Survival of the unselfish

7 September 2011
Renata Towlson is senior buyer (best practice) at Nottingham University Hospitals NHS TrustA recent edition of the Harvard Business Review published an article about “the unselfish gene”. In it, the idea that individuals are naturally selfish is rebutted, with the suggestion from biologist Martin Novak that “natural cooperation” is a third fundamental principle of evolution alongside mutation and natural selection. This interesting idea, supported by science, might soon alter the way organisations build their systems of incentives and rewards for human resources. In my line of work – NHS procurement - we very often look for potential collaboration, only to end up doing things on our own. Obstacles like bringing all the stakeholders to the table or the “consultation” decision process can take many weeks, sometimes months - or in the case of major contracts even years - to get the go-ahead, thanks to, among other things, inconsistent data. All this often outweighs the advantages of doing things together. Even with the temptation of economy of scale and the additional talent and expertise that collaboration can bring, more often than not collaborative projects fail. The NHS is the biggest employer in Europe. The procurement function should reap massive benefits of working collaboratively in most of its categories. There are some organisational and some cultural reasons why such collaboration does not succeed, but the biggest obstacle is inefficient and corrupted flow of information and data. Until very recently there were many NHS bodies that had no idea what kind of products and services they were purchasing, or in what quantities and quality. Some were extremely surprised to find out they were using multiple ranges of products on different qualitative and pricing scales for the same type of procedures or treatments. There is a need for systems that will capture all this information and data, and also being able to interface with legacy systems in order to capture national information, across all acute Trusts and other public health bodies. My own trust has already started this journey, and no doubt others will follow. Until the time when we finally have all the data at the click of the button, we can only work on changes to culture. The transfer and sharing of knowledge and data – as against legally protected intellectual rights – needs to be revisited by all parties concerned. There is not enough room for detailed analysis here, but I believe the way this category is protected and guarded in Western culture makes collaboration and co-operation extremely difficult. The survival of the NHS depends on an organisational model that will build around our “unselfish” gene, making collaboration the norm rather than a possible, half-hearted option.
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