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The Man in the Machine

I’ve somehow found myself becoming the lay member on our local CCG governing body.  That means I have to leave my position on Healthwatch, the Health and Wellbeing Board and a youth counselling charity (as it receives money from the CCG).  So, a good opportunity to reflect on, and learn from my recent experience.

As I listed various highs and lows in earlier drafts of this blog, two underlying factors kept occurring to me.  And they’re contradictory.  The first is the importance of individuals in stopping or making things happen.  The second is the way it seems to be collections of people – whether in a meeting or as an organisation – that can stop things happening, regardless of how good the individual members are.

I’ve already written about how a committee whose members are individually very capable can be collectively incompetent.  I don’t think our Health and Wellbeing Board has managed to be strategic or to develop a strategy that will produce solutions by driving commissioning.  On the other hand it has agreed a strategy on engagement through productive joint working between the CCG, Healthwatch, the voluntary sector and the Council.  I drafted that strategy, but that doesn’t mean it was my input that made the difference as I have equally fed in lots of ideas on strategy to the Health and Wellbeing Board, to no discernible effect.  I think what was different was a willingness of those involved to consider and engage with proposals, argue for changes and make them their own.  It was people working collectively rather than the power of individuals.

The way that individuals can obstruct or create change is fairly familiar.  In the last three and a half years, I’ve had a number of examples. It wasn’t always clear whether people closed things down because they felt threatened; they had some nefarious agenda; or were just bloody minded.  Agendas could be designed to present proposals rather than encouraging open discussion.  Talking endlessly on their interests excluded any other discussion.  The final recourse for one person was to say things which weren’t true (whether deliberate or out of ignorance), ignoring all evidence adduced to the contrary (e.g. ‘we can’t decide anything on this until we’re told what to do by Healthwatch England’).

In many cases, the person doing the day to day work also has control of the bulk of the knowledge.  They know what goes on each day, and they may have technical skills, which the trustee or person on the oversight committee doesn’t have.  That makes it difficult not just to challenge them, but to know what questions to ask in the first place.

It’s not all negative though.  There was also the person who took over a job and all those things which previously were apparently just not possible, now miraculously got done.  This was partly down to capability but also to attitudes.

So, what lessons can I draw from this?  What would I do differently next time?

As an individual you have to treat ‘the system’ (the culture, processes, infrastructure etc.) with respect – like a sailor does the wind and the sea.  You need to know when to make use of it, with the wind at your back and when to head for port to avoid a storm.  However the individual is not totally at the mercy of ‘the system’ – unlike the weather, it can be changed.

So at times I’ve perhaps worked too much within the system, following the rules, challenging minutes, writing reports, when perhaps I would have been better avoiding it and trying to achieve things in a different way.  Perhaps I should have done more to try and persuade people and build coalitions of the willing (rather than just assuming it was something I couldn’t do).  Sometimes the real work has to go on outside of the formal meetings.

As chair of a charity, perhaps I could have done more to change the system – I’d certainly intended to introduce more innovation into the way meetings were run, which I don’t think I succeeded in doing.

But perhaps the way I did have a positive impact, maybe inadvertently, was in promoting a collective approach.  Avoiding conflict may be a character flaw in some circumstances, but together with a positive, co-operative attitude, it can help the collectivity become more, rather than less than, the sum of its parts.

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