The post-bureaucracy starting gun has been fired. Urgency needed.
Time’s up.
There is no longer any room for analysis paralysis, status quo defences and incentivising the done thing.
We have a few years to find, embed and prove a positive credible alternative to institutional bureaucracy.
Otherwise some powerful, angry and unqualified crony could stand on a stage with a knowing grin and a chainsaw within 5 years.
Let’s be really clear, the status quo is indefensible.
Let’s be equally clear, advocacy that does not lean into, and reimagine, how technology supports this change, is unviable and irrelevant.
Revolution and disruption are overused terms, but societally that’s what’s happening, and for years I have been teaching and arguing for the need to disrupt ourselves or be disrupted.
My arguments taught to leaders in healthcare, the military and beyond, talked about the coming disruption, both large and by a thousand cuts.
Recently, with global developments, both the penny and my stomach have dropped that the COMING disruption has become the CURRENT disruption.
It may even be too late, given that the most powerful and influential nation in the world, especially in the West, has told us that the fabric is getting ripped up, and the rules change now.
What comes instead is very dangerous.
Why this matters in the UK public sector
Quite simply, we currently have a stable government. Currently.
But in the tectonic timescales of the NHS and other parts of the public sector, progress can move very slowly.
Yet circumstances in the NHS, in social care, in the military, in housing and beyond, can escalate quickly.
They are escalating quickly.
It is my view that if we (the system and those who lead it) rest on our laurels, if we want to have all of the safeguards of bureaucracy (have our cake…) and also bring about great innovation (... and eat it), then we’re kidding ourselves, and chainsaws loom.
In the next UK election the frustrations borne by our glacial and unfulfilled change, will feed a fire, fuelled by the noise of “great change” afoot on the other side of the Atlantic.
There is no time to lose, and we need to rewrite the rules so we have a credible alternative to the creaking wheels of bureaucracy. (I will write about my views on the model at a later point.)
Four years to demonstrate something credible, different and better.
Four years to show that there is a better, and more positive, antidote to autocratic, oligarchic chainsaws and consolidation of huge and unaccountable power and control.
Four years to show that there is a better future path ahead than what Yanis Varoufakis coins as Techno-feudalism, or what Yuval Noah Harari describes more scarily.
What we in the system must do now
I represent many groups, but I’m going to start with those in the system, particularly those leaders and individuals who are at the top, and can convene people.
I would recommend you do this:
Take time to talk about and acknowledge what is going on in the world with your colleagues. Discuss what people fear may happen if you as a group and other groups (don’t point to someone else to fix it - own your corner), and ask “what if someone came to us with a chainsaw?, and started ripping up the rules”.
If there is consensus that the stakes are high, then collectively discuss what the defcon level is? Is it high enough to start addressing the constraints?
Work together to discuss those constraints of governance and gateways, and whether the stakes now feel high enough to really, genuinely address them. What really needs to happen to make things really happen.
Set ideas and ambitions, and discuss how this discussion can go much wider and inclusively involve people. Trying to make it as collective as possible.
I’m going to post more, but I think this is going to need to unfold over the coming weeks and months.
But whether you're in NHS England, an ICB, a think tank, provider or so on, or a leader in the military, local authority or beyond, perhaps the discussion needs to be akin to war-footing. Not just focusing on the specifics but the model, and the 'operating system' that we create.
Tap into 2020 and fight for something better
The good news is that there is some time, not much, and not enough to be anything other than urgent. But there is a little.
The other good news is we had a practice run in 2020, where many of us came together, collectivised, positively supported each other and found solutions to big problems. It was imperfect but there was a lot to learn.
Let’s tap into that spirit, and try and start, with urgency around what is REALLY NEEDED (and not needed) if we are to come together and show what we can build and achieve if we acknowledge the old model is broken, but a new model bred from positivity, and making the use of the dominant technological forces, is very possible.
This will be hard, it will be messy and imperfect, and it will likely need to irrevocably shatter the current paradigms that we’ve built around us.
At the very least, is it not worth fighting for?
I believe so, and after a Friday feeling grief, and a weekend of reflection, it’s time for me to speak up and do my bit where and when I can.
To be continued…
Digital health leader | Strategist | Systems Architect | Head of Product, Digital Primary Care, NHS England NetworkShuri ally #Cohort7 DHLP, MSc, MBCS, MBB, Kings Fund BYA
5moAgree, we need to reimagine how we best meet people’s needs and challenge it all: remove barriers, go see, listen, learn and iterate quickly. Bravery, conviction, challenge, pace runners, leaders at all levels, skills to steal with pride, try, fail, learn, try, fail, learn and a risk appetite that not doing anything is failure.
Helping us to make better decisions for people, places and planet, together
5moThanks for writing this Liam. I have been saying for months now that I think Reform is likely to get in at the next election and I've been regularly and roundly told 'nah, no way, not in the UK'. I think the terror of what that actually means and what might happen is making so many people cling even tighter to the status quo, as if there's some world where we fix what we have already. So I agree, the next four years are mission critical and the only way we'll get somewhere good is by getting people with the power, experts and specialists and patients all working together to design something new. A possibly interesting case study from some work done by the New Citizen Project in West Yorks - https://www.newcitizenproject.com/participation-into-action
Thanks Liam- this needs spelling out, now and you've done it very clearly.
Founder & CEO, Bags of Taste, Social Entrepreneur & Innovator, winner of the .Org Foundation's global Innovator award. Other worlds are possible...
5moWe already have some solutions! Check out the Changing Futures project at Gateshead Council. It's amazing. And also BAGS OF TASTE because we operate in a similar way... Removing barriers for individuals. It's such a much more effective (and cost effective) way to work...