Cross Country and Virgin - Chalk and Cheese

Regular readers of Simplicity Blog know that I travel almost all my business miles by rail.

I've often congratulated rail providers publicly on this Blog for their excellent service. On Thursday I had an awful customer experience on a Cross Country train from Chesterfield to Birmingham New Street. I got so annoyed that I fired off an email on Friday to the rail public watchdog called "Passenger Focus - Putting Passengers First"

When service is excellent I like to tell the provider ... when it is absolutely crap we should also tell them.

This was what I wrote:

"I just wanted to vent my feelings.

Yesterday afternoon/evening I STOOD (along with probably 30 other passengers) for the entire journey on a Cross Country train from Chesterfield to Birmingham New Street. The announcements over the tannoy were awful – a very low volume and the announcer clearly had no idea that his diction is dreadful and indecipherable. No refreshments at all. It was - by a mile - the worst journey I’ve had on a train for five years and I travel about 5 times per week on average on business.

Contrast this with my onward journey with Virgin from Birmingham New Street to Coventry. I walked on to the train – a completely different ‘feel’ to everything about it. No problem finding a seat. The very friendly and reassuring voice of a pleasant train manager came over the tannoy to welcome me on board and tell me the details of the journey. I strolled along to the refreshments carriage – an absolute pleasure to be dealt with perfectly by a charming young lady who smiled a lot.

The contrast between Cross Country and Virgin was like chalk and cheese and I guess my question has to be is how the hell did Cross Country get that contract over Virgin – do the people who award the contract not take into account customers opinion?

Please do let me know what you can do with my feedback. For instance, can you forward this email to both Virgin and Cross Country on my behalf please?

Ironically enough I was returning from Chesterfield having just delivered a training session on customer care!!! – This journey gives me plenty of REAL data for future customer care workshops.

Hope to hear from you."

I will let you know if I hear anything!

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Malcolm's New Blog!

Malcolm pictured with his son at the launch of "Its a Goal" at Manchester United Football Club in 2006

My friend Malcolm McClean – well known entrepreneur and Director of Bearhunt has started a Blog.

In 2005 Malcolm wrote “Bear Hunt – Earn Your Living by Doing What You Love” published by Capstone, which has since been translated into Chinese; Turkish; Romanian; Korean; and a special version has been created for the Indian market. Malcolm says “You would expect me to say this, but these principles really work – whenever I get stuck or distracted I get a coffee and re-read Bear Hunt myself as a reminder to keep on doing what I’ve been doing. Ever since that momentous decision to do great things with great people, I’ve been able to do something that we all should aspire to – earn my living just by doing what I love.”

Malcolm is not only one of the most creative thinkers I’ve come across in business but crucially he is also a ‘doer’ – he gets results.

Among his achievements Malcolm was the founder of the brilliant initiative “It’s a Goal” which engages young men in football to reduce the incidence of depression in a target group of the population where depression is often ‘kept under the carpet’ and not talked about. The initiative now involves 4 professional football clubs in England including my beloved Manchester United.

Malcolm’s new Blog can be seen at this link http://www.bearhunt.org.uk/Blog/

I’m sure you will enjoy reading it and I hope you will respond to Malcolm’s views.

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Dreaming of a Holy Night

We are delighted that our Church in Coventry is to have Graham Kendrick appearing for one night only on Tuesday 8th December as part of his his US and UK tour. The concert tour is called "Dreaming of a Holy Night."

If you click on the arrow under the picture of Graham in the side bar you can hear more about the concert.

Graham has his own own website is at this link where you can read more about him and the tour http://www.grahamkendrick.co.uk/index.php

Graham Kendrick has been described as a ‘father of modern worship music.’ For more than 30 years he has been at the forefront of Christian music in the UK having written and recorded hundreds of songs, many of which are well known around the world, including Shine Jesus Shine, Knowing You, The Servant King and Amazing Love.

Graham is based in the UK and travels internationally participating in tours, festivals, conferences and training events, as a worship leader, speaker and performer.

Judging by the reviews of Grahams similar tour last year we are in for a memorable event in Coventry and by clicking on the picture below you can see details of how to obtain tickets for the concert - a very reasonable £10 per ticket!!!

PLEASE TELL YOUR FRIENDS TO TELL THEIR FRIENDS!

It hurts!

On Monday this week my 4 year old grandson Sebastian had an accident at school. This resulted in a trip to the hospital for an overnight stay and surgery on Tuesday morning on his broken arm. Here is a picture of the brave young soldier in his hospital bed. I'm sure all parents and grandparents are just like me - seeing our own children or grandchildren suffer pain hurts us.

The great news is Sebastian is much better and back at school tomorrow (Thursday).

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This made me laugh

My darling wife Annie found a brilliant birthday card today for my son Simon. It is hilarious so we scanned the card and here it is.

I thought it was really funny - hope you agree.

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Apologies for absence :-)

Sincere apologies for being away for a while – work commitments have meant I just have not had enough time to Blog as much as I would like. That in itself is great – we all have bills to pay - and it’s good for my health to be busy. But I genuinely miss making my regular postings on Simplicity Blog. However, I’m back and I will find time in the next few weeks to get back to regular Simplicity postings.

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Another thank you to rail providers

I’ve just been reviewing my work diary over the last month.

1st to 31st October - 19 days on train journeys – a total of 55 individual trains given various changes.

Train slightly late: 2 occasions
Significantly late: 0 occasions
On time or early: 53 occasions

I would say that’s superb given the complexity of rail travel and the number of variable factors.

Just as with the NHS there are often sweeping generalisations about poor rail services in England.

Rather than listen to those doom spreaders I speak as I find and as I have said many times on this Blog I feel we have a very good rail service in England.

The last month has again confirmed my opinion.

So thank you Virgin and Cross Country (both pictured above) These are the two main providers I've used in the last month.

November looks almost as busy for me on the rail network and I'm optimistic!

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I'm Proud of Diversity in Britain

Last night (Thursday) I watched in shock, amazement and embarrassment the appearance of the leader of the British National Party, Nick Griffin on BBC TV’s popular programme Question Time.

It therefore felt very timely today that I went to a celebration of Diwali where I met about 150 Asian Carers who live in the city of Coventry. I am a Director on the Board of Coventry Carers Centre and this was an opportunity for me to go along and meet these Asian Carers who provide care for members of their families and/or friends who are either ill or have some form of disability.

I had never been to a Diwali celebration until today and I found it a very moving experience.

Unlike Mr Griffin and his British National Party I am very proud that my country is so rich in diversity. It provides an opportunity for me to continue my life education. My journey is always enhanced when I meet the type of caring loving people I met today.

Mr Griffin might like to consider taking time out to go along to a Diwali or similar cultural celebration in his neighbourhood. He might just learn something about people from other cultures than ‘white English.’

I’ve spent my entire career working alongside thousands of non-British, non-white people in all aspects of healthcare including Doctors, Nurses and many other professions and my life has been enriched by this. Our Church in Coventry has a Zimbabwean fellowship and when these folks from Zimbabwe take an active part in our services they add immensely to the experience for all of us.

In summary I am delighted that the likes of Mr Griffin represent such a tiny proportion of people living in Britain. Mr Griffin and his cohorts hold radical, racist views that I do not wish to be associated with in any way. The only positive I can draw from Griffin appearing on such a high profile TV programme is that it will solidify the absolute disgust and contempt that fair minded people in Britain have for Griffin and his British National Party.

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Stupid, stupid, stupid!!!!

I have chuckled to myself about these things for years and I’ve always put it down to something that we can all laugh about.

Now I am getting a bit irritated about these things. What is really getting me at the moment is the absolute stupidity – I can’t think of a kind word – of some design ideas.

How the hell can the people who invent/design these things take any pride whatsoever in their job. Or maybe it’s just me and I should perhaps just get out more.

These things may appear petty and nit-picking but to me they are important. They illustrate why I never simply accept the concept of ‘expert’ in design or innovation. No person with one iota of common sense would introduce these things.

Here are just a few of the things I’ve noticed that drive me mad! You will have other examples and I’m sure you will let me know:

1 Toilet roll holders positioned in public toilets (on trains and in hotels in particular) in places that require the person sitting on the seat to be a contortionist to reach the toilet roll. Then when you do finally reach the toilet tissue the roll doesn’t ‘roll’ and you end up with the tissue breaking off at every perforation!

2 Those vacuum sealed clear plastic surrounds on electrical goods like memory sticks that are simply impossible to open without getting a knife or a pair of scissors and literally hacking your way through to the product. We risk amputations of fingers just to get to our precious appliance.

3 Tomato ketchup plastic sachets that simply refuse to tear despite your best effort - even with your teeth! – I mean who carries pair of scissors or a knife into a motorway service station when all you want is a burger with ketchup!

4 Milk cartons that require a corner to be cut off to enable pouring and doing it results in spillage every single time you cut the corner.

5 'Post it' note sealed packs that are simply impossible to get open (and that includes attempting to tear the thin covering with your teeth) without scissors or a knife.

We can and should laugh at these things but on the other hand I think there is a serious issue here. This stuff is so simple and yet it doesn't get any better. Why in hells name don't the designers try these things out before they are applied in practice?

Front line employees would never do anything so stupid.

For instance – it’s surely possible for someone to sit on a toilet seat and - without having the IQ of Albert Einstein - work out where might be difficult for people to reach the tissue!!

Surely the person who designed those vacuum sealed packs tried them out with a small group of guinea pigs before the product is mass produced – CLEARLY NOT!!

Maybe I am missing something obvious but if so I just cant see it ….

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Carry on trusting ......

As regular readers know I’ve often written on Simplicity Blog (and in many other places) my firm belief that front line employees should always be TRUSTED to just get on with the damn work.

I’ve always said the best leaders know they should just need to set out the broad parameters of their expectations of employees and then get out of the way and trust the people to get on with the job. I often use the famous quote of Henry Stimson, US Secretary of War in World War Two; ‘The only way to make a man trustworthy is to trust him’

I’m not going to change my mind on any of my core beliefs above. I still firmly believe I am right to trust employees.

BUT ….

It hurts me to the very core when a manager (like one I’m coaching at present) does all the right things about setting clear parameters and expectations for the team and every individual within that team and then some employees totally let down that manager by abusing the trust placed in them.

For a fleeting moment I think to myself; ‘Do I need to change my view about trusting employees?’ …. But I quickly realise there will - sadly - ALWAYS be a small minority of employees who will abuse the trust you place in them.

Am I disappointed – Yes.
Am I angry – Kind of.
Am I surprised – Very.
Most Important - Will I change my views about trusting front liners? – DEFINITELY NOT.

Do you get disappointed sometimes when employees abuse the trust placed in them and if so how do you rationalise it?

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Friend of Simplicity - Gary B Cohen

Today it is my great pleasure to interview Gary B Cohen author of a great book that I've just read called "Just Ask Leadership – Why Great Managers Always Ask the Right Questions."

Gary, as President and co-founder of ACI Telecentrics grew that company from two people to 2,200 employees and reached $32 million in sales at the company’s peak. ACI was recognized as one of Venture Magazine’s Top 10 Best Performing Businesses and Business Journal’s 25 Fastest Growing small companies. Gary is partner and cofounder of CO2 Partners, LLC operating as an executive coach and consultant. His clients run a wide range of organizations – from small entrepreneurial companies to multi-billion dollar enterprises.

Trevor: First of all Gary – thanks for taking the time in your busy schedule to answer a few questions for my Simplicity Blog.

Gary: It is truly my pleasure, and thank you for being willing to share my ideas and the book, Just Ask Leadership, with your audience. As you can see from the title, it would be difficult not to respond to a fellow Asker. Don’t be surprised, though, if I take the opportunity to ask you a few questions as well.

Trevor: I really enjoyed reading your book and found many similarities in your philosophy to my own about business, management and leadership. Not least the need for Simplicity. Do you think some managers make things too complicated?

Gary: Yes and no. To me it really depends on the situation. If you are referring to leading others, yes. If you’re referring to leading an organization, I would say no. I believe many of today’s crises are a result of the complexity of our operating systems. Leaders are applying linear solutions to complex systems.

In a discussion the other day with Joseph Grano, who is currently Chairman and CEO of Centurion Holdings and formerly Chairman of UBS, Joseph stated that it’s not that CEO's are unaware of the complexity of their organizations, but that they’re unaware of the complexity of the products their organizations offer. Leaders don’t and can’t understand every aspect of their organization, nor should they try. They put their organizations at risk when they do. Instead, they need to learn the right questions to ask and where to direct these questions. When leading people, both straight forward and more complex strategies are necessary.

The straight forward aspect of leading is really simple – Just Ask. If leaders did that more than Just Tell, they would see vast improvements in their organisations’ performance. What I don’t want people to believe is that any question, in any tone, will do. The types of questions – and they way they’re delivered - are equally important. Counter to popular opinion, there is such a thing as a Bad Question!

On the complex side of people leadership, leaders would benefit from understanding the brain and how it takes in and stores information. People favor certain types of information and disconnect from others, which has a huge impact on outcomes in organisational trade-offs.

By understanding the workings of the brain, leaders can ask questions that cut through thinking processes and create improved outcomes.

Trevor: The images of a leader telling people what to do rather than asking questions still persists in many organizations. Do you think this style is changing fast enough?

Gary: No, and this is what gets me going in the morning. To live in a free country and to work for a totalitarian company in which the leader always knows best is at worst repressive and at best controlling. In a day when information is more abundant than ever and we have more college graduates and post graduates in the work force, the smartest person in the room is rarely the leader, even though they would often have you believe they are.

The worker today wants to be engaged in decisions, making things happen and changing organizations to improve. This was also the case in colonial times: After 120 pilgrims died in Jamestown during the winter there were only 60 survivors left. The deaths resulted largely from failure to take care of the land and common ownership of the colony. With ownership divided so that the 60 people who were left each had their own plots and individual rights, crop production tripled.

When people feel they have a stake in what they do, performance increases. At CO2 Partners, we see this with organizations that change from telling to asking. Our entire educational system was built on knowing the answer. The teacher is the leader and you do what she tells you to do even if you know it is wrong. That was translated to the repetitive processes in our factories, where many thought that questions were unnecessary.

But we’ve seen today how the bad practices of just one or two employees can bring a company to its knees.

Trevor: My good friend Dave Wheeler from Arkansas has great practical experience as well as knowledge of the subject of leadership. Dave says the four most important words a leader can say are ‘What do you think?” – I assume you would agree with that, Gary. Why do so many managers find it hard to ask questions?

Gary: I’m not sure I would say those would be my four most important words, but I would agree that questioning is one of the best disciplines a leader can learn today to be resilient in the face of uncertainty.

Great leaders aren’t afraid to make decisions, too, but they rarely do so without asking great questions first.

Trevor: I have a passion for giving much more responsibility and power to people working at the front line. I would be interested to hear your ideas about how managers can be persuaded to let go of the power to their front line folks.

Gary: We seem to be in alignment on this idea. One of the first questions I suggest leaders ask is, “Whose decision is it?” It is a way to get them to understand at the beginning of each conversation that it does not have to be their decision. And before they can ask any questions at all the leader must trust the people on the team. If they don’t, why bother asking them anything in the first place? The issue of trust does not revolve around getting rid of team members the leader doesn’t trust, but more often the issue is that the leader does not know how to trust.

At CO2 Partners, this is one of the first places we go to help a leader and her company. Most leadership practitioners speak of Trust in terms of making the leader appear trustworthy. It is our belief that this is quite backwards.

Those who have the power must first give trust, which involves a certain amount of risk. There are some very deliberate ways to create this trust and it has nothing to do with time. It is only then that the idea of moving decisions downstream--to the front line-- can be accomplished.

Trevor: Do you have any Leadership heroes and if so, who are they and what is it that makes them stand out from the crowd?

Gary: One of my favorite leaders is Bill McLaughlin. I admit we are friends, and I am sure that has much to do with my rose colored glasses. He was one of the few leaders I interviewed for the book Just Ask Leadership who was consciously competent about using questions as a leader.

Most of the exceptional leaders I interviewed used Just Asking about 70-80 % of the time and were not really conscious of doing this until we discussed it in the interview. Bill knew he did it and was very deliberate about the questions he would ask. Another aspect of Bill that I have grown to admire is his authenticity - not the kind you learn at a seminar but the kind that only comes from deep contemplation and self awareness.

Humility is another aspect that comes to mind – again, not the kind you pick up trying to imitate the Dali Lama, but the kind that comes from seeing people outside of a hierarchy. He seems to see potential in people and help promote them through the questions he asks. He is the lesser part of the equation and the other person is the focus. He has experienced amazing successes and challenges in his career and yet still projects these admirable qualities.

A fictional leader I love is Dorothy from the Wizard of Oz. Next time you watch the movie, pay close attention to how she engages and aligns her team to follow the yellow brick road.

Trevor: Having a style that is all about asking questions might be construed by cynics as a manager being weak. I need to stress that is certainly not my own view. How do you answer those cynics Gary?

Gary: Yes, this is often a first thought shared by many, such as those who see water as weak, although it played a major part in forming the Grand Canyon.

If you ask weak questions (and there is such a thing as a weak question), you may be considered a “Weak Leader”. But there are tough questions that require real action from the listener.

Some examples of tough questions from a boss to his team member might be: “Trevor, what is preventing you from blogging twice as much per week?” or “How might you remove those obstacles in order to meet our overall goal that we agreed to earlier in the year?” Often it takes way more courage to ask and trust than to tell and blame.

Trevor: What one piece of advice would you give to a young manager just setting out on his career path given your own experience?

Gary: Understand that in our society there is a time to provide answers and a time to ask questions. You’ve most likely learned how to answer for the first 20+ years of life, so learn this difference and practice the art of asking. Pick up my book Just Ask Leadership or go to our website www.JustAskLeadership.com and take the Gold Assessment. It is a 360-degree feedback tool that polls 5 people who work with you on your leadership performance in general and Just Ask Leader style specifically. It will provide specific advice on how to improve. We have been studying leaders with this tool globally and have found that trusting others by using questions can have a 20% positive effect on the team’s engagement, alignment and motivation.

Few assessments provide that level of feedback. Buckminster Fuller was a wonderful thinker, and a friend recently reminded me of Bucky’s view on procession. This is the notion of just starting – just put your foot in a direction, even if it is not the right direction.

Most Nobel Prize winners never set out to win. They just started on their path, one thing lead to another, and before long they really became the change in the world that they wanted to see. This is true for anyone starting down any path – the first place to start is starting. Many people get stalled out and this often leads to paralysis.

Trevor: Finally Gary, have you visited the UK and if not do you have any plans to come to this side of the pond? I have a number of US friends who regularly visit my Simplicity Blog and it seems there are many similarities in both our cultures. I’m sure your Just Ask Leadership concept is equally applicable on this side of the water.

Gary: Several fantastic leaders have asked whether CO2 Partners would like to start a practice in England, and those discussions are still active. The book has only been out for a couple of weeks and the interest from the UK has been fabulous. When I was younger, I was an intern at the British Parliament for the Fulham member Martin Stephens who passed away many years ago. I lived off of Queens Gate right off Hyde Park and my memories often draw me back there.

If you or any of your readers know of opportunities to speak in England or Europe, I would more than welcome the opportunity. I gave a speech in June in Hanover, Germany to a company that does business around the world. The audience represented over 20 countries and each took to the Just Ask idea no matter how different their culture was from ours. Similarly, I spoke to the Intel global treasury department last year and there were over a 100 leaders from all over the globe.

The message of Just Ask seems to have resonance all over the world. Thank you for your willingness to help spread the idea.

Trevor: The pleasure is mine Gary - thank you again. I hope some Simplicity readers take you up on that offer of speaking engagements in the UK - you will be very welcome on this side of the pond - your message to Just Ask is so important.

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Friend of Simplicity - Ken Dainton

Today I have immense pleasure in publishing my latest ‘Friend of Simplicity’ interview with Ken Dainton.

Ken is a personal friend (he was best man for my marriage to Annie) and has been a professional management colleague in healthcare for over 25 years. In 1983 I moved 300 miles from my home locality as a (relatively) young and inexperienced manager to a big challenge in a new job in the National Health Service (NHS). I found myself in Torbay, Devon, England – a place where I knew no one.

The first person to make me feel welcome at work in Devon was Ken who at the time was the Administrator (which in those days (all but) meant CEO) of Torbay Hospital which has over 500 beds. Ken was very helpful to me from day one in all sorts of ways. He gave me great support and advice in a completely new locality where frankly, I felt completely lost.

I unashamedly ‘used’ Ken as my 'informal mentor' in those days and actually I still do.

As far as I’m concerned Ken is the best Chief Executive the NHS has never had.

Hundreds – possibly thousands - of people in the NHS have influenced me during my long healthcare management career. Ken – through his wisdom, guidance, experience and kindness has influenced more than most.

I hope you enjoy reading the interview and please respond with questions and/or comments for Ken.

Trevor: Welcome Ken - Please give a brief history of your career.

Ken: Very boring and conventional I'm afraid. I joined the Bath Hospitals straight from school on their local training scheme for administration back in the swinging sixties. We were expected and encouraged to obtain the Institute of Hospital Administrators qualification and leave for higher things. This I did, working in Wiltshire before coming to Devon 36 years ago. I have been rooted to this delightful spot ever since but fortunate to have enjoyed a variety of jobs including planning, HR, and operational management both within the hospital setting and in the community. I retired four years ago but returned on a part time basis. Work is now my hobby.

Trevor: Can you pick a couple of excellent leaders you have worked for and tell me what it was that made them better leaders than the average manager?

Ken: Unfortunately I can only think of one that I have worked for (perhaps that says something more about me than them!) but there are several others that I have worked with who I would single out. The qualities that stand out are integrity; good communication skills; vision; a pragmatic approach and ability to secure alliances; and the personal credibility (ability/knowledge/understanding/judgment/objectiveness) that breeds confidence in colleagues.

Trevor: I’m interested to hear your opinions about the UK National Health Service particularly in the light of the current debate regarding universal healthcare in the US.

Ken: I've lived in the States for short periods and what stood out for me was the number of people working well into their old age, some of them very frail, in order to pay their healthcare bills. The anxiety that was generated was palpable. For a civilised society with top class acute facilities it is barbaric. The NHS offers free at point of delivery, comprehensive, cradle to grave, non judgmental care. But those strengths are also its main weakness in that it tries to do everything for everybody (often backed up by legal action) and thereby creates an impossible funding and ethical dilemma. It seems to me that the ideal system would be the best bits of both-one with minimum bureaucracy, that incentivises innovation, encourages self help and reliance, and is explicit in what it services it provides.

Trevor: What’s your opinion of doctors being involved in management?

Ken: The first thing to say is that not all doctors want to be involved in management. I can understand that because it’s not what they trained for and doctoring is tough enough without any further distractions. However they can't then complain if issues are not addressed to their satisfaction. The second thing to say is that a common misconception of doctors is that management is about sitting behind a desk, dealing with finances or commanding a bunch of recalcitrant staff. Its not. It’s about shaping the strategy; establishing the agenda; setting priorities; keeping maverick colleagues on side; and advancing the clinical capacity and skills of the organisation. It is vital that doctors play a full and leading role.

Healthcare is a dynamic business, there is a political dimension (both local and national) and teamwork is essential to reconcile the many and various competing demands. Without clinical leadership the organisation will flounder.

Trevor: Can a manager from any organisation manage a large hospital? – What are the unique issues in hospital management?

Ken: I see no reason why managers should not be recruited from outside the NHS provided they have the personal attributes necessary. However, there is a steep learning curve that needs to be climbed very rapidly. There is a multiplicity of professions, specialist interests and power bases. Understanding the connections, motivations and dynamics is quite tricky. Learning who the movers and shakers are, both people and positions, is crucial. Taking advice from seasoned operators and tapping into the organisational memory is a key skill.

As with any new recruit the early, honeymoon period is crucial in gaining credibility and it is even more important for external appointees.

Trevor: Looking back on your career can you identify some of the big differences in management say 30 years ago compared to 2009?

Ken: Looking back some of the decision making processes were pathetic. On the other hand we were much more liberated from the vast weight of rules/regulations/legislation that there is today. Thirty years ago there was more thinking-on-ones-feet and initiative. These days the NHS is far more risk averse and there seems to be a written protocol to follow for every little issue. Management can easily deteriorate into a tick box culture and this drives increasing specialisation.

Gone are the days when a young manager could be a jack-of-all-trades (master of none) and learn by taking a chance and making mistakes.

Gone are also the days of the "public service" ethic. There are still pockets of altruism but society has changed. The other obvious difference is that there is no longer a defined career ladder to climb. These days it is more of a flexible climbing frame to scramble across both within and outside the service. Trevor:

What advice would you give to young managers just entering their management career?

Ken: Healthcare is a fascinating subject so:

*Take a professional pride in all that you do.
*Respect, and learn from, all other professions.
*Seize opportunities to develop.
*Listen to what patients, their carers and front line staff are saying.

Trevor: Are you optimistic about the future of healthcare management here in the UK?

Ken: I am a natural optimist. I am confident that the NHS has a future and there will therefore always be a need for good management. The top guys though will need a much tougher skin, have to be more politically and publicly astute and find a way of imposing that public service ethic on an increasingly strident audience.

Trevor: Brilliant - thanks Ken – keep taking the pills my friend!

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