Exchanging ideas to create the well-being advantage

I was listening to a radio debate last week about the government’s rejection of the McKinsey report that suggested a 10% decrease in NHS staffing would be necessary in the short to medium term to reduce costs.  There was some suggestion in the discussion that the loss of clinical staff was unthinkable, but that the NHS could lose swathes of administrative staff whose only purpose is to fuel the bureaucratic machinery of the health service.   Similar claims are frequently made about other areas of the public sector such as government departments and the police service.  This week David Cameron’s proposals for spending cuts under a Conservative government also included provision for a substantial reduction in bureaucracy in the public sector.

There can be little doubt that in organisations as large and complex as those in our public sector there will be considerable room for efficiency improvement and process streamlining – witness the significant investments that have been made in ‘Lean’ in recent years. However, there are risks in allowing the need to reduce bureaucracy to become the dominant mantra for organisational improvement.  To take the NHS as an example, both within Trusts and between them, there are substantial management demands.  Effective NHS managers are not solely bureaucrats and at their best they enable efficient, effective healthcare delivery and free up clinicians to focus on patient care.

In the Police Service, do we really want to get rid of civilian staff so that police officers spend their time compiling statistics to monitor crime rates and photocopying?  Haven’t we been there before?  I think most of us would prefer to see them dealing directly with criminals and their victims.   High quality administration is essential to the efficiency of public services and it should not automatically be seen as an unnecessary overhead – we have to be wary of knee jerk reactions that lead to a narrow targeting of administrative support staff as the only way to reduce costs.  Public service organisations need to employ and manage a range of staff who can work together to deliver service excellence in line with their demanding targets.  This will be very difficult to achieve if administrative support staff are made to feel that they are a barrier to this, rather than an essential part of the mix.