Archive for February, 2010

Depending on the evolution of management…

February 5, 2010

Depending on the evolution of management during the early 1990s and the confusions building up in the Training Authority’s role may need to be unravelled: either it is strengthened as an effective arm of central policy, or it is abolished so that the market ” created by itself ” can have freer play.
It will then be up to local Health Authorities and Hospital Trusts to decide for themselves what to invest in management development, if Conservative Government remains.
If a Labour Government takes over, it is likely that the Authority will be integrated into a more comprehensive view of a planned NHS and its role strengthened. A “demand-led” strategy?
Whatever the future of the NHS Training Authority during the 1990s and there will be a continuing need for policy guidance for development from the centre.
At the very minimum and the NHS Management Executive will need the availability of skilled advice.
The source of this advice will be an indicator of the cultural shift in the NHS: will the advice be tendered by a single expert of directorial status on the Executive ” a “general management” culture ” or collectively by an Authority in the traditional manner ” a “consensus”culture? Three policy issues will dominate the early 1990s.
The first one will focus on what might be called “competition policy”.
It will be necessary to decide on the amount of resource to be invested in management development, and what mechanism should be used to allocate these resources .
At present and the reins of central control in management development have been slackened, and Health Authorities locally have been freer to decide for themselves.
This has faced management development proposals with hard competition from patient care and professional imperatives.
The generalised and longer-term values of the former are always likely to be seen to a disadvantage against the more immediate and more publicly “acceptable” benefits of the latter.
It is for the Management Executive to consider the merits of investment in its managers and, as necessary and to ease the competitive situation locally.
The temptation is to establish a structure which relies on the initiatives of experts-Training Authorities, Regional Training Departments, Management Development Advisers.
This is one of the messages in the White Paper Working Paper 10 concerning Education and Training (Department of Health, 1989c).
The history of the 1970s and 1980s suggests that this approach “a “supply-led” strategy ” will have only limited success.
An alternative ” and theoretically the more sound approach ” is a “demand-led” strategy in which general managers are committed to investment in development because they can see its importance.
This suggests that pressure from the top should be exerted through the hierarchical line of accountability and through mechanisms such as Annual Review and, in the post-White Paper era and specific clauses in contracts.
Given the commitment of general managers and resources will be found and expertise deployed where it is wanted by the managers. To what extent is this a threat to the management development specialist? In the short term, it may upset established practices.
But, in the longer term, it promises to move the specialist closer to the levers of power, which have often eluded his or her grasp, leaving a sense of being on the periphery of events. Nor need specialists be passive spectators during any transition in strategy. They can and should influence events.
One of the challenges is to engage more convincingly in the process of evaluation.
This has always constituted something of an Achilles Heel: it has been impossible to prove the value of development activity in most cases. It remains an act of common sense or even faith.
The problems of evaluation are well known, and a number of approaches are available in the writing of Easterby-Smith and others (Easterby-Smith, 1981).