Leadership in Health Services

ISSN: 1751-1879

Article publication date: 17 July 2009



Bowerman, J. (2009), "Editorial", Leadership in Health Services, Vol. 22 No. 3. https://doi.org/10.1108/lhs.2009.21122caa.001



Emerald Group Publishing Limited

Copyright © 2009, Emerald Group Publishing Limited


Article Type: Editorial From: Leadership in Health Services, Volume 22, Issue 3

My doctoral work researched an action learning programme designed to develop leadership in a large health and safety based Canadian insurance organisation. The program – which took place over a 12-week period comprised bi-weekly two-day sessions, where participants worked on real work projects, listened to speakers from their own organisation, and learned about organisations and how they work.

One of the main things I learned from this project – and it occurred some ten years ago now, was that leadership development programmes such as this, need to be sponsored from the top, but are only as good as the people who sponsor them, and only for as long as they retain their leadership positions. In this case, the company CEO, who had originally sponsored the programme, left half way through its first iteration. His replacement never really bought into the programme, (despite her words to the contrary) and even though she espoused a need for organisational leadership, she was not enthusiastic about this kind of leadership in particular. To no one’s surprise, she brought the programme to a close shortly after her arrival. Other than the personal learning that the participants obtained, and it certainly resulted in a form of resilience on their part as well as providing them with greater insight into the political machinations of the organisation, the programme could be regarded as something of a costly waste – at least from a corporate leadership and learning perspective organisational change and leadership development programmes it seems do not necessarily fit together very well.

I was reminded of my experience with this program when I read John Edmonstone’s article, included here, about an advanced leadership program designed for clinical leaders in the National Health Service (NHS) in the UK. The programme, developed as a partnership between the NHS Leadership Centre and the University of Keele Centre for Health Planning, was designed to provide dedicated leadership and management development for medical and clinical directors. Edmonstone’s story, told in the form of an evaluation of the programme is something of a sad tale, unfortunately all too common these days. The constant political and leadership reorganisations in the NHS, the differing expectations as to the programme funding and the types of participants who should attend, the every varying support for the programme and its intended outcomes by the various parties, meant that it was simply unable to meet its potential in terms of developing leadership. Its original purpose became lost. There was insufficient structure, and too many assumptions that were never made explicit about its assumed ongoing nature.

If Edmonstone’s story is not unusual, and my own experience is a little similar, then what does it say for the future of leadership development programmes for those involved in our health services? They are extremely complex organisations, subject to a great deal of change at many levels. Just when the organisation seems stable enough to run an advanced leadership programme, the political and organisational changes are such that the programme becomes irrelevant. In addition, there is no guarantee that a good health leader will be allowed to stay- political re-organisations mean that leaders come and go, at the whim of politicians creating an ongoing sense of instability on the part of the employees of the organisation. In some respects, this is chaos theory at its very best.

We have to admit that formal leadership development of the type described by Edmonstone, or even of my own kind, may not be the way to go for leadership training. This is not to say that we do not need leadership – we obviously do – and I am of the strong belief that the kind of leadership we develop in organisations, the kind that is practice driven and can make a difference in terms of day-to-day operations, is in the end more important than the leadership of organisations. Because as we all too often witness, the leaders of organisations come and go, and they may espouse leadership development for the organisation during their short tenure, but their support is all often too tenuous to be really meaningful.

It is interesting, therefore, to contrast Edmonstone’s leadership development experience and my own somewhat pessimistic views with that of Sewerin et al. – a group of researchers from Sweden. In this article, the authors describe a very different kind of leadership development programme, action learning based, designed as a paradigm breaking experience where the participants assess aspects of their organisation in somewhat unusual ways. The LeKA programme has been running now for seven years at the Medical Department of Lund University. The dean of the department formulated the project task and requested that the participants design a training course for all team leaders intended to enhance creativity. The results are somewhat astounding – as are the methods used. The programme appears to have been very successful – it has been designed around the ongoing chaotic change of the medical services where it is centred and its results would indicate that the leadership development outcomes have been very positive.

The fact that the programme has been allowed to continue and thrive for so long begs some questions. Is there less political interference in Swedish medical institutions than there is in the UK and Canada? Are leaders there less threatened by in house long term leadership development programmes, even when they are very different from the traditional HR expert delivered type of content? Should I continue to be pessimistic or can we really start to develop the kinds of long-term leadership programmes that Sewerin et al. and even Edmonstone advocate? After all Edmonstone’s programmes were well received by the participants, even if they did not have the full change implications of the programmes described by Sewerin et al.

How can we bring about the types of long term and ongoing leadership development programmes that the participants in our health services deserve, and which will assist them in leading the massive changes they are confronted with on a daily basis? These are important questions in our quest for health service leadership. We trust that you will enjoy these and the other papers contributed for this issue, and that they will give you much food for thought as we continue to ponder how to develop and nurture the kind of leadership our health services require.

Jennifer Bowerman

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