- ISO 9000: making work as if working
- Education, education, education = waste
- The talent of a current leader
- What is management’s job?
- Health minister does the wrong thing righter
- Doctor reveals the truth
- Will IT work in health?
ISO 9000: making work as if working
I sent the Japanese translator of “Freedom from Command and Control” my recent presentation on ISO 9000, I thought it might be of interest as the Japanese ISO 9000 market is growing rapidly through market-place coercion – ‘you comply or we won’t buy’ – and Toyota (without ISO 9000) still stands as a beacon amongst the gloom created by this British economic disease. He wrote back:
“Thank you for sending me the text of your speech on ISO9000 and your slides. I am afraid it would take some more time until the tide here allows me to follow your suit to persuade my colleagues to get rid of it.
I am rather like to putting emphasis on coming back to Ohno’s concept and applying it to service organization as you do. That is to say, ‘trying a better way to make the work work’ rather than ‘convincing people to pull back from the poor way to make work as if working.’
ISO 9000: making work as if working. I wish I’d thought of that!
By the way, I made the slides and text of my presentation available to all – we need to stop the newly coerced countries being ripped off by this economic disease. As ‘mature’ countries give ISO 9000 up, the parasites (assessing organisations) now earn a good living off the gullible newcomers that just want entry to world markets. If you want this presentation send e-mail to Julie (firstname.lastname@example.org) and ask for the ISO 9000 presentation. Please pass it around the world.
Tony Blair promised us education, education, education. Just as his slogan carries waste, so do his policies. He set a target of 50% of students going to university. Now fewer than 30% of graduates find jobs. Worse, employers don’t trust the degree standards. They have just cause, the proportion of 1st and 2.1 degrees has risen significantly, no doubt a consequence of league tables and funding.
To solve the problem large employers now employ testing agencies to sift out good graduates. Re-work. Well done prime minister, plenty of knowable and unknowable costs. And the most important are the costs associated with false promises.
A newsletter reader leaked me some evidence of the talent we have leading one of our financial services organisations. First, the leader was asked a question by one of his staff:
“Why does everything have to be measured in league tables? ‘League tables’ is increasingly becoming the new swear word. I and my colleagues have many years experience in the industry and have got to the point where the job is no longer enjoyable due to the pressure of ‘selling’ (forcing) people to have a loan, current account or credit card to meet our targets!!!!”
The ‘leader’ replies:
“I agree with you that we should not over-use league tables although they are a valuable tool for us to see how other branches are performing and how other agencies are performing. We certainly don’t want to ever force customers to buy our products, rather we need to get more quality sales – that is customers who will stay with us for the long term.
On a broader basis, league tables should never be used as a threatening devise but purely as a motivational tool and we do need to be careful not to over-use this particular trick.”
Wrong on the first proposition, without knowing the extent and nature of variation he could be leading managers in making decisions about numbers that, while they are actually different may be just as expectable. Making decisions with no knowledge of variation brings extra cost to the system. Is that management’s job?
Right on the second sentence, but while he should not expect staff to force customers to buy, if he studied his system he might find (as I have with similar systems) the agent makes no difference to sales. Lots on all this in the book (a plug I know, but I don’t want to repeat it all here).
But to believe league tables to be a motivational tool (!). The best he can expect is people will be motivated to be seen to make their numbers, by fair means or foul – and lots on the cost of that in the book too.
When you study financial service organisations as systems you find abundant waste, poor service and poor sales – they throw away sales through bad design. And our top manager sits above all this thinking ‘how can I get them to do it?’ This man is not a leader.
A reader writes:
“I caught sight of this in a Forrester Research Report. When Forrester recently visited DaimlerChrysler’s diesel engine factory in Germany, we learned that its night shifts are more productive than its day shifts. DaimlerChrysler explained the discrepancy by the absence of management interference during the night shift.”
The UK’s minister for health has halved the number of quangos (quasi-autonomous non-governmental organisations) sitting above the health service. In my terms this means fewer specifiers dictating what health service workers should do. He recognised the plethora of such bodies was doing nothing for improvement.
But why didn’t he close all of them?
We saw the same strange logic with targets: targets don’t work so we’ll have fewer of them. I think we need to look into the ministerial mind. Any observations welcome.
A doctor wrote in the Sunday Times:
“We … have a two-tier NHS. One is a virtual NHS of constantly improving statistics; the other is the real NHS, where we cook the waiting times with elaborate trolley manoeuvres. The great triumph of our managers has been to met targets often without cutting a single minute off the time that our patients wait.”
He gives examples of how they have learned to ‘cheat’:
One of the key decisions in accident and emergency is whether to admit a patient or send him/her home. Sometimes you cannot make this decision without a blood test. To avoid breaching the four-hour target, patients are admitted even when it is not necessary.
On waiting times for out patient appointments: “Our managers have discovered a beautiful way of achieving a reduction of this waiting time. Instead of contacting patients and ascertaining when they are available, appointments are simply assigned and put in the post. Subsequently, many of these must be cancelled – but in the meantime the target has been met.”
He also describes how managers double-book slots in clinics, improving statistics but damaging quality of care and the patient experience. And most disturbing of all he describes how people talk about their ‘escape plan’. The NHS is such a demoralising place to work that it drives people away.
Ministers believe target make people accountable. It is the ministers who should be held to account.
The UK government is spending £6 billion on a new computer system that will have all patient records on and enable appointment making. Will it work?
They have four problems:
Will the many IT ‘partners’ work together? IT companies are notorious for writing contracts that earn them more money when things go wrong.
Will the system work? Anyone will tell you how difficult it is to keep customer records up to date.
Will the people use it? When do records help health personnel do a better job? Did the work start with this question or will health staff find the new system cumbersome in the execution of their tasks? Will consultants allow access to their diaries? Anyone who has worked with electronic diary management will know of the problems.
Will it improve health care? The answer to this is almost certainly no, because the ‘solution’ did not start by questioning the way health care works. Like all public services it is full of waste and has a damaging and large management factory.
Less than 16% of complex IT projects succeed. Why should we believe this one is going to work?
We have found the only approach that gets value from IT is: Understand the work as a system; improve without changing IT (except for taking it out); now ‘pull’ IT into the improved design. You can predict how it will improve things. Now there’s a difference! More about this in “Is IT bugging you?” in the articles section of the web site.