Cultural renewal required to restore value systems


NOT SO long ago only academics and jargon-prone management consultants spoke of the culture of organisations. Real, meat-eating executives had little time for this “soft stuff”.

Today all has changed, as the culture of organisations has moved centre-stage in attempts to explain what went catastrophically wrong in countless institutions across all sectors. The latest example is the Gibbons-Shannon report on the deaths of children in the care of the State and a few weeks ago we had the reports on RTÉ’s Mission to Prey and the problems in AE in Tallaght.

Dysfunctional cultures have been cited as the fundamental source of failure in Fás, AIB, the Department of Finance, the Garda Síochána in Donegal, Fianna Fáil, the diocese of Ferns, Our Lady of Lourdes Hospital in Drogheda and numerous other institutions.

Labels such as cover-up and collusion, denial, deference and timidity, arrogance, groupthink, extravagance, corruption, fear and so on were used variously to depict the culture of such organisations. In his excoriating criticism of the Catholic Church, Taoiseach Enda Kenny spoke of its “dysfunction, disconnection, elitism and narcissism”.

There is nothing “soft” about culture. It is the most difficult thing to change and it is high time that boards of directors and senior executives gave it due attention. A dysfunctional culture is a debilitating liability and may even carry the risk of corporate implosion as, for example, in the case of Rupert Murdoch’s News Corporation and some Irish organisations. On the other hand, a culture based on a decent set of values is a precious asset.

The significance of an organisation’s culture is brutally revealed in the health system. The suffering endured by people in hospital emergency departments has gone on for decades as they lay on trolleys or sat on chairs, for days on end in some cases. The problem seemed intractable without substantial extra resources.

But in the wake of the Health Information and Quality Authority (Hiqa) report on Tallaght hospital, Sir Keith Pearson, chairman of the hospital’s interim board gave the lie to this analysis: “It doesn’t cost money to deliver dignified care; once you get the culture, the values and the behaviours right at the leadership level, you release the clinical staff to get on and do what they do extraordinarily well.”

The metaphor of an iceberg helps to clarify the issue. Visible above the surface are the structures, procedures, physical facilities, money, demarcations and information systems. Below the surface, the culture, comprised of the beliefs, assumed pecking order, self-interest, values, attitudes and related psychological elements which gel to form a shared mindset.

Efforts to transform any system through investment in change above the surface will ultimately fail unless accompanied by explicit interventions to alter the tenacious embedded culture; as someone once said, “culture eats strategy for breakfast”.

Sir Keith’s analysis is borne out in emails I received from a senior nurse manager in another large hospital. She said: “We know what is best practice in AE . . . we know how it should be organised and run . . . we have seen it work elsewhere . . . but the problem is the culture in AE . . . especially the consultant culture . . . and unless we tackle the culture there will be no progress that will stick.”

According to Sir Keith, this is precisely what they did at Tallaght. Since the appointment of the interim board last December, they have concentrated on ensuring they had “the right values”. There were no patients on trolleys when the Hiqa report was released last month.

No amount of money spent on staff, beds, IT systems or infrastructural change will deliver sustainable AE reform unless the dysfunctional culture is tackled and a new value system embedded. When money is scarce, major improvements can still be made if there is a culture change.

Similarly, the reforms now promised in the domain of childcare – new structures, risk management systems, record-keeping, more social workers – will ultimately fail to produce the desired outcomes unless a new culture takes root within the system.

There is an onus on boards and senior management in all sectors to render the topic of culture discussable (it tends to be taboo) and to address the issue. They can do so by answering the following five questions:

Have we codified our values? In 2008 the OECD urged the then government to codify the values of the public service in order to provide “an ethical framework for staff”.

Do we have a sustained programme to embed espoused values in the hearts and minds of all staff, from the board and senior management down? It is not enough to merely display them in a large frame at reception like an ornament. It is vital boards spend quality time engaging with the values. I know of one board member who said “ah sure the values are for the staff”. Another who dismissively wondered if the place to learn about culture would be in the Abbey Theatre.

Do we periodically audit the extent to which we give consistent expression to our values in behaviour, systems, policies and structures?

Is there sufficiently detailed commitment to strengthen the culture set out in strategic plans and a thorough assessment of performance in delivering on these commitments in the annual report?

Is there any external audit of our culture?

A bit over the top? Consider that these are the kind of questions that lie at the heart of financial control and governance. Moreover, consider the huge resources devoted to auditing the money.

I would strongly advocate that the Institute of Directors promote the idea that ensuring the health of the organisation’s culture should be formally added to the role and responsibilities of boards.

Similarly, across the public service it should be a requirement that explicit, thorough attention be paid to cultural renewal, as recommended as far back as 2008 by the OECD. Because of the decisive role played by those at the very apex of the organisation, board chairmen, chief executives, secretaries general, the taoiseach, bishops and others in similar positions have a particular personal responsibility in this regard. If they do not personally lead on this, placing their own reputation on the line by the example they give in living the expressed values, it won’t happen.

There are countless examples among the most successful companies and countries in the world of how to go beyond anguished hand-wringing or cliched, token references to culture and to initiate well thought out programmes designed to create a culture that delivers competitive advantage, ensures respectful service, enhances reputation and enables unfairly tarnished and demoralised staff once again to feel pride in the place where they work.

Dr Eddie Molloy is director, Advanced Organisation, and chairman, Mental Health Reform

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