Evidence-based managers always spell out their assumptions and those assumptions need to address any problems that are likely to occur.

When I was taught the Hay method of job evaluation years ago their tutor failed to follow this principle and made an implausible assumption that any person doing a job will be performing.  Hay knew that performance management and job evaluation have to go hand-in-hand but completely ducked the issue – assuming away the inevitable.  In the medical field this would be equivalent to a doctor assuming that a patient will always take their advice and lose weight; take the pills; get more exercise; stop smoking – knowing full well that it was unlikely ever to happen.

Only one other HR person in the room shared my concern so I presume the rest just went away and did what they were told, thereby perpetuating an inherently flawed scheme.  What they actually needed was not a scheme but a complete system because effective systems are designed to solve problems, not to pretend they don’t exist.

Hay repeated their problem avoidance technique once again when they launched the Hay/McBer competence straitjacket.  This was based on a highly simplistic theory of management competence that if you find managers who are deemed to be performing, and analyse any common competencies, then those same competencies can be used for development purposes.  Apart from the obvious fact that this is a theory based on a circular argument – ‘good’ managers must equal competence must equal ‘good’ managers – Hay again ensured that effective performance measurement and management was not a compulsory part of their scheme.

These circular arguments, which often produce vicious circles, can be seen in many areas of HR theory. In the particular case of competence theory some of its roots can be traced back at least to Prahalad and Hamel’s own circular-argument-theory of core competence (i.e. good companies have a core competence so companies with a core competence must be good companies).  Then all it takes is an academic journal, or more probably Harvard Business Review, to confer its blessing and before you know it we witness the birth of yet another fad to feed the insatiable appetites of the non-thinking, non-evidence-based manager.

If you want some stark, longitudinal evidence of the failure of competence frameworks just look at the NHS, which has been using this Hay approach for many years, or indeed any other large, public sector body that has jumped on the same bandwagon – the National College for School Leadership, for instance (but don’t ask them for evidence as educational standards notoriously shift with the tide).

Then look at the ONS (Office for National Statistics) evidence, which shows that between 1997 and 2007 a 117% increase* in spending on the NHS had produced only a 52.5% increase in healthcare output.** If this is not evidence of poor leadership and poor performance management (including the medical profession) then I don’t know what is. But an evidence-based manager does not work, primarily, off retrospective data.  They use hard evidence to predict what is most likely to happen in the future: then they design strategic, HR policies and practices to resolve the problems they have identified, in advance.  So, regardless of how badly the NHS is currently being managed, the only thing that matters now is how are they going to manage better in the future?

In 2008 I voiced these concerns in a piece for Training Zone, pointing out that the very body responsible for learning in the NHS, the Institute for Innovation and Improvement, set a very poor example by failing to learn from its own mistakes and by a very unfortunate coincidence it proved to be rather prescient as only 3 months later the Mid Staffs Hospital crisis hit the headlines.

Needless to say, no one at the Institute responded (even when I raised it with them directly in the light of Mid Staffs) but eventually I managed to meet with their Director of Planning and Performance and Head of Strategic HR & Organisational Development in July 2010.  At this meeting they referred to their Leadership Qualities Framework (based on Hay) as a “deficit” model.  Technically that means leaders and managers are deemed deficient but ‘deficit model’ could also be taken to mean any model that has no discernible benefit or return on investment.

The most disturbing feature of such models is that they don’t actually make up the deficit, they just mask the fact that endemic deficiencies in leadership and management are not being dealt with.  In the case of the NHS this has produced a cancerous management culture that has been eating away at its healthiest tissue – managers and medical staff with integrity – for many years.  What it leaves behind is a management husk of people with the title of ‘manager’ who actually gave up on managing a long time ago (think of the ‘managers’ who fiddled waiting lists). The ‘managers’ I spoke to do not even believe in the methods their Institute actively promotes. They willingly admit their Hay framework is not evidence-based and yet, perversely, feel they have to support the pretence that it will help the NHS “… identify £15-20 billion of efficiency savings by the end of 2013/14”

This sort of duplicitous behaviour is usually a direct consequence of a climate of fear and retribution that exists at the very highest levels.  It is a very nasty, invasive and particularly pernicious form of cancer that thrives in crisis-ridden organisations, especially those directly controlled by politicians.  Furthermore, while these ‘managers’ readily acknowledged that their methods could be taking them “down the wrong route” they could not openly admit their mistakes; thereby acknowledging that the NHS is the very antithesis of a learning organisation. This inevitably means they are destined to repeat the same mistakes in a downward spiral that might prove to be a macabre dance of death.  Only frightened management is willing to “play along” (their words) with the charade that is the “Leadership Council” created by NHS Chief Executive, David Nicholson and only the very worst type of manager has the audacity (and total lack of self-irony) to refer to himself (or herself) as a ‘leader’ (Update – not for much longer).

This council is populated by, in leadership (sic) terms, a motley crew that has included Greg Dyke (‘Is the BBC a stupid organisation?’ ), Daniel Goleman (‘Where can I get my next EI fix?’) and of course senior medical figures, which leads us to the biggest elephant left in the room – who actually ‘manages’ the NHS?  For an organisation that is entrusted with looking after the health of 60 million citizens the answer from the Planning and Performance Director at the Institute was quite chilling -

“the NHS isn’t one organisation it’s hundreds of organisations… the medical profession has huge power …. a doctor is capable of unseating the Chief Executive…. a Chief Exec can easily get kicked out if they upset the medical profession”

Evidence-based management should never be a witch-hunts or seeking to blame.  All it is concerned with is value – getting the best possible patient care at the best possible cost – and that is what the NHS should stand for.  The evidence tells us very clearly that the existing medical-management culture within the NHS just isn’t working anything like it should and, as with many patients who have just been informed that they have cancer, is in denial.  Whatever Andrew Lansley (Health Secretary) is planning for the NHS (e.g. giving more power to GP’s) he will have to install a much more benign regime if he is ever going to make any progress.

For personal development linked to this topic visit the Consummate Professional Series

*ONS – UK Centre for the measurement of Government Activity ‘Expenditure on Health Care in the UK’ April 2009 **ONS – UK Centre for the measurement of Government Activity, ‘Health Care Output 1995 – 2007’, June 2009