The future – for heaven’s sake keep listening and talking.

The UK & Irish economies are in a sorry state. Although the recession is apparently over by the hairsbreadth of the last quarter, the real belt tightening is only just beginning. Dentistry, with which I am most familiar, is still getting used to this idea. I come across practice owners,  and an even greater proportion of associates, who still have their heads in the sand. Change has to come, the state will not continue to put the food on your plate, having effectively stolen the goodwill from many general dental practices it is now starting to squeeze the pips out of those left “in”.

If General Medical Practice is going to be forced into the changes below just imagine what is planned for dentistry.

This article is from Pulse Online, you can read the full article here.

GP consultation length faces cut by a third as ‘financial meltdown’ looms.

NHS chiefs have drawn up proposals to slash the length of GP appointments by a third as they plan for across-the-board budget cuts.

The idea has been mooted by NHS London, which has been receiving advice from the management consultancy firm McKinsey on how to make huge efficiency savings in the face of the impending funding squeeze. But BMA leaders have warned the proposals show GP services are heading towards ‘financial meltdown.’
NHS London plans include:
• A 33% cut in the length of GP appointment times
• Cutting the number of people going to hospital accident and emergency departments by 60% and the number going to hospital outpatients by 55%.
• Millions of patients being diverted to so-called polysystems or clinics that have not yet been built, with £1.1bn cut from hospital budgets across London
• A 66% reduction in staffing of non-acute services, these include community services for older people and district nurses.

The ‘London’s NHS on the Brink’ report, prepared for the BMA by John Lister, information director at London Health Emergency, accuses NHS London of a lack of transparency in the way it has drawn up its plans to respond to the expected freeze on NHS budgets from 2011. The report claims NHS London has refused Freedom of Information Act requests to release a confidential report drawn up for them by McKinsey, effectively denying interested parties any opportunity to scrutinise its underlying assumptions or supporting evidence. etc

The only people who are looking forward to this are lawyers, one of THE most important things to patients is time. In his book Blink, Malcolm Gladwell wrote of research by Wendy Levinson and Alice Burkin. Burkin, a litigation lawyer, said that doctors who take time are least likely to get sued. Levinson showed that surgeons who had never been sued spent on average 20% longer with their patients than their counterparts who had been sued.

If you haven’t read the book, next time you’re in a bookshop read the pages 39-43 of the paperback edition it’s fascinating.

So we’ll cut consultation times then, that’ll help everybody won’t it?

RIP – Bill McLaren

I have been a Welsh rugby supporter since my first attendance at Cardiff Arms Park for the Wales v Fiji game in 1964. Nothing thrills me in the same way as it does as when Wales are winning, the despondency felt after losing has got easier over the years (but not a lot). My family moved from Wales in 1971 just as “the golden era” started, frequently my father & I made the long trek from our home in Yorkshire for games until I went even further north to university.

During my time as a student I was mostly limited to watching the games on the TV. That of course usually meant the voice of Bill McLaren. He used to irritate the life out of my father when he would describe a player’s weight in stones “in his stockinged feet” and not the singular form. Dad said he was biased when Wales played Scotland, he of course was the model of neutrality!

I was in his proximity on only one occasion, this was after his retirement at a Heineken Cup semi-final at Lansdowne Road, Dublin. I followed a group of half a dozen “names” walking to the ground, including Tim Horan, Bill McLaren and his wife. It was a cold wet day and my one memory was of the concern and attention that Bill gave to his wife, he ensured that she was protected from the weather, it was apparent that he was still devoted to her after more than half a century together. A real gentleman.

Here’s his commentary from one of the best matches ever (with the right result for my father.)

Strictly Business: Why Are You Doing This? – Philip Humbert

From Philip Humbert’s most recent newsletter, subscribe at his website

Strictly Business:  Why Are You Doing This?

Every successful business leader has a clear answer to this vital question: Why are you building this company? Who does it serve and what’s your greater purpose? Answering these questions costs you very little, and it can pay huge dividends.

For some entrepreneurs, the primary purpose is simply to create a business that can be sold. They have a talent for designing systems to meet a real need while making a profit, and they love starting new businesses. Once the company is established, they often sell it and may repeat the process again and again through the years.

Most business owners, however, have some other purpose in mind, and it is often deeply personal. Some want to build a company they can pass on to their children. Others want to see how large and profitable they can make it, and they dream of a vast enterprise with thousands of employees. Still others, want a business that expresses their values or contributes to society in some way.

In coaching hundreds of entrepreneurs, I am struck that it does not seem to matter what the reason actually is. What matters is the ability to keep it in sight at all times. Knowing your personal vision, your purpose or mission, the “reason why we do this”, is absolutely critical.

The solution is simple: Keep your eyes on the prize! Step back, gain perspective, renew your commitment. Remember WHY you are doing this! If you are clear about the “why,” you’ll figure out “how.”


The Ubiquity of Competition – Seth Godin

From the ever excellent and thought provoking Seth Godin.

How does this apply to you?

The ubiquity of competition

Sure, there are playoffs in football, but competition is everywhere, we just forget to notice it.

There are three hundred photographers looking for work in a particular specialty. One puts a creative commons license on his shots in Flickr and they start showing up in many places, from presentations to brochures. Which of the 300 photographers has won the competition for attention? Which one of the three hundred has shared his ideas enough to be noticed?

There are twenty towns you can choose for your family’s new home. One invests in its schools, has a focus on inquiry, AP courses and community, while the others are muddling through, arguing about their future. Which one commands a higher premium for its houses?

There are a hundred new kinds of snacks and energy bars at the checkout of the supermarket. One is a little bigger, a little more exciting and a little closer to eye level. Which one of the hundred wins the battle for your impulse buy?

There are fifty people applying for a job. Forty nine have great credentials and beautifully standard layouts on their resumes. One resume was hand delivered to the CEO by his best friend, together with a glowing recommendation about a project the applicant did for the friend’s non-profit.  Who gets the interview?

There are ten great jobs for the superstar programmer who is looking for a new challenge. One offers offices not cubes, free lunch, great customer support and the freedom to work on interesting projects. Where does she choose to apply?

There are 30 places that sell bumper stickers. One shows up first in the Google ads when I do a search. Which one gets my business?

There are seventy houses for sale in town. One of them is represented by a broker who is a pillar of the community, a friend of many and a role model for the industry. Which one gets more people to its open house?

There are eighty million blogs to choose from. Thanks for picking mine to read today.

You don’t have to like competition in order to understand that it exists. Your fair share isn’t going to be yours unless you give the public a reason to pick you.

PS If you’re a fan of all things Seth you can download a “Seth App” for the iPhone from iTunes Store.

The Monday Morning Quote #70

‘Aspire not to have more, but to be more’.

Archbishop Romero

10 Actions To Take Your Leadership and Management Success To The Next Level by Duncan Brodie

Nice piece by Duncan Brodie.

10 Actions To Take Your Leadership and Management Success To The Next Level

Action 1: Do an honest self assessment

It might be tough to do but if you are serious about moving forward, you need to take a long hard look at where you are right now in terms of mindset, skill set, experience and personal attributes.

Action 2: Get some feedback

Feedback is hugely valuable to you.  Getting some insights from others helps you to understand where your strengths are and what you need to work on.

You can read more by Duncan and subscribe to his ezine, blog & twitter feed at his website

Action 3: Get clear on your priorities

The biggest concern I hear from professional people is that they are running at speed but still struggling to get things done.  We can all fill up our week or month with activities but you need to be focusing on the priorities.

Action 4: Set a few key goals

We are all (me included) inclined to be far too ambitious when it comes to setting goals for the year ahead.  When setting your goals focus on a few major goals that will have a significant impact on what you and your team deliver.  It might be process automation, updating a system, a new product launch, a new way of running meetings or a new way of reporting to name just a few.

Action 5:  Set aside time for leading and managing
A huge part of leading and managing is about making time for your staff.  Sadly many leaders and managers fill their calendar with lots of activities and forget about making time for staff.  You can be sure that there will be staffing issues during the year so plan with this in mind.

Action 6: Think about how you can add more value

Many organisations are currently facing or are likely to face real challenges in the coming year.  The people who step up to the plate and focus on adding value are likely to get noticed. Ask yourself how you could add value to the organisation.

Action 7: Think about your contribution to the wider organisational agenda

We all to a greater or lesser extent can get stuck in a silo mentality where we only think about our own function or department.
Those that aspire to be a leader know that they need to be able to contribute to the overall success of the organisation, not just within their functional area.

Action 8: Take on a new challenge

I don’t know about you but I often found that I delivered better performance when I took on a new challenge.  We all can to some extent become complacent and go with the flow if we don’t have a new stimulus.  Taking on a new challenge not only stretches you but builds your skills, experience and provides renewed motivation.

Action 9: Make more use of your team

As a leader or manager you have responsibility for a team.  If you want to get the best from that team you need to help each and every team member grow and develop.  This might mean delegating and empowering individuals more or even setting up a small action learning set to resolve a particular problem or challenge.

Action 10: Make a commitment to developing yourself

None of us know everything and we all need to continually work on our professional development.  Make a plan, set aside the time and take the action to develop yourself in 2010.

Bottom Line – Achieving more success and getting the personal rewards that this brings relies on you taking a number of actions rather than looking for one magic solution. So what action will you take to make the breakthrough in 2010?

You can read more about Duncan, suabsribe to ezine, blog or twitter feed at his website

Haiti – A personal perspective

Scan10001Shortly after our son was born in 1993, and accepting that we would not have any more children, my wife and I decided to sponsor a child through Plan International. As fate would have it, and I think that these things do happen by chance, we were allocated a little boy a few months older than ours. His name is Jose Dessources and he lives in a small village in Haiti. Over the past nearly 17 years we have received regular reports on him as he has grown along with the occasional letter and photograph. We have had the opportunity to send him small presents at his birthday and Christmas. There is little chance that we will ever meet Jose as Haiti, even before the events of last week, is not a recommended holiday destination for a couple of middle aged, northern European townies. Yet we do feel a sense of belonging with him, having been aware of the existence of one individual in a country where we can only just begin to imagine the poverty and deprivation. William (our son) has always been told that he has someone somewhere else in the world who has not been as fortunate to be born in to a relatively wealthy family and of whom we ought to be aware.

I do know whether Jose has been involved in the terrible earthquake of a week ago, I am sure that if he has survived then he will have been affected by it in some way whether by the loss of family or just by the knowledge of the events.

So three things:

  • If you are able, consider sponsoring a child it costs £13 per month. We chose Plan International but there are other equally good organisations. Their web site is
  • Please give something to help the victims of the Haiti earthquake. There are no shortage of worthy organisations that you can donate through.
  • Spare a prayer or just a thought for Jose and his family and friends and be grateful for what you have.

Thank you.

Authentic Leadership by Neil Crofts

Nice blog piece by Neil on Leadership

It is always exciting when our most urgent need and our greatest opportunity coincide.  In both the public and the private sectors we have an urgent need for great leadership.  Not just any old great leadership, but authentic, great leadership.

Firstly – What is Authentic Leadership?

In my rather varied career in employment I gained a great deal of experience in job interviews.  One of the most common questions was “what is your leadership style” – to which my standard answer was “from the front.”

I realise now that not only did I not understand the question, or the answer, the interviewers didn’t either.

In fact I was probably something of a natural leader. Whatever natural aptitude for leadership I had it was not nurtured and was left to fester into impotent rebellion.  I was even expelled from one school, specifically for exhibiting signs of leadership.

Eventually I became fascinated with the whole idea of leadership and studied it carefully.  When you look hard, what you notice is that there are different levels of leadership.

Autocratic Leadership relies of force and fear to lead, at one level you can think of Kim Jong Il at another you can think of gang leaders and even some teachers and business leaders.  Autocratic leaders rise to the top through bullying and stay there the same way.  People follow because they are afraid not to.  The only beneficiaries of autocratic leadership are the leaders themselves and their acolytes – although the position of acolyte is seldom secure.

Hierarchical Leadership relies on status, title or even a uniform.  Hierarchical leaders are appointed by someone senior to them who wants someone unthreatening beneath them.  You can think of Gordon Brown, the old style park keeper beloved of comics of the 60s and 70s and many business managers.  People follow because it is the norm to do so.

Hero Leadership relies on force of personality.  Hero leaders rise to the top because the responsibility of leadership is normal to them and because most other people would rather let someone else take that responsibility.  Think of Churchill and Shackleton and some inspiring business leaders – like Steve Jobs.  People follow hero leaders because they are inspiring and because they make their lives easy by taking the responsibility.  Hero leaders are extremely effective in narrow and specific circumstances – outside those circumstances they can be quite dysfunctional.

Authentic Leadership is the highest level of leadership currently available.  Authentic leaders rise to the top because their support of others encourages outstanding performance and results.  Authentic Leaders empower and encourage those around them to take responsibility and be brilliant.  Like a Zen master their, their greatest achievement lies in the success of their proteges.  Authentic Leaders outperform all others because they maximise the potential of those around them.  Think of the Obama election campaign.  Authentic Leaders are effective in a wide range of circumstances because their focus is on team effectiveness and on encouraging leadership within the team to be dynamic, flowing to where it is most relevant in the moment.

Secondly  – Why the urgent need for Authentic Leadership?

It is becoming increasingly obvious that earlier levels of leadership are not sufficient to tackle the urgent challenges we face in government, business or public service.  All three of the earlier levels of levels are primarily based in ego.  It is difficult to solve the kinds of problem we currently face from an ego based position because the solutions require collaboration.  When we come from an ego position it is very hard to truly collaborate.

Authentic leaders have the humility to take full responsibility and to serve everyone at the same time.  This is the path to success in overcoming todays challenges in business and government.

For more information on Neil and his work take a look at his website.

The Monday Morning Quote #69

“Live your life each day as you would climb a mountain.  An occasional glance toward the summit keeps the goal in mind, but many beautiful scenes are to be observed from each new vantage point.  Climb slowly, steadily, enjoying each passing moment; and the view from the summit will serve as a fitting climax for the journey.”
Harold B. Melchart

Integrity – Without It Nothing Works

From HBS “Working Knowledge” – the full piece is here.

“An individual is whole and complete when their word is whole and complete, and their word is whole and complete when they honour their word,” says HBS professor Michael C. Jensen in this interview that appeared in Rotman: The Magazine of the Rotman School of Management, Fall 2009. Jensen (and his coauthors, Werner Erhard and Steve Zaffron) define and discuss integrity (“a state or condition of being whole, complete, unbroken, unimpaired, sound, in perfect condition”); the workability that integrity creates for individuals, groups, organizations, and society; and its translation into organizational performance. He also discusses the costs of lacking integrity and the fallacy of using a cost/benefit analysis when deciding whether to honor your word. Key concepts include:

  • The personal and organizational benefits of honoring one’s word are huge—both for individuals and for organizations—and generally unappreciated.
  • We can honor our word in one of two ways: by keeping it on time and as promised, or if that becomes impossible, by owning up to the parties counting on us to keep our word in advance and cleaning up the mess our failure to keep our word creates in their lives.
  • By failing to honor our word to ourselves, we undermine ourselves as persons of integrity, and create “unworkability” in our lives.
  • Integrity is a necessary but not sufficient condition for maximum performance.
  • There are unrecognized but significant costs to associating with people and organizations that lack integrity.
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