Knowledge Matters

This is the second article regarding my recent observation of the functioning of the Australian Medical system.

Just recently I have had the unique opportunity to observe how the health system works in Australia and this is the second article that reflects on this experience. The first article was about Rethinking Medicine. My recent observation of the health system, highlights where “rethinking” could have a dramatic impact on not only costs of the system but also social, economic and personal outcomes.  “Rethinking” the existing system could see substantial improvements. “Rethinking” does require innovation and creativity but also the ability to see the problem and the world differently. I will touch upon this significant aspect of society later in this article.

This article concerns why “Knowledge Matters” or in terms of the Australian public service why “content” matters.

The public sector in the western world is gripped in a focus on what “leadership” means and what is integrity. Think of the recent Speakers and Entitlements debate in Victoria (Australia). This discussion reminds me of the 1980’s debates on NPM – New Public Management – an era where rigorous debates were encouraged that help reshape the concept of Public Sector Administration into Public Sector Management. The present discussion might just be a process of regaining the heart and soul of what is “public service” in a broader sense and not just the domain of the government. It may lead to defining “Public Sector Leadership” – PSL and thus why knowledge and content might matter.

Over the last three months I have been able to observer very closely the functionality and the significance of a system that is dependent on individuals knowing their content, being experts in what they do and being extremely competent. A competency that is dependent on knowledge – content and experience. I am talking about the Australian health system and how it functions to save lives. 

Consider a situation where a very accidental and incidental listening of a mid-fifties heart, identified a heart murmur. That resulted in the diagnosis of severe aortic stenosis, and eventually an operation that resulted in Aortic Valve Replacement and three bypasses. Not a simple life event and not one planned or for the individual unaware of for some fifty years, having been born with a bicuspid aortic valve.

However, it is the fact that the system functions because of individuals who have the right “content”, from the Doctor who simply identified the heart murmur, to the Echocardigram expert, to the Angiogram procedure and the CT scan, through to the Cardiologist, surgeon (s), the nurses, the theatre staff, the intensive care experts, the rehab staff and all the individuals from cleaners to volunteers and management that make this possible.

The fact that so many individuals survive such an operation and we are talking in the ten’s of thousands of individual’s in Australia who have had some sort of heart operation, it is because the system needs people with “content” knowledge at all levels. Imagine meeting your Surgeon who has a MBA from Harvard, maybe impressive but have no “knowledge” and experience of Cardiothoracic surgery and procedures – would you entertain having the operation?  Thankfully in Australia Health System, in the majority of cases we have at all levels from management and Boards to the nurses – qualified and “content” knowledgeable individuals.

However, how often do we see in organisation where there are situations where there maybe inappropriately qualified individuals, and this even occurs in the health system. So why would we risk not having “content” knowledge individuals in organisations and especially in critical and crucial roles.

And why would Public Sector Leadership not be based on individuals with “content” knowledge, especially where society is trying to address the so complex and wicked problems. 

The argument has always been around policy and service delivery “paralysis” that occurs where organisations and individuals can’t think outside the “box” (the square is only 2D), and the argument is that you need new blood not burdened by the “content” knowledge.

This isn’t the issue at all, the issue is to encourage better and lateral thinking with individuals who have knowledge. This may involve thinking outside the box (3D) and interaction with other sectors and thus other “content” knowledge. This is at the heart of the Rethink concept and movement.

In the words of the founder of the concept of Nature:

 “The most dangerous worldview is the worldview of those who have not viewed the world” 

 Alexander von Humboldt

The emerging New Public Sector Leadership – needs to be based on “content” and thus understanding with a (huge) twist of creativity and the willingness to challenge and Rethink solutions.

The Australian Health system, is an incredible “content” knowledge system that we should be proud off, but still needs to allow for those with knowledge to Rethink and build an even better and healthier society.

The Question is will we lose our way? – Knowledge Matters