Our Shared Agenda

The 'Big Bang' of 1986 turned the banking industry upside down. Unfettered competition and a deregulated market brought an avalanche of new financial products. We stood at a threshold – adapt or perish.  In the blink of an eye, predictable and unspectacular growth was to be replaced by exceptional business opportunities, hugely increased profitability and major volatility in financial markets – a state that has existed ever since and been accelerated by mergers, deregulation and the relentless, almost suicidal, drive for growth and market share.

 

Though some tried to 'hold back the tide' (as King Canute is often misrepresented as trying to do), most bankers realised that to survive, they needed to specialise. Some did so in consumer services, others in corporate banking and many joined the 'new boys on the block' peddling the more esoteric financial instruments and screen-based trading that did such devastating world-wide economic and social damage in 2008. 

 

But by no means was banking unique. Driven by the same '80s dogma that competition will deliver efficiency, huge changes took place in both the private and public (and, even, the voluntary) sectors.  Publicly owned utilities like BT, gas, water, power, etc were privatised. Undreamed of services and enterprises burst on to the scene (including two niche lending plcs that I created in the '80s). We, like many others, capitalised on the phenomenal advances in technology, especially in communication and information technology. 

 

Nations at the forefront of this technological revolution put an almost unbridgeable gap between themselves and the rest of the world, much of which became and remains little more than the provider of low cost, low value consumer goods.

 

As you'd expect, not everyone welcomed such unparalleled change.  Many, especially the billions on the margins of technology, wealth and education, found impenetrable barriers to their place in this new order.  

 

For others, the pace of change was just too fast. As in Anthony Newley's 60’s hit, their cry was “stop the world - I want to get off.”  But we can't stop the clock or turn it back.  So what are we doing to cope with such an unpredictable, changing future?

 

Wherever you care to look you'll find that new knowledge and techniques are becoming available so quickly that the only answer seems to be to narrow the breadth of one's job in order to have the time (and the mental capacity) to process the mass of new information increasing the job's depth.

 

Take medicine as an example. It is estimated that the half-life of medical knowledge is about ten years. Therefore many practising a few years after qualifying may be less than fully competent to provide the very latest and best care. 

 

To cope, and conscious of an increase in professional negligence claims, many clinicians working in hospitals have narrowed their fields of specialisation. Often the physician who would have covered the whole gamut of general medicine now concentrates on patients of certain age groups, say the elderly or very young, whereas his or her colleagues may now specialise on specific areas of the body, e.g. thoracic. Even General Practitioners, who as the name implies are the epitome of generalists, now specialise in an area within large multi-handed GP practices.

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Similarly in other walks of life, the amount of new information and frequency with which it is received are increasing at an alarming rate. Pity those in the legal profession wrestling with an endless stream of new legislation. Little wonder that in most large firms, the partners each specialise in one area of the law, say divorce, property, or trusts. And who would want to be in IT? No sooner have they come to terms with the latest software or operating system than yet another version hits their desk. You will know of similar parallels.
 

The predominance of specialists - especially those working in professional silos - adds to the challenges for those steering large multi-functional/professional enterprises as became all too clear to me during my years directing NHS hospitals.

 

I have mentioned elsewhere that the NHS is constructed of many professional silos - surgeons, physicians, nurses, midwives, pathologists, etc. All have undertaken many years training unique to their particular profession and are members of a distinct Royal College. Within any one hospital, each group has its very own pay structure and T&Cs and each is represented by a separate union or professional body when it's time to negotiate annual salary increases and other matters. You won't be surprised to learn that some do all they can to thwart any move that threatens their unique identity.

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However, although much differentiates them, one can never doubt their willingness to work across the 'silos' on issues of patient care. I was always hugely impressed when watching a multi-professional team at work in the operating theatre or at seeing various professionals run through the hospital to join others as a 'crash team'. And I will never forget being invited to sit with nurses, doctors, therapists and others as they jointly planned the palliative care of terminally ill patients.  

 

If these clinicians could step outside their professional 'silos' in those settings, would they also agree to do so when I asked them to help the Trust deal with some important strategic issues? Thankfully they did - as I discuss in a series of papers prefaced 'The Shared Agenda'. 

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