Working inside a large bureaucratic organisation where means and ends are largely dictated by political considerations outside the organisation’s ability to influence, I can see the corrosive effects of the race from judgement. Thinking is done by an elite few, disseminated to the many who provide the service. Our own experience and judgement not only count for nothing, but are positively discouraged through sanctions. The behaviour this engenders is that it is safer to follow the rules than to think for ourselves. A good example of what can happen is illustrated by the demise of the Liverpool End of Life Care Pathway. It was a framework which nurses and doctors followed without understanding the underlying judgements that created it in the first place. The Pathway became discredited. In our complex world we seem increasingly to defer to systematised experience and not to trust our own. Just look at the proliferation of people selling quick wins and how they do it: Ten steps to a fitter body; the Seven Habits of Highly Effective People. We are encouraged to learn from others in order to overcome the limitations of our own cognitive abilities and the narrowness of our experience. We are social animals and have a natural tendency to calibrate our thinking in response to our social surroundings. Perhaps if we improved the quality of our thinking instead we might avoid the trap of alienation outlined in Chris’s blog.
Crouch’s thesis is that the financialisation of public institutions reduces the meaning of what they do to a limited number of numerical targets and performance indicators often of a financial kind. This has the effect of also reducing the spectrum of knowledge we need fully to be employees, citizens and customers and constrains expert judgement. It has the effect of trumping all other valuations of particular organizational or social problems with one supposed truth, that of the bottom line or a financial target.
One example he gives of the consequences of financialization from the UK is the monetary incentive offered to GPs to refer more patients with suspected Alzheimer’s disease for further medical tests. The incentive is problematic on a number…
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