the blog Synergy

Sunday, June 04, 2006

Focus on People not Programmes

In management, leadership and organisations I have always believed people matter more than programmes.

I need to nail my colours to the mast right away by saying I am not an anarchist who believes we can manage without process. I am not calling for total chaos with no strategic direction or vision. Quite the opposite in fact - I have always believed we desperately need process. My contention is that many organisations get the balance between passion (People) and process wrong.

In my view the most successful organisations – and the best to work for - are those who operate with a gallon of passion and a pint of process.

The organisations I have seen that get stuck and bogged down in insular behaviour and a guarantee of non innovation have a gallon of process and a pint of passion.


I was a manager for 35 years in the UK National Health Service which is a very labour intensive organisation. Over 1 million people work in the NHS. I remember very well in about 1990 I did some in-depth analysis of the budget I was responsible for. My annual budget was around 1 million pounds. I discovered that over 85% of that money was in fact wages. In other words flesh and blood. Human beings. People.

Of course it was important to make sure the non-staff expenditure was controlled and yes it was important to be prudent about spending on the marginal stuff like encouraging careful use of consumables ... BUT it is through PEOPLE that stuff happens.

If we are serious about looking after the 'bottom line' we have to look after folks doing the work. It really is as simple as that.

For every pound I was responsible for, 85 pence went on flesh, blood and brain power – a stark way of putting it.

I therefore always tried to put my management skills into finding out what made the staff tick and then I saw my job as a manager to do things that helped front line staff do their job with patients.

To me a manager in healthcare is a facilitator simply employed to make the job of front line staff working with patients less complex and good place to be.


My experience also taught me that the NHS is far more ‘process driven’ than ‘people driven’ which is really ironic and paradoxical when one considers just how labour intensive it is.

I think one reason the NHS is often considered ‘under innovative’ is because we do not allow people at the front line to flourish because they become too bogged down in complex and often unnecessary processes that are designed to ‘protect’ the organisation rather than to allow creativity to flourish.