Leadership and Change Management of the National Health Service - Paper Example

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Wesleyan University
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The National Health Service was started in 1948 with a core principle of regardless of wealth; everyone needs to have a better healthcare (Nhs.uk., 2016). The National Health Service is free to all the citizens of England except there are few charges on the drugs, services such as optical, and dental. The public health service serves more than 64.6 million people in the the United Kingdom and 54.3 million people in England alone (Nhs.uk., 2016). In a period of 36 hours, the National Health Service deals with over one million sick people. It insures all things such as end-of-life care, antenatal screening, emergency treatment, routine screenings, transplants, and treatments for long-term conditions. In 2014, the National Health Service was named as the most impressive regarding its care terming it as patient-centric, safe, effective, efficience, coordinated, and cost-related problems by the Commonwealth Fund (Nhs.uk., 2016). The National Health Service is among the top five of the worlds largest workforce; it has employees more than 1.5 million. Additionally, the National Health Service funds come directly from taxes.

Recently, there has been a dispute between the junior doctors and the ministers. The dispute is due to a new contract that the ministers want to implement (BBC News., 2016). Therefore, the junior doctors leaders are opposing the possibility of a new contract in England. The ministers composed plans to change the contract terming it as outdated and unfair. According to the contract, the basic pay of the junior doctors will be increased to an average of 13.5% (BBC News., 2016). However, this will come with consequences, for instances, there will be restrictions on certain elements of the pay package such as what will the unsociable hours will constitute of. For instance, on Saturdays payments of day hours will at the usual rate whereas at night extra premiums will be offered and remaining part of weekend will be lower than the current payments. Also, the system linked to progression through set training stages will replace guaranteed pay increase linked to time in the job. Additionally, ministers have vowed to give protection of pay to existing doctors for the first three years. However, a small percent of doctors who work for extra hours and qualify for premium payments will be discarded. The changes are partly formulated in a way it will reduce costs hence increasing the numbers of doctors registered on the weekends. Thus, there is a likelihood doctors will be working more during the weekends and under the current contract this would have led to extra pay. Moreover, to effectively implement some of the changes it will require a lot of time. For instance, the termination of guaranteed pay rise associated with time-in-the-job implies some doctors will find their pay rise slowly grow during their service as junior doctors. Also, doctors starting their career in National Health Service under this new contract may be worse off than they would have been under the current contract.

Freemans Stakeholder Theory

Stakeholders can either be a group or an individual who profit from or hurt by, and whose rights are respected or violated by the corporation or organizations action (Freeman, Harrison, Wicks, Parmar, and De Colle 2010). A stakeholder is a generalization of the idea of stockholders who have certain claims on an organization or corporation (Freeman et al., 2010). Therefore, both the stockholder and the stakeholder have the same right to demand special action from the management. Freeman provides two definitions of stakeholders; the narrow definition defines stakeholder as groups that are very important for the survival and success of an organization or firm (Freeman et al., 2010). On the other hand, the wide definition defines stakeholder as any group or individual who can affect or be affected by the organization or corporation. These groups or individuals include the owners, employees, suppliers, customers, and the local community.

Owners provide finance in form of bonds and stock hence they have financial claims in a firm and they expect to gain profit from them. The owners can either directly give money to the firm or have some historical demands made through a series of exchanges that are morally justified (Freeman et al., 2010). The corporation directly has impacts the livelihoods of the owners because they make substantial investment with portion of their retirement income on the stocks and bonds so as they gain from it when they lose their ability to work. However, the stakes of owner differ depending on the type of owner, preference of money, preferences for morals, and the type firm.

The employees on the other hand have their lives and jobs at stake- in this case are the doctors. The employees provide the specialized skills for the corporation or organization. In return for the skills and labor they provide, their expectations are to be provided with security, wages, benefits, and work that is meaningful (Freeman et al., 2010). Also, another expectations is the corporation will provide for them and help them out in times of problems or hard times. On the other hand, the corporation or the firm expects the employees to adhere to the company rules and management instructions, to sell the brand of the firm and to be responsible citizens in the local community in which the organization operates.

Suppliers, as explained in the sense of the stakeholder, are key to the prosperity of an organization or firm. For they provide raw materials which helps in determining the quality and price of the final product (Freeman et al., 2010). In return, the firm or the organization becomes a client to the supplier and becomes significant to the prosperity and survival of the supplier. Moreover, when a corporation or an organization sees the supplier as part of their stakeholder team instead of as source of materials, the supplier will then respond whenever the corporation has a need. When a bond is built between the two, they can fall and rise together. For instance, the, if the firm is on the brink of falling the suppliers, can help in different ways such as price cut offs, accepting late payments among others. For such a relationship to be built, it depends on several variables like the number of suppliers the firm has and whether the supplies are finished goods or raw materials.

Customers are very vital for a firm for they exchange resources, in most cases is in the form of money for the services provided by the corporation or organization. In return, the customers gain the benefits provided by the service. In the form of revenues, customers are the among the main contributors of lifeblood of an organization or a corporation (Freeman et al., 2010). Furthermore, customers in some way indirectly contribute to the development of new products and services of a firm given the level of reinvestment of earnings in the large firms. Besides, creating a close relationship with the customers creates an environment of success for other stakeholders and most successful corporation emphasize on focusing on the customer. Since focusing on the needs of the customers the management automatically addresses the needs of the suppliers and owners. Furthermore, it seems that the ethics of customer service carries over to the community.

The local community provides the firm with the right to construct facilities, and in return, it profits from the taxes and the contribution of the firm socially and economically (Freeman et al., 2010). The local community expects the firm to be a good citizen, as any other citizen. The firm cannot expose the community to unreasonable hazards in the form of pollution, and toxic waste. Additionally, the firm is expected to work with the local leaders if it wants to leave a community to make the transition as smooth as possible. Also, it is expected of the firm to work with the community if it discovers any dangers that can affect the community. When a firm disobeys these, it will face repercussions just like any other citizen.

Handys Taxonomy

Charles Handy come up with four kinds of organizational culture: power culture, person culture, role culture and task culture (Handy, 1996). Firms with power culture the power is concentrated among few individuals whose effect spreads throughout the firm. There are fewer rules and regulation, and employees are judged by what they have achieved instead of how they act or do things. Moreover, decisions are quickly made even if they are not to the best interest of the firm. The National Health Services power is based on the role culture. Whereby it is very bureaucratic and highly controlled with every stakeholder knowing their roles and responsibilities. Everyone power is determined by the position of the person in the organizational structure. Decision-making is very slow, and the organization is less likely to take risks a good example is the incident of the junior doctors. In firms with the task, culture power is based on teams that are formed to achieve goals or solve problems. Lastly, an organization with person culture, power is based on the employees themselves. This implies the employees feel they are more important than the firm. They just come to work for the sake of money and are never attached to the firm and mostly they never decide on the favor with the firm.

Scheins Levels of Culture

Organizational culture is a difficult thing to understand since it is an abstract concept. But in 1980, Edgar Schein a professor of management developed a model of organizational culture to make a culture to be visible in an organization (Schein, 2010). According to Schein, an organization has direct and indirect mechanisms that bring out culture. The direct mechanism directly influences the organizational culture model, and they include behaviors, opinions, status, and appointments. On the other hand organizational culture is not influenced by the indirect mechanisms directly but they are determinative (Schein, 2010). They consist of the mission statement, vision statement, rituals, guidelines, designs, corporate identity.

Schein came up with three different levels of organizational culture namely artifacts and symbols, espoused values, and basic underlying assumptions (Schein, 2010). The artifacts and symbol level represents the organizations surface. These are the noticeable aspects of an organization they are the logos, architecture, corporate clothing, structure and processes of organizations. The NHS, the staff, are required to put on specific clothing for health and safety or hygiene especially while in the theatre. The espoused values level is concerned with standards, values, and rules of conduct of an organization (Schein, 2010). For instance, reviews on how objectives, strategies, and philosophies of an organization are expressed and how it makes it publicize them. The basic underlying assumptions are experienced as self-evident and behavior that is unconscious and they deeply rooted in the culture of organization (Schein, 2010). Assumptions are not easily identified from within.

Sometimes the three level of organizational model is represented as an onion model based on its distinguished layers. The outer layer is relatively easy to adapt and change. Seemingly, the deeper the layer, the adjustments becomes more harder (Schein, 2010). On the other hand at the core of the onion is where assumptions are found around the core there are values. On the outer layer are the artifacts and symbols and these can be changed more easily. Also, there is another layer referred to as heroes between these layers in which the values are found. Heroes are individuals who play a significant part in the organization and are admired for instance, in this case, is t...

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