Annex A > Chapter 8 - Management and Culture of the UBH and the UBHT > The development of the clinical directorate structure > Dr Roylance's key management concepts
<< previous | next >>
Dr Roylance's key management concepts
137 Dr Roylance told the Inquiry that `healthcare is led by consultants'. [160] They were self-teaching and self-correcting. [161] Dr Roylance explained that it was `impossible' for managers to interfere. [162] It was `a fact' that only clinicians could identify defects in the performance of other clinicians. [163]
138 Dr Roylance saw the role of management as being to `provide and co-ordinate the facilities which would allow the consultants to exercise clinical freedom'. [164]
139 Dr Roylance explained some of the difficulties in managing consultants in the following passage:
`... anybody who wishes to manage consultants should do their apprenticeship in the voluntary sector where none of the staff are paid and they can all please themselves. Unlike consultants in that area, I am told it is much easier to get rid of them without an industrial tribunal, but consultants are not manageable. Some people say ... it is like "herding cats".' [165]
`... one has to adopt a leadership style and one has to free up their abilities and recognise their culture.' [166]
140 Dr Roylance's management philosophy attached importance to the following:
a) Management `by values' and not `by objectives'. At a meeting of the UBHT Executive Committee on 21 May 1993, Dr Roylance tabled a discussion paper on Trust values. He said that:
`UBHT had delegated responsibility to operational level and had pursued a policy of management by values and not by objectives. For this style to achieve continued success, the Trust Board needed to reinforce its values. Dr Roylance asked the Board to reflect what values should explicitly be presented to the workforce.' [167]
b) Delegating responsibility to operational level. Dr Roylance's oral evidence to the Inquiry included the following exchange:
`Q. ... the clinician at the bedside made the decision which he or she thought was in the best interests of the patient?
`Q. And management felt that it could not, and should not, interfere?
`A. And does not, in any part of the Health Service.' [168]
<< previous | next >> | back to top
Footnotes
[164] WIT 0108 0018 Dr Roylance
[167] UBHT 0006 0202; Executive Committee meeting, 21 May 1993