Of course businesses and public services need administrative systems to make them work. But uncontrolled administrationalism I believe is one of the central reasons why many state-run endeavours are in trouble worldwide in this early part of the 21st Century.
Let me tell you a story. There are many similar stories, but hopefully, it will highlight one of the biggest problems we face in this amazing era of science and technology.
The Diabetes Unit
Once upon a time there was a diabetes unit in a beautiful kingdom. It was staffed by five very cable specialist doctors and two rehab therapists. The unit was very busy and had one administrator and two secretarial staff. The unit was busy but functional and the people working there were happy.
One day, the national health executive decided to restructure the then-current unit system to an "integrated health flow system", a term coined by the minister of health who thought it was a very good idea. He had after all won his seat in parliament on the slogan: 'Modern efficiency for all!.'
A wise wizard had let the minister of health know that the latest international buzzwords was "integrated health flow system". So he decided that such a system was necessary. It needed specialist administrators and accordingly created new administrative posts for ex-units. Posts were advertised, and as you may expect, most existing administrators re-applied for there own jobs. None of them got these posts and each was faced with a choice: leave or accept a sideways demotion. Salaries would remain the same, so most opted for the latter option.
It was a busy time. The new administrators were hired, and unsurprisingly, they proceeded to implement new "quality and flow efficiency measures" and a raft of new policies for the clinicians to follow. For example, they noted that all the clinicians used paper files and so implemented new computer systems to augment the paper file systems. This meant that all clinicians had to keep paper AND computer records. In addition, in line with new policies, doctors had to fill in new pink forms for each test they ordered with a clear rationale for the order. On receipt of the test, the doctor would need to fill in a green form and a duplicate computer form to prove that results had been actioned.
The therapists had to follow similar protocols. Instead of direct ordering via secretarial staff, therapists were now required to make orders to the central head office for health appliances. For example if a therapist had to order 50 pressure gadgets they had to be ordered on the computer system which would issue an order number. Each gadget would be assigned a serial number which would be allocated to a particular computer file on fitting, and accordingly the therapist's stock would be updated.
On occasions, the central office would forward an order to a manufacturer who might only be able to fulfill a partial order. Thus only 40 out of 50 appliances might arrive, but unfortunately it would be only possible to accept a whole order on the computer and impossible to allocate appliances to patient files without full accepting of the stock. Thus the therapist would need to keep a special discrepancies log.
Therapists complained that they were spending a full day a week managing stock and computer systems but the new administrator felt that the secretarial staff were already overwhelmed processing the new pink and green forms the doctors were now completing. The new administrator felt that a new secretary was justified on a part time basis to cope with the heavy administrative load of the local diabetes health flow system. The new secretary would manage the growing waiting list and act as a public relations officer for the growing number of complaints from the public.
In the mean time, the previous administrator decided It was time to implement a quality review program of the health flow system. Subsequently each member of staff would have to complete a detailed review of their health practices within the system and justify the use of each hour of their work week. The second administrator had his eye on a new post in head office and was pleased of the opportunity to implement a quality improvement planned for the system. All medical staff found that their work week has lengthened and that they were working overtime without extra pay. Waiting lists had also lengthened and the minister of health couldn't understand why both costs and waiting list had almost doubled. It just dint make sense. So he decided to send an auditor to the diabetes unit to sort matters out...
A decision was taken to create a moratorium on new posts. So when one secretary took maternity leave, her post was not covered. Similarly, when a doctor and therapist each took sick leave for anxiety-related illness, they could not be replaced.
The End.
The story you have read is what I believe is one of the key factors that makes living in the 21st century often so frustrating. It paints a picture of what I believe often happens in modern work systems; and which results in a bloated and expensive public service. Not to mention the human stress, the waste of time, and the control of professions by people who have no real concept of the actual purpose of the work carried out. The consequences of this are as follows:
1. Severely decreased availability of funds for core-business activities, like continuing professional development of coal-face staff.
2. Reduced funds for updating instrumentation and new methods.
3. Demoralisation and consequent suppression of innovation and research by workers.
4. Burnout, exhaustion, illness and an increase in error rates.
5. A rise in customer alienation and dissatisfaction.
6. Decision -making about and prioritization of core-business activities either forced or heavily influenced by unqualified administrators. What some people call the tail wagging the dog.
It really is disheartening that in this age of science, technological advancement and amazing discovery, that administrationalism is dragging its feet kicking and screaming into the future. Bobby Deep, doesn't complain often, but he ain't got no time for dat.
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