The new approach being mooted to performance improvement in hospitals, including, it is understood, a white traffic light which will indicate that a change of management may be about to take place, suggests a liking for, what he terms, the Abramovich style of management, writes Denis Doherty.
Performance improvement has become a feature of the public and private sectors and, understandably, our hospitals are expected to up their game too. There are many ways of approaching performance improvement and the one being mooted for our hospitals has some novel features. A traffic light system will provide an instant snapshot of how a particular hospital is performing. In addition a fourth light, white in colour, will indicate, it is suggested, that a change of management may be about to take place. This to me suggests a liking for what I term the Abramovich style of management.
Allow me to elaborate. Roman Abramovich is a Russian multi billionaire and one of the wealthiest people on the planet. In 2002 he attended the Champions League final between Manchester United and Real Madrid and was so taken by it that he decided, it is said, to enquire if Manchester United was for sale. The answer was no but, as it happened, Chelsea Football Club was and Abramovich bought it in June 2003. Chelsea then bought a group of the most talented players around, including Ireland’s Damien Duff. At the end of the next season, despite finishing second in the Premier League and getting to the semi finals of the Champions League, Abramovich decided to change the management. Jose Mourinho, the self-styled ‘special one’ was appointed manager. Over the next three years Chelsea won the Premier League twice, the FA cup and the League Cup twice. Relations between Abramovich and Mourinho turned sour and Abramovich changed the management again. Avram Grant, the new manager brought Chelsea to the Champions League final only to lose out, on penalties, to Manchester United. The management was changed again at the end of the season. Felipe Scolari who managed the Brazil team that won the 2002 World Cup was the next manager but after only nine months the management was changed again and under Gus Hiddich, as caretaker manager, Chelsea won the FA Cup. In June 2009 Carlo Ancelotti was appointed manager, won the Premier League and the FA cup but failed to win the Champions League resulting in the management being changed again at the end of his second season in charge.
Ministers tend to come and go and like Abramovich are sometimes difficult and have a tendency to interfere in what hospitals judge to be none of their business
Roman Abramovich isn’t interested in just winning silverware in competitions in England. Remember, it was watching a Champions League final that ignited his interest in buying a football club. Winning the Champions League trophy became his obsession and although Chelsea came close a number of times they just couldn’t win it. In the summer of 2011 Andre Villas-Boas was a highly successful young manager at Porto in Portugal and premier league side West Bromwich Albion, who were in danger of relegation, had recently sacked Roberto Di Matteo. Abramovich appointed Villas-Boas as manager and Di Matteo, a much-respected former Chelsea player, as assistant manager. Their task was to re-build the team over the coming three years. By March 2012 Chelsea were performing so poorly that Villlas-Boas was sacked. The best managers don’t change jobs during the playing season so Di Matteo was appointed interim manager. Against all the odds, in the following three months, Chelsea won the FA Cup and the Champions League. Almost by default Ambamovich’s obsession was realized.
In the USA it is accepted that entrepreneurs and the best managers learn from experiencing lack of success and in the NHS in the UK many of the managers who lose their jobs move to other NHS jobs and succeed in them
Why did Di Matteo succeed where more experienced and more illustrious predecessors failed? I thought John Giles, the shrewd and experienced RTE soccer analyst, put his finger on it when he described Di Matteo as a very good navigator. Chelsea FC needs a good navigator. The owner is known to be difficult and to interfere in team matters, the players constitute a minor united nations group: they are all very rich and hold high opinions of themselves. Chelsea supporters are not known for their sportsmanship and have developed high expectations of success over the past nine years. As interim manager, Di Matteo was able to concentrate on the short-term. He knew the factions that existed and was able to work on what they had in common. He was able to pander to the senior players, many of whom are in the twilight of their careers and feared they were being pushed out by the previous manager. The approach that worked so well for him this season won’t necessarily work well next season and his ability to convince the owner that he can succeed at the highest-level year in and year out will determine if he will be the next manager of the club.
Hospitals are similar to Chelsea in many ways and dissimilar in others. Ministers tend to come and go and like Abramovich are sometimes difficult and have a tendency to interfere in what hospitals judge to be none of their business. In recent years they lack the ability to invest what is required to achieve the results they demand. As Ireland has become more cosmopolitan, so too have the workforces of our hospitals. Professional hierarchies remain and some of the newer professions feel undervalued and unable to make the contributions of which they consider they are capable. Public hospitals have limited involvement in the selection of key staff. Like the Chelsea supporters, the expectations of the general public sometimes exceed the ability of the system to deliver. Since 2005, there has been little or no investment in leadership development or in management training and development. Confidence has been undermined to the extent very talented people are underperforming.
We really cannot afford to change managers and discard them. That would be bad not just for the individuals concerned but also for the system
At this time of major change, talented navigators are sorely needed. Sometimes changing the management can be a good option. Good choices, in the first place, are even more important. Abramovich hasn’t got that right yet but got lucky with his choice of Di Matteo as interim manager. Managers need to be developed and empowered to enable them to realize the results expected of them. Managers need to be given sufficient authority to enable them to meet the responsibilities they are given. Even then the navigational approach of some managers may be ill suited to the vessel they are in charge of and a change of navigator may be justified.
Change should not be viewed as synonymous with failure. In sport, most great managers were not always successful. In the USA it is accepted that entrepreneurs and the best managers learn from experiencing lack of success. In the NHS in the UK many of the managers who lose their jobs move to other NHS jobs and succeed in them. In Ireland we tend to be less tolerant of what we judge to be failure. We really cannot afford to change managers and discard them. That would be bad not just for the individuals concerned but also for the system.