I met up recently with an old friend. She has decided to give up work in March. The hospital she has worked in for many years as a family therapist was transferred from the private sector to the public sector last year. She is giving up because the (UK) National Health Service (or NHS) that has now taken over the hospital has made the unit a “national asset” and patients are being referred to it from across the country. She can no longer practice as she used to because the patients are disconnected from the families that should support them when they leave hospital care. Costs have also gone up because of the additional remote support that need to be given to both patients and their supporting families. In addition, she finds the extra “meetings about meetings” and paperwork completely stifling.
It reminded of a similar problem that is embedded within the UK prison system. It has been proven that offenders are much more likely not to reoffend once they leave prison if they get family support during their term inside. Yet most prisoners are deliberately sent to another part of the country to do their time. Families (often poorer than most) cannot afford regular visits. So the likelihood of prisoners reoffending when leaving prison goes up.
In each of these cases, I suppose the patient or the prisoner could be seen as the “customer”. Yet these two state-run systems have been designed without the customer’s requirements (or real needs) in mind. They have been designed at the expense of other measures (such as top-down political targets, reduction in costs etc.)
The current business fads of rationalisation, outsourcing, off-shoring, cost-cutting and factory call-centres seem to have driven traditional sane local business practices and have allowed madness to prevail.
I can’t prove it, but I believe that local, common-sense sanity has to create more flexible, cost effective public services over the prevalent national (or international) managing-by-abstract-measures madness. But that is a very difficult case to prove when big egos, big technology, big politics and big finance have each, in their own way, presented measurement madness as the new religion.
Maybe measurement is, itself, the root cause of the problem. Maybe we should be suggesting a new way to educate the cohorts of ignorant managers and measurers.
Taiichi Ohno would have thought so. One of his great quotes fits well here:
“People who can’t understand numbers are useless.
The gemba (or real place) where numbers are not visible is also bad.
However, people who only look at the numbers are the worst of all.”