Targets drive behaviours – not all of them good

An article in The Independent (http://www.independent.co.uk/life-style/health-and-families/health-news/healthcare-experts-accuse-nhs-of-fiddling-figures-to-meet-performance-targets-10193482.html) highlights again the iniquitous culture of targets in the UK’s National Health Service.

The headline talks about ‘experts accusing the NHS of fiddling figures’. These experts happen to be the very people who make a living out of crunching numbers to feed the beast of data collection and analysis.

It would be far more fruitful if, instead of ‘accusing’ anyone, these super-rational men and women had some insight into human behaviour to understand why people in organisations act as they do in the environment of fear and loathing created by successive governments in a desperate attempt to manage the system and to ensure that limited resources are used wisely.

To a certain extent, the NHS has itself to blame for allowing the current situation to arise. People have known for years that the gap between demand and funding was going to grow, requiring new thinking around how to provide for the health needs of the UK without bankrupting the country. The NHS did not respond to the challenge.

Instead, it was left to hubristic politicians to ‘Save the NHS’ and impose on it disciplines that Josef Stalin would have recognised and been completely at home with. The NHS now has a 5-year plan! It also has Gulags where those who under-perform and who fail to hit the centrally-dictated performance targets become the ‘disappeared’ – their lives and careers destroyed by the unforgiving and relentless dictatorship of the centre.

In order to survive, like anyone who has lived under a dictatorship, people adapt their behaviours. We should not be surprised that people ‘game’ the system. It gives back to us humans some power and autonomy and avoids the prospect of the Gulag.

Rather than accuse people of fiddling, the so-called experts, the commissars of data, would do much better to gain an understanding of human nature and create a system which, surely, has to be human at its core and has to be designed around people rather than data.

Data’s important but people are more important.

Until we design a health service around people, the ghost of Josef Stalin will continue to haunt the corridors of power, smiling at the irony that his legacy has surfaced in a capitalist country. Those ordered to deliver for the State will either perish in the Gulag or survive through craft and ingenuity. Positive values such as honesty will be squeezed out by survival instincts – that’s what happens in dictatorships. The system will evolve so that positive values become the exception rather than the norm. We await our Solzhenitsyn…

The views expressed are personal to the author.

The Executioner

Once upon a time, two secondary school teachers thought it would be a good idea to create a fun summer school during the long holidays of July and August.

They organised a range of activities at their school over two weeks. Attendance was voluntary. Children could choose whatever activity they liked.

The teachers did this because that was the kind of people they were. Their motivation was to see children enjoy themselves, to see them develop.

Other teachers, similarly motivated, joined in. They too were happy to give up several days of their holiday for the privilege of joining in with the children, strengthening bonds in an informal and fun setting.

Soon, the summer school was thriving. Children, parents and teachers were all benefiting from the summer school.

The Head Teacher was keen to keep the summer school going, After all, it helped his school stand out above the others in the area who might be competing for children.

But he had a slight anxiety. Because it was run on a purely voluntary and informal basis there was a danger that it could disappear as easily as it had appeared.

To assuage his anxiety, he decided to pay the teachers a nominal amount to reward them for their contribution and to ensure the continuation of the summer school.

The summer school continued to grow and flourish.

Then the Head Teacher retired and was replaced by another.

The new Head Teacher did not really understand the summer school. All he saw was an amount of money leaving the school’s coffers to pay for it. And what did it contribute to the school’s performance in league tables or Ofsted inspections?

He could have abolished the summer school, but he didn’t want to make himself too unpopular.

So he asked all the teachers to fill in a form to justify the money they receive from summer school. He did this because he thought the teachers were doing summer school for the extra money. He did not know they were doing summer school because that was just the kind of people they were.

So far no forms have been returned to his office. The summer school is unlikely take place in 2015.

Rhetoric and Public Relations

When I was teaching an Introduction to Public Relations course many years ago, I shared with my students my discovery of the ancient art of rhetoric and its similarity to PR.

At that time, all I knew of rhetoric (apart from sharing the modern-day pejorative view of it) was three broad categories itemised by Aristotle – logos, the appeal to logic; pathos, the appeal to the emotions; and ethos, the credibility of the speaker.

Given that rhetoric and PR are both about persuasion, or moving others to think and act differently, I thought that an understanding of rhetoric might be useful for my PR practice. I was especially concerned by PR’s apparent lack of interest in audiences/message recipients. Could PR learn from rhetoric?

In a recent online discussion, I was struck by the belief of many practitioners that PR should be a force for good in the world. This moral vision is often at odds with the reality – most of us are happy to trim our values and subordinate them to our need to earn a living. We all like to fit in. Strong corporate cultures, especially those driven solely by profit. shareholder value and so on, tend not to be too tolerant of individuals who point out unethical practice. Whistle-blowing is career-limiting.

In my recent readings (A Ciceronian Sunburn by E. Armstrong; University of South Carolina Press) I was struck by several things, not least rhetoric’s role in moral philosophy. In Cicero’s words, rhetoric aims at moving others to virtue through eloquence. In modern parlance, it’s about the quality of conversations and the co-creation of a better world. It is about valuing poets (story-tellers if you will) for their ability to ‘teach, delight and move others’ to virtue. It is about the quality of the ‘word’ as the instrument of motivation.

Rhetoric should be taught as part of all PR degree courses because it provides a theoretical basis to the art and purpose of communication.