I wanted to tell you about someone whose ideas are strongly influencing my thinking about organising for large-scale change.  A few weeks ago, Don Berwick introduced me to Marshall Ganz from Harvard University. Ganz has a 45-year track record as a labour and community organiser and activist. He was unofficial “Mobiliser-in-Chief” for Barack Obama’s election campaign. He is regarded as one of the most significant players in the campaign, even though his role was largely anonymous.


I have attempted to distil some of the ideas and wisdom of Marshall Ganz for this piece.  I have taken ideas from the conversation, from articles, interviews and from his recently published book “Why David Sometimes Wins” (as in the biblical story where Goliath, rather than David, is expected to win). The book tells the story of the California farm workers movement in the 1960s, (“David”) which organised a poverty stricken, dispossessed migrant workforce into a powerful, civil-rights focussed, social movement, under the auspices of the United Farm Workers. This inexperienced yet passionate and strategically savvy group of activist leaders achieved concessions from the Californian grape industry (“Goliath”) that more established, well resourced labour unions could only dream of.


The ideas are profound and I want to do them justice. So I am creating two separate pieces. In this piece I am focussing on Marshall Ganz’s views on motivating and mobilising for change. In my next posting, I will concentrate on the art of strategising for large-scale change


You might ask what relevance a group of Californian labour activists in the 1960s has for the change agenda that NHS leaders currently face. My answer is plenty. Ganz defines leadership as “accepting responsibility to create conditions that enable others to achieve shared purpose in the face of uncertainty”. The farmworkers leaders could not use coercion or force compliance on their followers like mainstream organisational leaders can. They had to rely on other leadership skills and tactics that, I would argue, we need more of in our current NHS context; motivating, mobilising and building a community based on common interests, creating capacity for change from within. In conversation, Ganz makes the distinction between “compliance” and “commitment” organisations. If you want to read more about this, I recommend the seminal Harvard Business Review article “From control to commitment in the workplace” by Richard Walton (2001). Essentially, compliance organisations rely on rigid hierarchies, systems and standardised procedures for co-ordination and control. In commitment organisations, the co-ordination and control mechanisms are based on shared goals, values and sense of purpose.


I have never seen a healthcare system deliver sustained transformational change through compliance. One of the biggest priorities for the coming period in the NHS is to build the foundations for a commitment based quality and productivity strategy. We need to equip NHS leaders to be commitment-based leaders, “able to engage and enable lots of people to become innovators, adaptive in the face of uncertainty”. I agree with Ganz that understanding how successful social movement leaders meet this challenge is of significant value to organisational leaders. We need to learn how to create purpose for our workforce in a world where traditional management levers like hierarchy are diminishing, in an environment that is increasingly complex and volatile.

In his work, Ganz strongly promotes the social movement-inspired leadership strategy of mobilising through story telling.  He says that as mobilising leaders, we have to be able to give a public account of ourselves (“the self”); our background, our motivations and our direction. He gives the example of Obama’s “story of self”. In his election speeches, Obama rarely mentioned his resume, rather choosing to introduce himself by where he came from, (his grandfather’s decision to send his son to the US to study), the factors that made him the person that he is (his parents’ decision to name him Barack, meaning “hope”) and the direction he is going in.

Ganz took his approach to “self” into the heart of the Obama election campaign. He designed many of the training systems for campaign volunteers, including a weekend training camp called “Camp Obama”, teaching thousands of campaign organisers to share personal narratives and create compelling politics around human experience and emotions, rather than around issues. He led workshops on motivating from “a place of hopefulness” rather than of fear, and on how to build from common ground to shared values and commitments. “What we helped them understand is that the first thing they need to learn is how to articulate their own story, in other words, what is it that moved them to become involved and engaged, because it’s from their own story that they’re going to be able to most effectively engage others”.

A “cascade of training and leadership development” led to a massive field organisation that continued to built upon itself, where volunteers continually joined and moved up the ranks and everyone felt “they owned a piece of it”.

What might our NHS equivalent of “Camp Obama” be in preparation for the coming era of change? How do we equip all our leaders to be mobilising leaders? How do we build a message of hope, of a better future for our patients, populations and staff, rather than fear about cost reduction?

According to Ganz, the biggest breakthrough was the whole approach to campaigning, moving from the traditional marketing approach of American electioneering to real organising. “The difference here is that a whole tier of volunteer leadership was cut into the action in this campaign. No-one has ever done that before. At our first training in Los Angeles where we said, “look, you’re going to have access to all this stuff because you’re part of the campaign”.

When we think about designing the NHS engagement strategy for quality and productivity, we need to have the same mindset.  It cannot just be about communicating and winning hearts and minds. It has got to be about real organising, giving people the skills, support, networks and power to start taking action now. At the end of the day, our whole approach to cost and quality has to be about action to make a difference. The thing we have to remember about social movements, as Ganz says, is that they are about changing the world, “not yearning for it, thinking about it, or exhorting it”.

Part two of this piece will be my next posting. In the meantime, if you want to be inspired and called to action by Marshall Ganz’s ideas, download the notes and videos from his online Harvard curriculum on “Organizing” at www.hks.harvard.edu/organizing/ . It is a treasure trove of materials and it is freely available