Tuesday, 16 June 2015

C.P. Snow and the drama of administration

Some years, in fact almost two decades, ago I wrote an academic paper about what the novels of C.P Snow could tell us about management and organizations (Grey, 1996). Little-cited and presumably little-read, it has sunk without trace but I was thinking about it again because I have just come across an old (and largely excellent) TV adaptation of his novels and have been watching the DVD.
Snow is nowadays an almost forgotten novelist, but in the 1950s and 1960s was both popular and widely admired, even being tipped for the Nobel Prize for Literature. He is most remembered now for his 1959 lecture on The Two Cultures of arts and science, and the gap between them; a lecture savagely attacked by the now perhaps even more obscure but then gargantuan figure F.R. Leavis. Actually I find this rather uninteresting, whereas his almost entirely forgotten 1961 Harvard lectures on Science and Government are fascinating. Anyway his main novelistic achievement was the eleven volume Strangers and Brothers series, and it is the adaptation of this that I have been watching. Over three million words long, Snow's is one of the most remarkable roman-fleuve ever produced in the English language, standing alongside his hero's Trollope's Barchester novels and his contemporary Powell's A Dance to the Music of Time sequence.
Snow (1905-1980) started life as a physicist but subsequently became a senior civil servant, involved amongst other things in the British atomic bomb project, and later a government minister for technology in the 1960s. All of this and more gets fictionalised in the novel sequence. I have read, and re-read, his novels since I was in my teens and I suspect that part of the reason for my interest in organizations stems from this. I was thrilled when researching a book on Bletchley Park to discover that Snow had been involved in recruiting some of its staff.
The novels are at least in part about the drama of administration, with an emphasis on decisions made within closed groups – sometimes a Cambridge College, as in perhaps his best novel The Masters, other times government – and the meetings, negotiations and small-p political manoeuvring that surrounds them. He coined the phrase, and used it as the title of one his novels, ‘corridors of power’ which has now entered the language and which sums up this theme of his work.
It may seem odd to call this a drama. After all, administration conjures up anything other than a dramatic image. Yet Snow shows how within the mundane transactions of organizational life, drama may be found. And this is not just about personal interactions. Always in Snow there is a mixture of the personal and the big-P Political: for example the Cold War in Corridors of Power (about an attempt to pursue a policy of British nuclear disarmament) and The New Men (about the development of the British atomic bomb in and after the Second World War).
There are many aspects of the novels which are of interest in terms of organizations, especially the treatment of small, powerful groups, which I explored in that 1996 article. Perhaps especially interesting is his repeated view that policy and strategy arise not from the grand designs of leaders but from what he called – using a physics metaphor – the Brownian motion of a myriad of minor decisions. That is a useful corrective to the current lionization of leadership and a validation of close attention to the detailed processes of organizational life.
The context of Snow’s novels is rather dated and specific – they depict a slice of English (not even British) life in the mid-20th century which is now rather obscure. Even so, my own experiences both in Cambridge, when I worked there, and in Whitehall, where I have sometimes had peripheral involvement, suggest that perhaps not so much has changed, at least in England. And beyond that many of his insights, particularly into small-group interactions, transcend time and place.
I don’t suppose that Snow was a great novelist, and he will probably never reclaim his former status as a popular novelist and public intellectual. Nevertheless, anyone wanting to understand either English society in the mid-20th century or, more pertinently to this blog, the more-or-less timeless nature of organizational power-play could do no better than to read Snow’s novels.
Grey, C. (1996) ‘C.P. Snow’s Fictional Sociology of Management and Organizations’, Organization 3, 1: 61-83.
For an introduction to Snow’s novels, see:
Tredell, N. (2012) C.P. Snow. The Dynamics of Hope. Basingstoke: Palgrave.
For what is still the best analytical account of Snow and his novels see:
Ramanathan, S. (1978) The Novels of C.P. Snow. London: Macmillan.
Surprisingly, there has been no proper biography of Snow, but his brother’s memoir is worth reading:
Snow, P. (1982) Stranger and Brother. A Portrait of C.P Snow. London: Macmillan.

Saturday, 13 June 2015

Healthy bureaucracy

This post relates in some ways to my previous one about NHS management, but is both more specific and yet with a wider import. In the current issue of the satirical magazine Private Eye the Medicine Balls column discusses one of the consequences of recent NHS reforms (the column is not available on the Private Eye website, but appears on p.17 of Issue 1394). These reforms, like most or even all public sector reforms, purports to reduce bureaucracy. Yet the column describes how the new rules mean that whereas a doctor’s surgery seeking to run community health services from its premises used to have simply to make a contract with the local health trust, now it involves a negotiation between four different bodies with multiple convoluted procedures.
This is a story that could be repeated endlessly across both private and public sector organizations. Bureaucracy is the enemy above all others (see p.81 of the book) and yet in the name of defeating it ever-more complicated bureaucracies are developed. What sense might we make of this? I think that one answer is that ‘bureaucracy’ has ceased to mean anything very precise (and certainly nothing like Max Weber’s meaning), but instead has become a catch all terms for ‘things we don’t like in organizations’. It takes a brave person to argue, as Paul du Gay does in a book I refer to several times in my book, in praise of bureaucracy (by which he does indeed mean Weberian bureaucracy), and for a practicing manager, civil servant or politician it would be simply unthinkable.
The irony of this, though, is that it is not just thinkable but necessary for managers, civil servants and politicians to devise systems which conform not to Weberian bureaucracy but to precisely its everyday sense of inefficient red-tape. We thus have the worst of all worlds: a crusade against the praiseworthy features of bureaucracy (accountability, impartiality, clarity) in the name of an anti-bureaucracy that embodies the most deleterious features of bureaucracy (complexity, sclerosis, proceduralism).
There are so many examples that it is difficult to know where to start in naming them but they range from the impossibility of switching internet service provider without a ‘key’ from your current provider to allow it, through to the chaos caused in courts because of ‘efficiency savings’ to interpreting services. But to take one recent example, last week a new system for driving licences was introduced in the UK. According to the government minister responsible this would “reduce unnecessary red tape” (aka bureaucracy). The result? Chaos.
Of course any one example can be dismissed as both minor and specific. But the cumulative effect is general and major. A huge array of transactions, both economic and civic, are becoming all but impossible. Weber would have found this completely understandable because it is emblematic of some of the problems to which bureaucracy was as a solution. He might also have observed, had he been alive, that bureaucracy would be the best way of addressing the FIFA corruption scandal. Or, at a more local level, a way of controlling free-wheeling head teachers, freed from bureaucracy to do their own thing.
The association of bureaucracy with ‘something bad’ goes back many decades but it’s a misnomer. It’s difficult to imagine an effective campaign for bureaucracy. Yet a good dose of bureaucracy, in its healthy sense, would make all our lives better.
Du Gay, P. (2000). In Praise of Bureaucracy. Weber, Organization and Ethics. London: Sage.

Tuesday, 2 June 2015

Unhealthy management

The British National Health Service (NHS) is one of the largest and most interesting organizations in the world. It is perhaps the key legacy of the post-1945 Labour government, establishing the principle that healthcare is available free at the point of use and on the basis of clinical need. Almost 70 years later, an authoritative report by the Commonwealth Foundation in 2014 identified it as the best overall healthcare system of a range of developed countries (the others were New Zealand, Australia, France, Germany, Norway, Sweden, the Netherlands, Switzerland, Canada and the US), and the best in eight of the eleven criteria of the report, and in the top three for two of the other three criteria. And this was achieved despite having lower spending per head of population and/or as a percentage of GDP than those, and other, countries.
Perhaps as a result, the NHS has always been a target of dislike, even hatred, for neo-liberals because (rather like the BBC) it demonstrates how non-market, collective provision of services can be both more efficient and more equitable than market provision (by contrast, the US system was the worst of those covered by the CF Report). As such, it has for the last thirty years or more been subject to endless reforms to marketise it through actual private provision or internal competition, and to introduce private sector disciplines and management to make it more efficient. Successive governments have insisted that ‘throwing money’ at the NHS is no good – what is needed is this market-accented reform. Yet, despite this, it is constantly depicted as being in crisis, with daily stories of its failure.
The irony is that these stories reflect, precisely, the consequences of the neo-liberal reforms. This week, there are two such stories. One is about the spiralling cost of employing agency nurses and doctors (i.e. not employed by the NHS directly but bought in). The other is the ‘fatcat’ pay and perks of senior managers. It’s true that both these things are problems – but why have they come about?
In the first case, it’s because of the demand for labour market flexibility and the assumed wastefulness of paying the overheads (sick pay, pensions etc) of permanent staff and the government have been warned for some time that their market-focussed policies were causing the problem. In the second case, the roots of the problem go right back to the 1980s when the neo-liberal claim was that to get the ‘best’ managers the public sector had to pay the going private sector rate. So in both cases supposed public sector waste is a direct consequence of the assault on … public sector waste.
These are case studies in the problematic nature of efficiency which I discuss a lot in the book (especially pp 130-131), but in the case of the NHS this has a particular inflection. The efficiency of the NHS, as attested by the study mentioned earlier and others, arises from the fact that the benefits of healthcare are themselves collective. Innoculation is an obvious example: it is effective to the extent that it is widespread across the population, and it will only be widespread across the population if it is not rationed by price but available on clinical grounds. But the same is true even in less obvious cases – for example, the ill-health of an individual employee impacts upon his or her employer and colleagues. And, for that matter, a collective system will always be able to get better prices on drugs than an individualised system, and the costs of medical procedures always fall as they become mass, standardised procedures (think cataracts and hip replacements).
It has become a truism that the costs of healthcare are rising in all developed countries because of ageing populations, the fact that healthcare inflation is higher than general inflation, and the costs of new medical procedures arising from almost daily scientific advances. The only way to address this is, precisely, by throwing money at it. It’s getting more expensive and that expense can’t be met from efficiency savings. It’s a pervasive meme of neo-liberalism to imagine national finances as if they were household finances. Very well, then. Knowing that granddad and grandma are going to be living longer and needing increasingly expensive healthcare you divert resources to that. But we know that this works best (it’s cheaper, and the outcomes are better) when it is done collectively. The US spends 17.7% of GDP on healthcare compared with 9.4% in the UK (2011 figures) but with much worse health outcomes because of its system. Imagine if the UK spent at US levels using the NHS system! It would be a Rolls-Royce health system.
There are two familiar objections to this, both of them fallacious. One is that the NHS entails the rationing of care. That is true, but it is true in all systems. In an insurance-based system such as the US it is done by insurance companies adjudicating on individual cases, whereas in a socialised health system like the UK it is done via expert assessment of the cost-benefit ratio of treatments.
The other objection is that a tax-based system like the NHS is unsustainable because there is only so much tax that people can pay, so what is needed is a mixed private-public system of the sort found in France or Germany. It’s worth noting, though, that those co-payment systems are also under strain. Even more to the point, people don’t miraculously have money to spend on health insurance that they don’t have available for taxes. To see the problems of co-payment systems one only has to look at what has happened to NHS dentistry which has moved to such a model. And let's be clear what this means: it means people pulling out their own teeth without anaesthetic.
The issue, then, remains one of the best mechanism for translating spending into healthcare. In Britain, no politician is really willing to challenge the free at the point of use principle, an interesting illustration of how deeply embedded the collective principle is, despite the neo-liberal decades. Instead they say that so long as the free at point of use principle is retained, it does not matter whether the provider is public or private. In this model, the NHS is simply a commissioner of services. But this neglects the other cornerstone of the NHS: provision on the basis of clinical need. In other words, private providers will only provide services at no charge if it is cost-effective for them to do so, hence they ‘cherry-pick’. There is no way of squaring this circle: collective provision is both cost-effective and equitable because it is collective provision.

Fourth edition: tell me what you think

I’m just at the beginning of thinking about what will be the 4th edition of what I call ‘the little book’. If anyone reading this blog has any suggestions about what should or should not be changed I’d love to hear from you. Either leave a comment on this blog or email me on chris.grey@sagepub.co.uk