Blair Mcpherson's Comments
Comment on: Why NHS management should be centre stage
If you want better leadership in the NHS appoint people with good management skills. A good nurse or doctor does not necessarily make a good manager any more than a good teacher necessarily makes a good head teacher.
Why can’t the NHS provide good patient care and be a good employer? Why is it that public sector organisations too often seem to think that being customer focused means disregarding the views of staff? We far too often see change imposed and then having demoralised and devalued staff we see senior management initiate a staff engagement strategy to convince the workforce that they will listen and will...well that's it will listen.
We don’t talk about it anymore but there was a time when local authorities were ambitious for their populations and felt their remit extended beyond the provision of services to a grander vision. Local authorities had a community leadership role and the vision was to bring a range of agencies together to improve the quality of life for local people. There were many measures of success that partnerships could use but the most dramatic had to be to close the gap in life expectancy. Chief executives of local authorities would open conferences by quoting the shocking figures on life expectancy between those who lived within one part of their Town/District/County and those who lived in another. Often the difference in life expectancy was as much as 10 years. This was a disgrace they would say but something they could aspire to change. The mantra was no single agency working in isolation could tackle such a complex multilayered problem but working together we could address health inequality whether its root be homelessness, long-term unemployment, teenage pregnancies, drug abuse, poverty or discrimination. As a Director of Community services I attended many of these conferences and Directors of Public Health were always in attendance. Often a Director of Public Health was one of the key speakers. It was clear that they viewed local authorities and their chief executives as kindred spirits providing the leadership and commitment that was lacking from their own senior colleagues in the NHS. Directors of Public Health were frustrated by NHS colleagues who couldn’t see beyond hospital waiting lists, foundation Trust status and tackling the drugs budget. If only they were part of the Local Authority were people understood the big picture. And then their wish came true. Unfortunately in the meantime LA’s curtailed their ambitions, a new government, a series of austerity budgets and a more limited role for local government. Local Authorities were now preoccupied with closing libraries, swimming pools and museums, outsourcing IT, Payroll and HR, no longer leading schools, providing housing or commissioning care services. The Directors of Public Health will once again find themselves isolated , marginalised and operating on the periphery. Transferring at the wrong time they must now hope that Health and Social care commissioners can see that bigger picture. Blair McPherson writer and commentator on the public sector www.blairmcpherson.co.uk
Comment on: Only in America?
Should read " to shoot them and imprison them"....
Comment on: Local authorities should run commissioning
Yes LA's should run commissioning. Pooled budget and joint commissioning have been tried and failed.Local democratic accountability dictates that this should be LA 's and they do have a better track record than NHS organisations but can't see central government going for such a big transfer of power and budget. The real issue is what future hospitals traditionally they have run the NHS.
Do clinicians make good managers? The NHS management culture has been repeatedly criticised as bullying and inappropriate for the task of transformation. The medical model of management is based on the idea that as your boss I am more experienced, more qualified and more learned than you. Since I have done your job I know how to do it better than you so you follow my instructions because I know best. Some refer to this as the command and control model I tell you what to do and you do it but that has military carnations and this autocratic style is more to do with the idea that I am in charge because of my professional expertise. The NHS has traditionally undervalued management skills such as managing people. Doesn't mean clinicians can't make excellent senior managers but if they do it will be because of their management skills not their professional background. www.blairmcpherson.co.uk
Comment on: Who guards the NHS’s reputation now?
Is it embarrassing that senior managers get a generous redundancy payment and with in weeks take up a new post in the NHS within the same locality? Yes.Is this another hidden cost of re structuring? Yes. Has this happened before? Yes. Will this happen again? Almost certainly.
Is care best promoted by competition?
Comment on: Break away from 'heroic' leadership
I agree with no more heroes but take it in turns leadership is not the answer nor is leadership at every level. The obsession with leaders has become unhelpful as a previous article in HSJ argued what we need is less leadership and more management. Or put another way less vision and rhetoric and more recognition for the skills necessary to manage the service.