Saturday, November 11, 2006

And all it cost is £7.50

Even though I no longer work in the National Health Service I still get frustrated when I hear stories about what actually happens in the service.

What follows is a true story – it is not some made up urban myth. I was told the story by Simon, my Surgeon friend a couple of weeks ago.

It seems the Radiology staff in his hospital could not use a camera because the tripod had a small plastic flange missing where the camera should be housed. Simon asked how long it had been on order with the Hospital Supplies Department and was told the Radiology Department had been waiting nine months for the part.

This meant that the department had, for nine months, only one camera available for a particular procedure when they should have two – in other words the department was operating at 50% capacity.

Simon returned to his office, went online to the Kodak Website and found the required part on the Website. It was available in stock at £7.50. He ordered it online and paid for it with his own personal credit card. The part was delivered within two days and this meant the camera was up and running again.

The hundreds – possibly thousands of pounds that were being ‘spent’ in paperwork and procedures to order a tiny piece of equipment and the lack of capacity for nine months was all solved in 10 minutes at a cost of £7.50.

Amazing but true - and some people insist 'big is beautiful.'


Ray K said...

Madness. It used to irritate me enormously that I was being held to account for the budget of a day hospital but did not have the flexibility to order things directly. I often could have found something at discount through the internet and received it within the week, rather than wait 4 months for the supplies dept to get it at full price.

Trevor Gay said...

Madness indeed. Well said Ray and your point provides more evidence to back up what I always believed about the NHS in all the years I worked in it. The management just seems to have to go 'big' in our purchasing when ward managers could easily manage purchasing budgets more effectively themselves for all the ‘small’ stuff ... if only the system would let them!

I well remember the cleaners being given budget responsibility in one small mental heath hostel where I was manager and guess what? ... The cost of all the domestic consumables went down as they bought things locally looking for bargains. There was always an underspend on that budget heading.

Come on … This really is not rocket science. Simplicity is the Key of course :-)

Dan said...

This is a striking (and all-too-common) example of Learned Helplessness (, instituted on an organizational level.

Our organizations have terribly trained people to believe in the "it's not my job" mantra, restricting their perceived ability to act and narrowly defining specialties.

It's amazing that we'll trust a surgeon to take a knife and cut someone open... but we won't trust them to purchase a tripod part.

Similar things happen in other professions, of course. Program Managers are trusted to handle projects worth millions of dollars, but they need to submit receipts for any voucher items over $50...

Trevor Gay said...

Hi Dan - I once suggested that staff in my department should sign their own monthly travel claims and submit them direct to finance department for payment without their manager counter signing the claim. You would have thought I had suggested anarchy. Needless to say the suggestion did not get implemented - all sorts of 'jobsworth’ reasons were put forward to ensure the idea never got off the starting block.

Then a few months later I found by accident an example in the States where this had actually happened and guess what? - The travel expenditure went down by 50%. What happens when you trust people is – surprise, surprise, - they won’t actually ‘fiddle’ the system – they will respond with honesty. The company found when managers were signing the claim the responsibility was ‘shared’ between the employee and the manager. If the member of staff has to sign it ‘alone’ then they are suddenly in the spotlight totally and become more accountable and the company discovered the staff were totally honest. If staff can ‘cop out’ through getting the manager to counter sign the claim it somehow eases the conscience of the employee about fiddling the mileage. Amazing story – you can read it in ‘Liberation Management’ by Tom Peters

Once more this is not complicated or revolutionary so why don’t we do these things?

Dan said...

Ah, that's the question, isn't it? If it's not hard or revolutionary, why isn't it done?

I'd point back to the Learned Helplessness which is so common in our organizations. Even when someone rises above it, they are often met with stonewalling, if not outight hostility.

Jerry Harvey understood this better than almost anyone else I've ever encountered. Check out what he had to say about the Anaclitic Depression Blues in his book titled "How Come Every Time I Get Stabbed In The Back, My Fingerprints Are On The Knife?"

Brilliant stuff!

Trevor Gay said...

Hi Dan - I will check out that author. When faced with hostility the only way is to keep going if we believe in something strongly enough - as Sir Winston Churchill said 'Never Give Up, Never Give Up, Never give up'

‘Learned helplessness’ is a neat expression and reminds me of one of my favourite quotes from Tom Peters 'Powerlessness is a state of mind, not a state of reality'

Sometimes I wonder if great things might have been achieved but for the fact that people give up when they are just on the edge of something great.

Thanks for your comment - as always thought provoking.

Anonymous said...

I like reading the story. I'm having a great story.


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