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Got yer holidays planned?
Where to?
The littluns will want a water park, with safe, warm water to bomb into.
Mum will want a bit of peace and quiet and not to see the inside of a kitchen for a fortnight.
Dad will want… Ok I’m stereotyping, but you know I’m probably right, and…
… one thing I do know, the teenagers will want nothing to do with any of it!
If you wanted to managerialise all this, you’re talking about The Abilene Paradox. A concept in organisational behaviour. The originator was Jerry Harvey, based on a real life anecdote;
‘… family members agree to take an trip to Abilene, each believing the others want to go. Later, they discover none actually did…’
… illustrating how groups make counterproductive decisions when individuals keep quiet to maintain harmony or avoid disagreement.
Sound familiar?
It came to mind after reading a new report from the Health Foundation, based on interviews with leaders of England’s ICBs. More here.
It’s an excoriating critique from the mouths of the people actually having to…
... slash their budgets in half, sack 50% of their colleagues, with no plan, no idea what work is left for them to do and all the time, trying to do the day job.
To quote directly from it… and forgive the vernacular… ‘it’s a $h!£show’…
… and it is.
The service is going through a period of exceptional instability, collapsing morale, and deep confusion about the future direction of the NHS.
It’s causing untold distress.
The question that keeps nagging away is; why have otherwise intelligent and experienced NHS leaders gone along with this?
The Confederation has been silent. Providers are being taken-over and thinking about their own problems and apart from the Health Foundation, the ‘think tanks’ have been thinking about everything but.
Senior people at ICBs, NHSE and the DH+ are not fools...
... many have spent decades managing complex budgets and dealing with political pressure. Yet they have acquiesced in a restructuring that many privately (and not so privately) describe as chaotic, destabilising and corrosive to morale.
What explains it?
It starts with the Abilene Paradox… each person assumes the others want it, so no one challenges it. What appears to be consensus is actually a failure of anyone to say…
‘This is a bad idea.’
The next stop is Groupthink, identified by Irving Janis. In tightly connected leadership circles, dissent becomes uncomfortable.
Careers depend on relationships, reputations and access. The cost of being the awkward voice in the room can feel higher than the cost of going along with the plan, and …
… then, there’s simple bureaucratic survival.
Robert Merton wrote about how large bureaucracies reward compliance with the centre. Challenging the prevailing direction does nothing for yer career.
Put this lot together and you get something very familiar in large systems… institutional compliance without conviction.
History is full of moments when institutions complied without conviction. Topical for now, Suez. A classic… ministers, officials and advisers marching towards a policy most, privately doubted.
Large organisations don’t fail because people are foolish. They fail because the system makes it hard for intelligent people to say ‘stop’.
Streeting has no experience of big organisation management, NHSE and the DH+ have a lot of people who do. Why haven’t any of them taken our great leader to one side and reminded him…
… Mid Staffordshire showed that institutions don’t fail because no one knows something is wrong. They fail because the system makes it easier to comply than to challenge.
If senior leaders acquiesce in organisational upheaval and large-scale job losses without openly challenging the logic or the timing, what else will they acquiesce in?
Once a system demonstrates that it will absorb disruption without resistance, political leaders conclude there is effectively no limit to what the organisation will tolerate.
This is the real risk...
... when leaders align with power rather than the evidence…
... when leaders are no longer the buffer between power, people and performance...
… when leaders learn to protect themselves rather than confront uncomfortable truths…
… when leader's survival becomes more important than the purpose of the organisation…
… when, leaders, over time, become skilled at not discussing the real problem…
… when leaders are managing up and not managing the problem…
… when leaders are complicit in poor decisions and upheaval becomes routine, instability becomes acceptable and decisions that once would have been challenged simply pass through…
... when all that happens...
… we have no need for leaders.
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