Page 58 - Managing Change in Organizations

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Changing organizations

intended as a means of ensuring clear definition of roles and thereby to create a plat-
form for improved partnerships. Overall the case study powerfully reinforces the hori-
zontal focus of strategic change, applied not principally to reduce costs but rather to
create improved care. That said, we do not suggest that cost effectiveness is not a key
driver behind innovations of this kind, albeit given the apparently infinite demand for
healthcare this is probably more about securing a higher volume of activity within exist-
ing budgets, i.e. about reducing cost per case. The other crucial point here is the essen-
tial role of partnership. Partnership between professional groups both within the hospital
and in the community is essential and represents a complex challenge in the healthcare
environment for the latter part of the twentieth century.

Changing organizations

Many offered an easy answer. Change was being driven by new technology. New
technology destroyed jobs and, some said, diminished many of the jobs which
remained. At the time some commentators obviously felt that there was a finite
amount of work to do. If technology destroyed jobs then either there would be
fewer jobs around or working weeks would need to be reduced, the retirement
age reduced and other innovations such as job shares would be needed.
Without suggesting that the economic problems of the modern world had been
‘solved’ and taking account of the point that the structure of employment had
changed dramatically (e.g. more part-time work), even a cursory glance at employ-
ment statistics in the Western world suggests that much of this ‘lump of work’ or
‘finite limits of work’ argument is nonsense. Throughout the 1980s more people
entered employment despite the fact that technology and other changes have
increased productivity, often quite quickly. Again I recall being impressed by talk
of 3–4 per cent p.a. improvements in productivity in the 1960s. Now 6–8 per cent
p.a. can be commonplace, particularly when recession or competition stimulates
corporate restructuring. Moreover, in many cases improvements of 50 per cent or
more are not uncommon. Yet this is not the only change since 1971. The power
of ‘vested’ interests is now by no means as strong. Whether you believe that this

is due to ‘Thatcherism’ or to long-term social and economic changes is unimpor-
tant. It is nevertheless the case that collectivist ideas have given way to a focus on
the individual. Indeed the moral challenge we now face is whether ‘possessive’
individualism is to be the order of the day (Macpherson, 1962).
Thus various changes have gone forward across much of the world. In partic-
ular, public sector organizations have been privatized, market mechanisms have
been introduced, large organizations have been broken up and others have been
‘flattened’. Decentralization has created corporate structures focused on ‘strategic
business units’. People talk about ‘networked organizations’, ‘federal’ organiza-
tions and empowerment.
It is obvious that all of this has placed greater demands on the capabilities of
managers. But these changes have also transformed the nature of what some call
the ‘psychological contract between the employing organization and the
employee’. If ‘jobs for life’ cannot be guaranteed then people have to apply for
their ‘own’ jobs on reorganization; where flattened structures mean empowerment
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