- Are ministers psychologically incompetent?
- Insider tells all on Prison Service’s ‘shared service centre’
- The experience you get with HMRC
- The experience you get with the NHS
- The experience you get with tax credits
- How do we feel?
- Real nonsense, real damage
- Regulator favours targets over purpose
- Targets damage your health
- How bold was the minister?
- How bold are the managers?
- I remain optimistic!
Writing in the Education Guardian last month, a professor says: ‘I recently heard a former No 10 insider say that the belief that bigger is always better is still firmly entrenched in government, in spite of the lack of supporting evidence revealed in an unpublished Downing Street study.’ [If anyone can get this study for me I would be grateful]
Ministers exhibit the behaviour so interestingly described by Norman Dixon, author of ‘The Psychology of Military Incompetence’. When presented with evidence that doesn’t fit with their prejudices, they ignore it. In military conflicts it led to human losses. The losses incurred by ministers following their current ideology are many.
One type of loss is the inefficiency created by following ideological dogma. The doctrine that shared services will lead to efficiency is just one example.
A reader writers:
‘I was part of the team setting up the HMPS [Her Majesty’s Prison Service] shared service centre in Newport and the experience certainly did open my eyes. Firstly, there was a wholesale lifting and shifting of work from the prisons to a centralised function (HR, Finance & Procurement). This in itself seemed odd, as no one could actually tell you what was wrong with the current process of doing everything in-house. If a prison officer wanted to query his pay or allowances he went to see someone on site. In the new model, he had to ring a call centre that would put him on hold, call a person who would know the answer and then pass on the information. So two people would be employed to do one person’s job?
Secondly, there was a system in place in each prison that would allow the purchasing of equipment, clothing and food from suppliers. Some of these suppliers were in a catalogue (that would be updated on a regular basis) and some were not. Most of the fresh produce was not and the suppliers were usually local and therefore knew what each prison wanted. Under the old system, the prison placed an order over the phone to the supplier who rocked up with the produce. If there were any anomalies then the driver and the catering manager could adjust the invoice accordingly before submitting to the accounts payable clerk for paying. Simple. In the new world, an order would be placed on the new computer system (usually from a catalogue), the goods would arrive and would be checked in and receipted by the catering staff and entered onto the system, the bill would then be sent to the shared service centre’s accounts payable team for them to release for payment. The issue was (and probably still is) that the computer
system is stupidly precise. What I mean is that if a prison orders 6kg of beans it shouldn’t matter how they receive it. However, the catalogue system meant that if you
ordered 3 x 2kg cans of beans then you should received 3 items to meet that order. However, if the supplier only had 3kg can and only brought 2 then the system would reject the receipt and prevent payment. This was the same for every item. I was in Leeds and was watching a chap receipting an order. The prison had ordered 500 apples which usually
came in 10 boxes of 50. However, on this occasion all the boxes had been bundled into 1 crate so there was only 1 item in the consignment. The chap receipting therefore entered the number as being received as 1. The system then rejected the order as it required an additional 9 boxes to be delivered before it would pay.
As a result of this fantastic system the team on the accounts payable section sawtheir work in progress escalate and the number of suppliers threatening to take their business elsewhere increase.
Thirdly, there was the implementation of a workflow system which only hampered the individual processing the work. It was to record the volume of work received, whether it could be done (‘transactable’ or ‘non-transactable’), and whether it was completed within the required Service Level Agreement. This meant that when a work item was received the team would read it and decide whether it could be done. If it could they would complete it and then enter it into the workflow spreadsheet. It if couldn’t be done, they would try to find out what information was missing, they would fill in a form about the reasons it couldn’t be done and again log it on the workflow spreadsheet. This then could be analysed later to understand how the service could be improved. Needless to say, the accounts payable team had a high volume of work of which verylittle was ‘transactable’.
Fourthly, there was the introduction of 6 Sigma. I’m going to hold my hands up here and state that I am a blackbelt. I quite enjoy the work but even I realise that some
stuff done under the banner of 6Sigma is stupid. Very stupid in fact. Like the shared service projects: A form was being completed incorrectly, so it took a ‘greenbelt’ three months of defining, measuring, analysing and improving to realise that it needed to be redesigned to make it less complicated.
After nine months I left. Mostly because of the shear blinkered view that centralisation cuts costs.’
HMRC is one of the regime’s flagship service factories. I get lots of correspondence from people who think their service has gone down the pan. The service experience is
not only poor, it will have associated with it high costs – two types of losses.
A correspondent writes:
‘I’m in the process of reading your excellent book ‘Systems Thinking in the Public Sector’ and wanted to share my own recent experience with you out of sheer frustration more than anything else…
The Inland Revenue sent me a letter and a form this week informing me that I might be due a refund on my National Insurance contributions for 2007-2008 as I might have been
overcharged. The letter asked me to provide some ‘further information’ so they could make an assessment whether I was due a refund. The ‘further information’ they wanted was (wait for it) ‘How much National Insurance have I paid during 2007-2008?’ I phoned them up (on the inevitable 0845 number) and pointed out that they already have this
information (along with my money), so what was the point in sending the form? I was told that they needed me to confirm whether what I had paid matched their records. I
assured them that it did match exactly, and confirmed on the spot the exact amount I had paid (to the penny) during 2007-2008. I was told that they couldn’t make the decision
over the phone so I would still have to write this information on the form and send it in, otherwise they couldn’t process my application. I asked if this meant I was definitely entitled to a refund, and pointed out that there must be a threshold for the maximum amount of National Insurance chargeable, and if what I had paid during 2007-2008 exceeded it, then the decision should be easy to make.
Again, I was told that I would have to send in the form, so I asked if they could tell me hypothetically if what I had paid had exceeded the threshold, and if not, why had I been sent the form in the first place? They were unable to provide me with this information; neither could they explain the benefit in sending me a form that asked me to tell them what they already knew, in order for them to determine whether my National Insurance payments had exceeded a threshold that they set. I therefore had no option but to fill in the form, which included having to write out a section consisting solely of my name, address and contact details WHICH THEY ALREADY KNOW BECAUSE THEY USED IT TO SEND ME THE FORM!!! They didn’t even include a freepost envelope so I had to drive 5 miles to my nearest post office, pay £1 for parking, buy an envelope (12p) and a stamp (36p), then drive 5 miles back home. Now I will probably have to wait weeks for a ‘decision’ to be made, all because this system will not allow for someone to do a primary school-level subtraction sum and inform me of the result!!!’
And while HMRC managers fret about service standards and activity statistics they remain blind to the way their system treats customers – and how much waste they create. Even
more incredibly HMRC managers talk at conferences about how they are ‘removing waste’. Because they have employed ‘lean manufacturing tools’ they have no idea of what waste
actually looks like. But customers know only too well.
A reader writes:
‘Late last year, after some time of suffering from pain in my gut, I visited my doctor for a check up. The doctor examined me and asked me, what I thought was wrong.
‘I think it is a hernia, or maybe a problem with my intestines, or, at worse, cancer’ I told him. ‘You were right the first time -you have a hernia.’
I asked the usual questions: Will it go away? No; Can I do anything to help it? No; Will it get worse? YES.
The doctor told me that, because of cuts in the health service, he was not allowed to refer me to the local hospital. He recommended a special support truss for me to wear,
during my work. The work I do is physical and wearing the truss made some of the jobs that I had to do, very painful as the truss would ‘dig in’ my stomach, and push hard
against the hernia. I re-visited my doctor and told him of the problems that I was having, and he re-iterated what he told me previously and suggested that I should complain to my local MP.
I wrote to my MP and explained the problem that I was experiencing. He replied and also wrote to the Chief Executive of my local hospital trust. A reply from the Chief Executive contained 95% waffle – this was my doctor’s interpretation of the letter.The letter ended with: ‘If Mr. [X] feels strongly that he would like to be assessed, his
GP is free to refer him to the hernia clinic’. This information is a complete reversal of what the doctors at my surgery have been told to say. My doctor wrote to the hernia clinic and a few days later a date and time was set for my assessment.
The day duly arrived and I took time off work to go to the hernia clinic. I handed in my letter to the nurse and sat down in the waiting room. After a quick examination,
the consultant agreed that I did indeed need the operation. I was given a folder of my notes and took these to the pre-op assessment department. I handed these to another
nurse and sat down in the waiting room. It was only a matter of weeks from that time before I was admitted and had the operation.
Why, after paying my National Health stamp for more than 40 years, should I have to fight to get the necessary treatment?’
A novice systems thinker writes:
‘Having just completed the Systems Thinking Fundamentals course, I thought you might like to hear my experience with The Tax Credits System:
Having been homeless (in principle) for four and a half years, my family was offered a house by our local housing association. We had to accept as this was the only 4 bedroom property that had been available in at least ten years.
As part of the process of moving, you have to inform people of your new address. My wife called the Tax Credits Helpline and gave them our new details. About a month later, we noticed that her account was unusually low on funds and couldn’t work out why. A trawl through the last few bank statements showed that we were missing a payment from Child Tax Credits. She called them the following day and asked what was going on. The reply was shocking: ‘Your claim has been terminated, as you and your husband are separated, you’ll have to re-apply’. Strangely two letters appeared in the post (one to our new and one to our old address) a few days later confirming the termination.
We called and called the helpline over the next few days to try and sort things out, only to be told that the case had been handed over to ‘head office’ for them to ‘fix’. I tried to find a number for ‘head office’ and randomly got through to a chap that deals with income tax enquiries for my region. Although he was not ‘trained’ to handle Tax Credits calls, he was very helpful and arranged a meeting with an ‘expert’ in our local Tax Office. After the meeting we left the Tax Office with some giro’s and was told that we would be receiving them every four weeks (which we have) until our claim is fixed (still waiting, three months later). Last week we received a lovely letter demanding we pay back every penny we have been paid this year as it is an overpayment! I called the helpline right away and (20 minutes later) the unhelpful person just repeated the status of our claim back to me instead of answering the question I had about the letter and what I should do. Eventually, he said that I’d have to dispute the overpayment and that he’d send a form.
Let me get this straight. HMRC make a mistake and log my wife and I as separated when all we did was move. They openly acknowledge this mistake and are trying to fix it (three months and counting). They put a temporary fix in place to make sure we still got paid, one that was organised by an income tax expert from a different department. But then send a demand that we pay back this money or else. We then have to dispute the overpayment, citing the information they freely reel off when we call them. How can such a simple mistake lead to such wholesale failure and waste?’
The correspondent who wrote about HMRC finished his e-mail saying: ‘No need to reply, it’s enough to know someone is going to read my email and understand how I feel!’
People feel powerless when dealing with the new public service factories like HMRC and DWP; people feel let down by the health service and dismayed (to say
the least) about the number of people killed by their hospitals; people avoid claiming tax credits because of the trouble they get into, caused by the terrible service design. We all feel angry, frustrated and despairing when we have to deal with services that don’t work; and we feel we cannot trust government to put it right, for all they do makes things worse. We feel robbed – it is taxpayers’ money that funds the ‘reform’ regime and ministers blithely waste billions.
The minister for local government, Hazel Blears has launched her next round of wasteful, wrong-headed, bureaucratic imposition in a white paper entitled ‘Communities in control: Real people, real power’. As a correspondent notes: ‘It is a meagre mix of shallow, rehashed initiatives which New Labour is trying to portray as a coherent policy narrative.’
People are to be incentivised to vote; if you vote in local elections you may win a prize. Psychologists know that when you incentivise behaviour (‘do this to get that’) people focus on the getting that; incentives take value out of the task. The problem facing ministers is people don’t vote. Instead of asking why they work on how to make them. And in doing that they devalue democratic activity.
Councils are to obliged to respond to petitions and they must put money into a new ‘community kitty’ to be used for ‘participatory activity’. The minister says: ‘Participatory democracy does not threaten representational democracy’, which is a clear sign that she knows it is her scheme’s Achilles heal – ministers always try to pre-empt opposition by labelling it as dumb. Blears said: ‘It’s an empty argument that is in the past. We’ve reached agreement on that…’
And so we can look forward to more bureaucratic administrative activity in the name of community engagement, competing and interfering with the representational system (people we voted for) which will only fuel peoples’ dissatisfaction with services and reinforce their belief that things are getting worse rather than better.
But you might win a holiday if you bother to vote!
The Housing Corporation has published a report explaining how a housing association (Ujima Housing) became insolvent earlier this year while the regulator (the Housing Corporation) failed to notice the warning signs. Incredibly, the Housing Corporation awarded this association the highest rating for financial viability in 2006/07. The report reveals that the regulator had a target date by which all financial assessments had to be completed. Ujima didn’t produce financial information in time for this,
which should have triggered regulatory action. However the regulator was so focused on meeting its own target that it simply did the assessment without the data.
Writing in the BMJ a hospital consultant gives examples of the ways in which targets have undermined patient care. It is not the first evidence and it won’t be the last. But I’m confident the regime will ignore it.
Joining in the current controversy over the Labour government’s leadership, Ivan Lewis, minister for adult care said Labour is at its best when it is ‘BOLD Labour’.
I showed Ivan Lewis all the waste that has been created by regulation of adult care. I put it to him that the best way to improve performance was to remove the waste and this could only be done by removing its cases (the regulations). I asked him for the freedom to work with a client to complete a whole-system re-design, ensure it was stable, assess the new economics and then establish a better way of regulating such that no waste ensued.
How bold was Lewis? I think you know the answer.
When I talked to another minister – Tom Watson – about the waste (failure demand) created down-stream by failures in DWP and HMRC and the massive costs associated with dealing with it, leaving aside the fact that these are the most vulnerable in society, he was as bold as Lewis.
The problems people are having with in the delivery of benefits, tax credits and employment services have been documented by the Joseph Rowntree Foundation. See: http://www.jrf.org.uk/knowledge/findings/socialpolicy/2233.asp
As the evidence mounts the inability to listen and learn is only compounded. Ministers are stuck, incompetent to use Dixon’s term, seeking only evidence to support policy (ideology) rather than listening to evidence which would lead to better policy.
I was persuaded to bid for work in an NHS organisation. I was assured people were aware of and ready for the challenges offered by Systems Thinking so I went along to explain how Systems Thinking works and to make it clear that the work in ‘check’ would reveal how current ‘system conditions’ (targets etc) were causes of waste. Because of this I suggested we should open communications with the Department of Health as we would need the freedom to do the right thing and stop doing the wrong thing when the work moved to re-design. Despite the enthusiasm of the top team the director of finance black-balled the idea. His view was the work would lead to publicity which might be politically ‘difficult’.
So there we are, when offered the opportunity to learn and design a system based on purpose from the patient’s point of view some managers would prefer to do as they are told, not rock the boat and ignore any adverse consequences for their patients.
I am reminded of being in a seminar where another finance man working for a Trust said: ‘We might make a loss on A and E’. How can anyone conceptualise A and E that way?
But I remain optimistic! Over the last few years the number of public services using Systems Thinking and the Vanguard Method has grown in spite of the regime. In the near future we are going to publish many examples, to show how wide-spread Systems Thinking is and to encourage sanity in this insane time.