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It was reported in the Irish Times (12th/13th April) that Taoiseach Brian Cowen wants to reduce the number of administrators in the health service and concentrate employment in staff who tend to patients. However, he’s clearly not sure about this course of action because he concedes that talk about administrators has become glib. He almost has a problem in his sights. That problem is not a surfeit of administrators but managerialism. No, the problem is not management – real and necessary – but managerialism, a commitment to unproductive nonsense, which is stifling initiative, wasting the time of productive workers and managers, and providing incomes ranging from well off to ludicrous to a relatively large number of people.

The problem has become institutionalised and is not confined to Ireland or to the health service. Inevitably it will have to be tackled but that will be very difficult for two reasons. Firstly, there will be a difficulty in finding managers who are prepared to stamp it out. In a culture of managerialism, a manager who wishes to keep his or her job or achieve advancement has had to be a true believer or at least pretend to be a true believer. Secondly, it is difficult to argue effectively because waste has hijacked the terminology of efficiency and enterprise and used it to stifle both. There are creaking systems in place to promote innovation, set and measure goals, enhance performance etc. etc. There is a rich lexicon of bafflegab but the outcome is interminable meetings, contrived objectives, staff diverted from productive work in response to an insatiable demand for pseudo-management information, absence of leadership and management, and low morale.

Any attempt to reduce the numbers of administrators in an organisation plagued by managerialism will paradoxically reduce the efficiency of the frontline staff, who will be lumbered with work done previously by administrators. At this late stage in the history of the problem, senior managers who might be charged with implementing efficiencies would very likely find it unthinkable to change the focus of the organisation away from servicing the pointless, complex management system and back towards the real purpose of the organisation. If Mr. Cowen wants fewer administrators, he will find many managers happy to implement reductions but very few – if any – who still know that a management information system is a tool and not an end in itself.


One Comment

  1. One of the ways to deal with this is to get away from the notion that everything activity is amenable to the market and that market economics ensure efficiency. The market is based on the unverifiable notion that’people will act to maximise their profit’. Clearly different people have a different notion as to what profit might be but market economics defines profit as monetary surplus. Therefore it has developed a whole series of metrics to calculate what might be profit and loss. To apply this to the health service is madness. A whole class of people have been created across the private and public service whose whole function is to gather metrics so they measure what can be measured and ignore or deprcate what cannot. Incidentally they award themselves many priviliges and large salaries.

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