It’s not how you start…

…its how you Finnish.

Scandinavian healthcare is quickly becoming the exemplar of good practice that hasn’t been seen from this part of the world since Jan Carlzon shared the secrets of his turnaround of Scandinavian Airlines in the multi-million selling management bestseller, Moments of Truth. If you’ve never read it then I’d suggest you do; its an Oldie and a Goldie and I think it is of greater relevance now in an increasingly service based economy than when it was first published in 1987. However, if you work in the Public Sector, then I’d suggest you read it in small chunks and with great caution, think of it as a science fiction fantasy about how life on another planet might be…you could just get some wacky ideas about customer service that your organisations will never let happen! But you can dream, and as Captain Sensible said, you’ve got to have a dream.

northern-lights-scandinaviaSo back to Scandinavia. The Danes are officially the happiest nation on earth; who wouldn’t want that title for their country of residence…and lets face it, the title of richest or wealthiest is kind of naff now, we would all far rather have the secrets to health and wellbeing than be the richest people in the cemetery. The Swedes have IKEA; that’s enough for any nation, anything more and it will go straight to their perfect blond horned helmet shaped heads. Norway is a haven of natural resources, with one of the worlds largest oil reserves sitting snugly under the arctic shelf and a state managed pension fund that is the envy of the globe, and the Finnish, well the Finnish have one of the most, if not the most, technologically advanced and joined-up healthcare systems in the world.

So whats the secret of Scandinavia’s success at getting stuff done and being generally fabulous? Could it be a diet of fish, clean air, the long summers, the short winters during which people stay indoors and think a lot, Absolut Vodka or maybe just the sounds of Abba? Whilst all these things doubtless play an important part, I think its their ability to plan and make decisions…they seem to have the uncanny ability to decide that something needs doing, find out all about the best way to do it, and then, you’ve guessed it, they actually do something. Jan Carlzon makes the wonderful and potent observation in his book Moments of Truth, that its only once people within an organisation are in possession of information, that they are able to make informed decisions. In fact he suggests, once people are in possession of information, they can’t and shouldn’t avoid making decisions because the information and knowledge they possess places an obligation upon them. If only this were so in the UK’s Public Sector.

We in the UK have known since the dawn of time (almost) about most of the issues that are now coming home to roost. Lets be honest, unless you’ve been living in a cave in the Highlands and Islands of Scotland, you’ve known for some time now about the significant Public Health issues that would be coming over the not too distant horizon, increased ageing, increased obesity the rising onset of age related conditions and the emergence of ever more innovative technology. We in the UK’s Public Sector have a great tradition of producing strategies that have sought to then deal with these issues by creating plans…its as if we are somehow convinced that once we have a plan we will be home and dry, we herald the development of our plans as something momentous, slightly greater than the birth of a child and just a little less than an England Football win, “Bell, call the Town Crier and spread the good news, let all the world know that we have a plan, and fetch the champagne while you’re at it my fine fellow”.

But plans on their own are of course useless (plans, uh, what are they good for, absolutely nothing, say it again, etc.), nothing was ever fixed because of the existence of a plan. If plans were solutions there would be no more angst, poverty, need or inequality anywhere in the world. Things have only ever been fixed, altered, improved, changed and removed or introduced because of decisions that were made and implemented as a result of the plan. My favorite comment of this year so far has to be the one by a Finnish Health and Care Minister, who said, “for things to happen, someone somewhere has to make a decision to do something”…I’m not sure I’ve ever heard anyone in the Public Sector in this country come out with something quite as succinct, meaningful and direct. As Eisenhower famously observed, “Plans are nothing, planning is everything.”  Less plans and more planning please…


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