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<blockquote data-quote="Yorksman" data-source="post: 367437" data-attributes="member: 55568"><p>The reason why the hospital is fined is out of the misguided belief that by restricting the supply of money, the management of the hospital will rectify errors in an attempt to get the funding restored. This is a fundamental error in target driven management systems which underestimate the ingenuity of the managers to manipulate the systems. Corporate hangers on are better adapated to survive management systems than workers in any <em>'sink, float or swim'</em> culture.</p><p></p><p>Around 1987 the NHS had a budget of around £7 billion but found that it had to approach the Government in January and ask for some more money because they had run out and didn't have enough left to manage until the end of the financial year in April. The Government stumped up the cash and told them, <em>"don't let this sorry state of affairs happen again"</em>. The following year it did. The NHS asked for more money in or around February and the Government reacted by asking the question, <em>"Again? Don't you guys budget?"</em> to which the NHS replied, <em>"Budget? Sorry, don't understand what you are getting at. We spend the money as and when we need it."</em> Ever since then Government has been attempting to work out ways of getting the NHS to manage itself. It started in the 1990s with the 'Internal Market' and has now descended into the same target driven management system that has destroyed much of the financial services sector. The budget is now around the £110 billion mark and the NHS employs 1,700,000 people. Of this 1.7 million, there are 39,780 general practitioners, 370,327 nurses, 18,687 ambulance staff and 105,711 hospital and community health service (HCHS) medical and dental staff. To save you adding it all up, that's just short of 535,000 leaving the question, what do the other 1,165,000 people do? It doesn't include all cleaning staff or porters who tend to be contracted in through private contracts thesedays.</p><p></p><p>Managing any organisation, at a distance, is bad. Well managed companies have managers who are known and seen on the shop floor. The theory of management by targets works on the basis that people will do what is necessary to achieve the targets, that is, do what is in their best interests rather than the organisation's best interest. The theory holds that on balance, the organisation benefits from having people working in their own best interests.</p><p></p><p>Except the theory is wrong. Financial services are in a bad way precisely because this is wrong.</p></blockquote><p></p>
[QUOTE="Yorksman, post: 367437, member: 55568"] The reason why the hospital is fined is out of the misguided belief that by restricting the supply of money, the management of the hospital will rectify errors in an attempt to get the funding restored. This is a fundamental error in target driven management systems which underestimate the ingenuity of the managers to manipulate the systems. Corporate hangers on are better adapated to survive management systems than workers in any [i]'sink, float or swim'[/i] culture. Around 1987 the NHS had a budget of around £7 billion but found that it had to approach the Government in January and ask for some more money because they had run out and didn't have enough left to manage until the end of the financial year in April. The Government stumped up the cash and told them, [i]"don't let this sorry state of affairs happen again"[/i]. The following year it did. The NHS asked for more money in or around February and the Government reacted by asking the question, [i]"Again? Don't you guys budget?"[/i] to which the NHS replied, [i]"Budget? Sorry, don't understand what you are getting at. We spend the money as and when we need it."[/i] Ever since then Government has been attempting to work out ways of getting the NHS to manage itself. It started in the 1990s with the 'Internal Market' and has now descended into the same target driven management system that has destroyed much of the financial services sector. The budget is now around the £110 billion mark and the NHS employs 1,700,000 people. Of this 1.7 million, there are 39,780 general practitioners, 370,327 nurses, 18,687 ambulance staff and 105,711 hospital and community health service (HCHS) medical and dental staff. To save you adding it all up, that's just short of 535,000 leaving the question, what do the other 1,165,000 people do? It doesn't include all cleaning staff or porters who tend to be contracted in through private contracts thesedays. Managing any organisation, at a distance, is bad. Well managed companies have managers who are known and seen on the shop floor. The theory of management by targets works on the basis that people will do what is necessary to achieve the targets, that is, do what is in their best interests rather than the organisation's best interest. The theory holds that on balance, the organisation benefits from having people working in their own best interests. Except the theory is wrong. Financial services are in a bad way precisely because this is wrong. [/QUOTE]
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