THERE is a medical centre in Seattle which has built up a reputation for being efficient and cutting costs, such a great reputation allegedly, that one Scottish health board has begun using public money to send three of its senior staff on a course there in order to learn how to save more public money.
NHS Highland is the trail-blazer in this case. We can only hope that NHS Lothian doesn’t follow in its trans-Atlantic footsteps. The public has had enough of these nonsense junkets.
It’s ironic enough that the Scots, traditionally known for prudence and parsimony, are expected to learn lessons on penny-watching from the land of wanton consumerism and big spending, especially as the US clinic is private. Illness after all, is a recession-proof business.
But the story behind it is even more bizarre. The courses run at the Virginia Mason Medical Center and Hospital are based on the methods used by Toyota, the Japanese car manufacturer. And Toyota is known for two things.
Instead of building a lot of cars it thinks the public wants, selling as many as possible and reducing the price of the rest to shift them, as most Western companies do, it operates more of a made-to-order system on its production line. Hard to see how that can equate to a health service.
But Toyota’s other and greatest claim to international business fame is that its operation, from boardroom to shop floor, functions on a particular employee engagement system which is something that, in a previous life, I happened to learn a great deal about.
At one time, I would have been happy to see all Scottish companies and organisations take it up. But anyone who knows anything about it would realise that it is highly unlikely to work today in this country (where “engagement” means you can’t get through to the call centre) and especially not in public services.
Engagement, despite its warm fuzzy title, is a challenging system of people management that relies on the extremely enlightened views of the employer. It means accepting that the employees may know better, about some things at least, certainly than their line manager and often than their managing director or chief executive.
It means empowering employees and rooting out poor people managers, even if they provide good results.
It’s a system that recognises the concept of “discretionary labour”, which put simply means that if you provide all the equipment and resources staff need, if you show appreciation and give them incentives and rewards, acknowledge their achievements, give them all a sound development path, and allow them more control over their own jobs as well as the ability to influence the whole operation, they will work harder.
How many people in Scotland today, including health service workers, could put their hands up to working for an organisation like that?
Of course it may work better in America with its sink or swim culture and its avowed intent to be “the land of opportunity”. But even there, it doesn’t work very well.
A study a couple of years ago found that the average number of suggestions each US employee made to improve the performance of a company every year was 1.1. The average Japanese worker made 167.
The average Scot could make 3000 and no-one would pay a blind bit of notice. And in public services, be it councils, education or health, where consultants, regulators, bosses, officials and mandarins have put systems in place to control the use of every swab or paperclip and woe betide anyone who challenges these systems, the idea is laughable.
Services and businesses in Scotland are facing cuts in budgets or potential closure. The only answer seems to be even more cuts because it is hard to see any other option. And it is impossible to engage staff in daily fear of losing their jobs. We live in a different culture from Japan which is why even Western Toyota plants don’t enjoy the same success. They try to emulate the same production techniques as those back home but can’t import the level of employee engagement that lies behind them.
It may be NHS Highland today but it could be any health service or publicly-funded body tomorrow that chooses to fling our taxes and rates at yet another ill thought out fact-finding “mission” or junket. Lothian’s authorities and services could lead the way by making a New Year resolution to ban them all, at least for 2013.
Save the bacon
IF you’re having a festive ham on Ne’er Day, make sure it comes from the UK, Sweden, Estonia or Luxembourg which are the only countries to so far comply with new European pig welfare legislation which comes into force tomorrow.
Yes, porkers are the latest victims of the recession because the other 80 per cent of EU countries are still using cruel and illegal practices banned in 1999 which can see sows spend their lives in stalls and tethers. And that includes some farmers in France, Germany and Ireland. Cruel pork is, of course, cheaper to produce and buy, and often hidden in pizzas and processed products.
A good New Year to all. I wish you a clear, cruelty-free conscience – if not a clear head.