Annex A > Chapter 8 - Management and Culture of the UBH and the UBHT > The development of the clinical directorate structure > Bristol's management culture
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Bristol's management culture
Oral culture
141 Dr Roylance saw his role as that of a communicator. He said:
`I spent the whole of my time in communication. I did little else, because in my position it was the passage of information of one sort or another that was my role. So that I spent the whole of my time communicating, not just a bit of it; I spent my time going around assisting managers, assisting, when we had them, clinical directors, commercial managers. I spent a lot of my time improving their chances of success by talking to them, counselling them, by holding countless training [courses] and of course the very structured committee arrangements and Working Party arrangements of this Trust.' [169]
142 Dr Roylance said that he hoped that the description of the process of management at the Trust as an `oral culture' was a:
`... fairly accurate description. What it means is that people talk to each other. I think that is very important, and I think it is a highly efficient and highly effective way of managing, that people should talk to each other.' [170]
143 Dr Roylance saw himself as someone who encouraged people to think twice before `they diverted their efforts to a non-contributory consumption of paper' but at the same time as someone who `did not excuse anybody for not writing down that which ought to be written down.' [171]
144 Dr Thorne wrote a paper for a UBHT Executive Group Workshop on 3 June 1992, entitled `Cultural Analysis of UBHT'. In this paper, Dr Thorne referred to the oral culture. She said:
`... the organisation at Executive Director level is primarily an oral culture - consequently to produce great reams of written material at this stage is counter cultural. The counter cultural nature of that material would give it greater meaning and "embeddedness" than I might want to convey. At UBHT if it is written down it is either very important or ignored.' [172]
Club culture
145 Dr Thorne's paper also referred to a perceived `club culture' at the UBHT. She wrote:
`UBHT sees itself as a "family or club", you are either a UBHT type of person or you are not. Thus people who fit may do very well and progress rapidly on merit, those who do not either move sideways, down or out ... Where and how people move is a key indicator of their ability, presence and status. However, the "in"/"out" distinction is not a lifelong category and it is possible for anyone to "shoot themselves in the foot" through incompetence, failure to follow the cultural imperatives, or by breaking an unwritten rule of cultural conduct ... It is not appropriate to challenge the message and strategy publicly because it is translated as questioning loyalty. Loyalty to the Chief Executive is a critical cultural attribute - hence disloyalty is viewed with severe disapprobation.' [173]
146 Mr Boardman described a club culture in similar terms. He said:
`Dr Roylance actively tried to create a "club culture" for both the immediate executive team and the wider cadre of general managers. This was done explicitly, often using one of the models cited in Charles Handy's management textbook ("The Gods of Management"). This helped create a culture where:
`(i) you were either a UBHT "type" or not;
`(ii) progress appeared to depend on your "fit" within the club rather than performance;
`(iii) to challenge policy or strategy was perceived as disloyalty;
`(iv) people who transgressed the club's unwritten rules were required to be "put back in their box" until they conformed once more.' [174]
147 According to Mr Boardman, this `club culture' did not create a self-assessing or critical environment. He said:
`I think the general culture of the organisation would not have encouraged whistle-blowers ... I think this goes back to the club culture, where whistle blowing is a manifestation of disloyalty, because what you are saying to the organisation is, "we are not doing as well as we could be". I think to say "we are not doing as well as we could be" is disloyalty. It is a message which club cultures do not wish to hear.' [175]
148 Dr Roylance was asked about steps taken to protect whistleblowers from victimisation. He replied:
`I do not know what sort of victimisation you might imagine. I made absolutely certain that management would prevent victimisation.' [176]
Light touch from the centre
149 Dr Thorne's paper highlighted a decentralised management style employed by the UBHT's management. She wrote:
`... the core of the leadership style is centred on a belief that it is not the manager's job to solve problems but to present them back to the individual to sort out for him or herself.' [177]
150 Dr Roylance, for his part, said that this was `overstating it.' [178] He told the Inquiry that when people went to him with problems, he would:
`... spend a very considerable time ensuring that they got themselves into a position to see the right solution, to make the right decision, and then to implement it. And I would give them my full authority and support for them to do it. What I knew would be unhelpful would be for them to unload the decision on to me and for me to assume the role of unit or sub-unit general manager and solve the problem. Of course I could solve the problem; that is why I was in the position I was in.' [179]
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Footnotes
[172] UBHT 0296 0001; `Cultural Analysis of UBHT'
[173] UBHT 0296 0004; `Cultural Analysis of UBHT'
[174] WIT 0079 0014 Mr Boardman
[177] UBHT 0296 0007; `Cultural Analysis of UBHT'