club resulting in arbitrary targets which are financially driven. Cutting management posts is seen by many local councillors /politicians as a painless way to make cuts, certainly more popular than closing libraries, day centres and swimming pools. There seemed to be no model, formula or comparator to arrive at the decision to cut one in five management posts. Cabinet/board was having none of it when HR prompted by senior management introduced the usual obsequious arguments such as, what do you mean by manager, people with manager in their title or people above a certain salary grade? And what about supervisors? Would it be better to talk of budget holders? The response was unequivocal you have approximately 500 managers in your directorate we want to see 100 posts go and we don’t want the remaining post to be paid more that would be unacceptable in the current climate. And we don’t want it just to be first and middle management posts we expect to see fewer senior managers.

Armed with this brief each directorate set about creating new management structures that would deliver the one in five reductions knowing that any perceived lack of commitment or failure to achieve the reduced head count could mean your head was next. But what does this dramatic reduction mean in practice? No doubt the impact varied depending on the nature, range of services and historic staffing levels. However some common themes emerged the management of services had to be merged, people’s spans of responsibility had to be increased and people’s portfolio of services became more diverse.

My own experience illustrates this change. A merger of departments and reduction in senior management posts meant that overnight  my social service portfolio had added to it libraries, museums, records, adult education, student grants, registrars and coroners support. These were not insignificant additions the library service alone had 76 Libraries but it was the diversity of services rather than size of staff group and budget that presented the challenge.

 Whilst manager’s core competences in managing large budgets and large staff groups are relevant across all services as is the ability to think strategically and influence key decision makers there is a loss of detailed knowledge and an increased reliance on junior officers/managers. There is the increased anxiety that you know less and less about the day to day management of such a wide range of services as you put your faith in the competence and specialist knowledge of those you manage.

All is fine until something goes wrong. How much were you expected to know? Who will be held responsible? Should your immediate reports have been more ” hands on”? Were they under resourced for the task?

We have seen high profile casualties. The Director of Education who was also give social service child protection services, the death in care, the recriminations, an over reliance on the competence of junior officers, too much faith in the expertise of middle managers, a failure to understand the resourcing issues or to resist cuts?

A cull of management posts is not painless but it may appear less controversial than other measures to make savings. The problem is not how to reduce the management head count but by how much. The answer may be different for different services certainly the cost of getting it wrong is.

 Blair McPherson former Director of Community services and author of books on management the latest of which is Equipping managers for an uncertain future published by www.russellhouse.co.uk

We live in a modern world so I was not surprised to be contacted by a student through Face Book. She was doing a presentation and referring to an article I had written on Equality and Diversity in Health and Social Care. She asked if I could tell her what my motivation was for writing the piece. This is what I said in reply.

I wanted to say that Equality and Diversity is not an optional extra in Health and Social Care services and explain why. Because some people seemed to be saying we were spending too much time and money on E&D when the training budget was being cut, workloads were increasing and there were so many changes happening. My answer was no it is really important and this is why……

The full article was published in Ethnicity and Inequality in Health and Social care vol1 issue2 December 2008 published by Pavilion. Here is an extract

Equality and Diversity as a way of delivering the wider Health and Social Care agenda

My passion is equality.  It seems to me that equality is what the public sector is all about.  It is the emphasis on the moral case for equality rather than the legal or business case that makes the public sector different from the private sector, the not for profit sector and the voluntary sector.  For me it is obvious get equality and diversity right and all else follows.  If equality and diversity in recruitment is right you will have a workforce that reflects the diverse population you serve.  If you recruit people who do not all come from the same background, hold the same beliefs and think in the same way you are more likely to have the creativity and insight to respond to the challenges of providing services to a diverse population.  You are more likely to be customer focused if your staff recognise different sections of the community want their needs met in different ways and you are more likely to have people who can think of different ways of meeting needs.  Of course this will only be realised if you have managers skilled in managing a diverse workforce.  This requires focusing on developing managers’ people management skills.  It also requires developing a safe working environment – one where staff feel able to challenge and be challenged.

Staff who are customer focused quickly realise you need a range of providers and services to meet a diverse population’s needs. That means working with a range of partners and it is often those in the voluntary, community and faith sector who are most able to cater for the small localised niche markets.  If you get equality and diversity right you will have developed your listening skills as an organisation and so you will have the right approach to engaging communities and working in partnership with the voluntary, community and faith sectors.  Such skills will stand the organisation in good stead for promoting community cohesion.

How will you know if you have got equality and diversity right?  By monitoring recruitment and service take up, by setting targets based on local population profiles and by service user and citizen satisfaction surveys. Such an approach to equality and diversity promotes a performance management culture.

Am I over stating the case to make my point?  Meeting the really big challenges means radically changing the way people behave in the organisation.  It means engaging staff at every level in doing things differently and it requires people to be inspired.  Leagues tables have limited motivational appeal, so does saving money.  Claiming the customer is king is hard to maintain in the face of hospital closures, cuts in services, removing children from their parents or admitting someone into a psychiatric ward against their wishes.  And despite the traditional emphasis on charismatic leadership front line staff don’t do it for the chief executive.  In fact in the public sector staff tell us in staff surveys they don’t trust senior managers, they don’t do it for the money, they do it  for the people they serve and they do it because they want to make a difference.  The challenge is to maintain this public sector ethos when services are contracted out to the private sector or to the “third sector “a cross between the private and voluntary sectors.  The challenge is to maintain this sense of commitment to the general good rather than the bottom line.  The challenge is to do this at the same time as the public sector is adopting many of the methods and much of the language of business.  What better/clearer way of doing this than focussing on fairness because that’s what equality and diversity is all about.  Fairness in how we recruit people, fairness in how we select people for promotion, fairness in how we treat people at work, fairness in how we allocate scarce resources and fairness in how we provide services.  Fairness is relevant, fairness inspires.

Of course fairness is a principle and the tricky bit is applying it in the real world but that is the challenge for the organisation; that’s what everyone should be working on.

Blair McPherson author of An Elephant in the Room-an Equality and Diversity training manual published by www.russellhouse.co.uk

2011 will be remembered as the year that the image of the caring nurse was shattered by widespread evidence of neglect on NHS wards. This was the year we realised the disturbing truth that inspecting services could not prevent abuse. It was also the year we were confronted with the knowledge that complaints even serious complaints were all too often not taken seriously. 

It is comforting to think that those who neglect and abuse vulnerable people are bad people. Better that than acknowledge they are the same as you and me and that given a certain set of circumstances we are all capable of the indifference recently revealed to be widespread in the care of elderly hospital patients. A few bad apples can be removed and better recruitment and supervision could identify the wrong un’s at an early stage. So why is abuse and neglect of people with a learning disability and older people such a recurring and widespread problem?

Neglect and abuse persists despite recruitment practises aimed at selecting people who have a positive attitude to old age. Bad practise and indifference to the discomfort of individuals continues despite renewed emphases on supervision. We should acknowledge that the problem is not simple one or two bad people. We need to recognise that disciplining and dismissing the worst offenders and providing more training for the rest won’t stop abuse and neglect from happening if the causes lie outside of the individual.

Of course we should dismiss those who abuse older people but we know this is just the tip of the iceberg. Those who shout or swear at a patient for being incontinent or steal their money and valuables or burse them through rough handling are easily identified and dealt with. But neglect and indifference is subtler than this, it is ignoring requests for assistance so that the individual soils or wets themselves, it is putting off cleaning them up in the hope that it can be left to someone on the next shift. It’s making the individual feel that they are being a nuisance with their requests for a drink or to be helped sit up when you are so busy. It is giving a patient a bath whilst carrying on a conversation with a colleague as if you were washing a car not a person as you share what you did last night and what you are having for tea to night. This is the real problem the staff group as a whole stop seeing patients as individuals they are just another incontinent, confused, feeble body that needs washing, feeding and toileting. The way things get don is organised to make life easier for the over worked under resourced staff. The good patient is the one who places no demands on staff but is grateful for any help, the good patient is cooperative and cheerful.

We cannot rely on inspections to prevent abuse and neglect although we can reasonably expect that a properly resourced inspection service will make it harder for it to go undetected. We cannot assume that just because a complaints system is in place mangers will act decisively all though we have a right to expect they will. We should not think that abuse and neglect is down to one or too bad people because the persistence of abuse and neglect despite dismissals disproves this.

Blair McPherson author of Equipping managers for an uncertain future published by www.russellhouse.co.uk

In the end it won’t be lack of money that does for the public sector. It won’t be the loss of skills or the lack of experience due to early retirements and redundancies. It won’t be the increased role of the private sector and a greater reliance on faith, community and voluntary groups. It won’t be the erosion of the public sector ethos as a more ‘business’ like approach takes over. No, what will do for the public sector is pessimism and cynicism.

Pessimism and cynicism are corrosive. If you don’t think things will get better, if you believe there is no hope for improvement even that things can only get worse then why would you struggle on? If you start to believe that the real motivation for change is self interest, career advancement and some well paid jobs for a select few then why would you try harder, work longer or do anything other than as little as possible?

This could be summed up as a loss of faith. No longer believing you can make a difference, no longer believing others are motivated by the same desire and no longer believing that what makes the public sector different is the aim of doing what’s best for the wider community rather than making a profit.

Maybe this doesn’t matter when it comes to emptying the bins. If the private sector can do it cheaper and make a profit then why not give them a contract for refuge disposal or office cleaning? But is it right and proper to increasingly give over the care of frail and vulnerable older people to companies whose primary aim is to do it as cheap as possible in order to make as much profit as possible? If that is acceptable presumably it’s acceptable to do the same with the care of people who have a learning disability and the care of people who have mental health problems? And what about child protection services?

The vulnerable are by definition not able to stand up for themselves they need people and organisations whose overriding motivation is to help them enjoy a better quality of life. Already many local authorities no longer directly provide residential care or home helps instead placing contracts for these services to be provided by a range of businesses. And what is the difference between a foundations hospital that takes private patients and a private hospital that takes NHS patients?

The danger is that pessimism and cynicism leads to people being unable to distinguish between the private and public sector at which point why have a public sector?

Blair McPherson is author of Equipping managers for an uncertain future and UnLearning management both published by www.russellhouse.co.uk