NHS reforms: counting the hidden costs of change

Quote

"The greatest danger in times of turbulence is not the turbulence; it is to act with yesterday’s logic." Peter Drucker

News
Today the British Medical Association issued its official response to Health Secretary Andrew Lansley’s proposal for far-reaching reforms of Britain’s health service, the NHS.  These include giving more freedom and choice to patients, passing to groups of local doctors the responsibility for purchasing hospital services, eliminating whole swathes of management, and privatising an increasing number of clinical services.

The BMA argue in their response that the reforms could well undermine the stability and long term future of the NHS, setting different groups of clinicians against each other, and be costly to implement.  In a hard hitting letter to Mr Lansley, the BMA writes, "We urge the government and NHS organisations to focus on those areas where they can truly eliminate waste and achieve genuine efficiency savings rather than adopt a slash-and-burn approach to health care, with arbitrary cuts and poorly considered policies."

Any change in organizational structure has relational costs and implications; new relationships must be created, requiring time for people to gain understanding and trust; existing relationships can be improved but other productive ones may have to be truncated.  One problem with the present analysis is that the indirect costs (in terms of money, time and productivity) incurred in changing relationships are not brought into the equation and set off against the intended financial benefits.

A question that should be at the heart of any sweeping reform to public services is, “What relational architecture would be the most effective in increasing quality of services and to improve efficiency?”

Read on...

Our colleagues at the Relationships Foundation published a book at the end of their Relational Health Care research project, entitled “Relationships in the NHS”.  The third chapter argues for the notion that relationships are the most important, and the most neglected, resource in the NHS.  Read it here www.relationshipsglobal.net/Web/OnlineStore/Product.aspx?ID=51 

Walk the talk

Are you involved in any discussions regarding change in your organisation?  The next time your opinion is sought, why not raise the question of what relationships will be affected under each option, and are the relational as well as financial costs and benefits of the changes being taken into consideration?

The last word

From the Bible, Ecclesiastes 7, verse10: “Do not say, ‘Why were the old days better than these?’ For it is not wise to ask such questions.”