PREAMBLE: For this issue we have selected a recent UN News Release that addresses global consequences of the greed and corruption in the financial industry. While almost all people have been affected by the economic crisis, the World Bank states that the crisis is set to drive 53 million more people into poverty in 2009, seriously threatening the prospect of achieving the Millennium Development Goals.
ECONOMIC CRISIS TO DRIVE MILLIONS INTO POVERTY IN 2009
13 February 2009 – The spreading global economic crisis is set to trap up to 53 million more people in poverty in developing countries this year on top of the 130-155 million driven into poverty in 2008 by soaring food and fuel prices, bringing the total of those living on less than $2 a day to over 1.5 billion, according to the World Bank.
The new forecast highlights the serious threat to achieving the United Nation's Millennium Development Goals (MDGs), which aim to slash poverty, hunger, infant and maternal mortality, and lack of access to health care and education, all by 2015. Preliminary estimates for 2009 to 2015 forecast that an average 200,000 to 400,000 more children a year may die if the crisis persists, making a total of 1.4 to 2.8 million over the period.
“The global economic crisis threatens to become a human crisis in many developing countries unless they can take targeted measures to protect vulnerable people in their communities,” World Bank President Robert B. Zoellick said on the eve of the Group of Seven (G7) finance ministers' meeting of leading industrial countries in Rome on Saturday, which he will attend.
“While much of the world is focused on bank rescues and stimulus packages, we should not forget that poor people in developing countries are far more exposed if their economies falter. This is a global crisis requiring a global solution. The needs of poor people in developing countries must be on the table.”
New estimates for 2009 suggest that lower economic growth rates will trap 46 million more people on less than $1.25 a day than was expected prior to the crisis, for a total of an extra 53 million trapped on less than $2 a day, on top of the 1.37 billion before the current crises.
A World Bank policy note issued in the run up to the G7 meeting reports that almost 40 per cent of 107 developing countries were highly exposed to the effects of the crisis and the remainder were moderately exposed, with less than 10 percent facing little risk.
It is critical for exposed countries to finance job creation, delivery of essential services and infrastructure, and safety net programmes for the vulnerable, according to the note, entitled The Global Economic Crisis: Assessing Vulnerability with a Poverty Lens.
Yet three quarters of these countries cannot raise funds domestically or internationally to finance programmes to curb the effects of the downturn. One quarter of them also lack the institutional capacity to expand spending to protect vulnerable groups. The note urges financial support in the form of grants and low or zero interest loans for these countries.
Mr. Zoellick recently called for the establishment of a Vulnerability Fund in which each developed country would devote 0.7 per cent of its stimulus package to aid poorer countries set up safety net programmes, invest in infrastructure, and support small and medium-sized enterprises and microfinance institutions.
Source: UN News Service. http://www.un.org/apps/news/story.asp?NewsID=29897&Cr=financial&Cr1=crisis
Showing posts with label global. Show all posts
Showing posts with label global. Show all posts
Wednesday, 15 April 2009
Monday, 16 March 2009
LEADERSHIP AND MANAGEMENT OF HEALTH ORGANIZATIONS – 7 QUESTIONS
PREAMBLE: When this issue was first posted on March 16, we attempted to test a 7-day polling function offered by Google. Our trial topic was “health leadership and management”. However, interest in the poll was insufficient, so we removed the questions from our sidebar on March 23. We also reconstructed the material that now follows, to be consistent with this decision.
Given the role of poorly prepared leaders and managers in the global financial crisis, it is possible that a similar crisis may be developing in health organizations.
As a “backgrounder” we supply extracts from an Opinion piece in the Globe and Mail, in which Henry Mintzberg, Cleghorn Professor of Management Studies, McGill University, took aim at “America’s monumental failure of management”. His focus on the global financial crisis and the contribution of US management teaching, including that of Harvard University, stimulated our interest in reflecting on current approaches to health leadership and management and the potential for similar failures.
Reference: Minzberg H. Globe and Mail p A11, March 16, 2009 http://www.theglobeandmail.com/servlet/story/RTGAM.20090313.wcomintzberg16/BNStory/specialComment/home
Comment: One of our concerns is that the current fashion of promoting leadership studies among health professionals early in their career development may be at the cost of first building their management skills; if so, this will eventually adversely impact the managerial competence of their organizations.
BACKGROUNDER
In his critique of American leadership and management training practices, Minzberg states: “American management is still revered across much of the globe for what it used to be. Now, a great deal of it is just plain rotten - detached and hubristic. Instead of rolling up their sleeves and getting engaged, too many CEOs sit in their offices and deem: They pronounce targets for others to meet, or else get fired.”
Further on he addresses “hubris on a massive scale” from which we extract the following:
“Management is a practice, learned in context. No manager, let alone leader, has ever been created in a classroom. Programs that claim to do so promote hubris instead. And that has been carried from the business schools into corporate America on a massive scale."
Minzberg then comments on the iconic Harvard Business School which, according to its MBA website, is ‘focused on one purpose - developing leaders.’ He states: "At Harvard, you become such a leader by reading hundreds of brief case studies, each the day before you or your colleagues are called on to pronounce on what that company should do. Yesterday, you knew nothing about Acme Inc.; today, you're pretending to decide its future. What kind of leader does that create?"
He notes that Harvard prides itself on how many of its graduates make it to the executive suites. He states: “Learning how to present arguments in a classroom… helps. But how do these people perform once they get to those suites? Harvard does not ask. So we took a look.” He then summarizes a study he carried out with a colleague Joseph Lampel:
“Joseph Lampel and I found a list of Harvard Business School superstars, published in a 1990 book by a long-term insider. We tracked the performance of the 19 corporate chief executives on that list, many of them famous, across more than a decade. Ten were outright failures (the company went bankrupt, the CEO was fired, a major merger backfired etc.); another four had questionable records at best. Five out of the 19 seemed to do fine. These figures, limited as they were, sounded pretty damning. (When we published our results, there was nary a peep. No one really cared.)”
OUR SEVEN QUESTIONS ON HEALTH LEADERSHIP AND MANAGEMENT
These questions were composed by the authors of this blog, and required only “yes” or “no” responses, a format that we recognized would severely limit the scope of the exercise. As already noted, responses were insufficient to form a basis for any comment or interpretation, so we removed the poll from this issue on March 23, and offer the same seven question (below), but now with our own commentary.
Introduction: A wide range of educational institutions (with varying capacities in health, leadership and management, from modest to substantial) have a major impact on the preparation of leaders and managers for the health field, yet health systems everywhere are creaking under the strain of expanding need and constrained budgets. We suggest therefore that the time has surely come to examine some related questions regarding leadership and management in the health sector.
The Seven Questions:
1. Like GM, are some health care organizations now “too big to fail”? COMMENT: We believe that this is very much so, and that examples exist at every level, from the World Health Organization to any number of health service entities within countries. What looms large are issues of accountability.
2. Is too much emphasis now being given to “leadership” training for health organizations at the expense of basic management skills? COMMENT: We are aware of numerous instances where individuals have been inside-tracked into leadership training, without having first gone through the process of learning much about health organizations from working within them.
3. Noting a trend towards recruiting CEOs for large health organizations from outside the health system, based on their success in unrelated fields e.g, food, energy, tourism, are such CEOs adequately prepared for the health context? COMMENT: This is a definite risk in political cultures that are more oriented towards cost containment than positive health outcomes.
4. Do such CEOs give enough philosophical commitment (comparable to that of the health professionals they lead) to health goals and objectives? COMMENT: We believe that there is a risk here, and one that needs to be studied. Just how well can "leaders" from outside health identify with health goals, or will business models dominate to the detriment of evidence based services?
5. With such CEOs is there a greater risk of remote leadership with an easy exit out of health in the event of failure? COMMENT: To the extent that health services are viewed as a business, we believe that there is a risk in relation to this trend; while career mobility and sourcing talent are important recruitment considerations, there are also downside risks in relation to loyalty to a health mission e.g, consider the greed and irresponsibility in the financial industry that has surfaced over the past year.
6. Are “leaders” of health organizations receiving disproportionate compensation, driven more by the size of their operating budgets than consistency with evidence of efficacy and positive outcomes, while extolling teamwork and sustainability? COMMENT: We dont know the answer to this, but it is a serious question: if more transparency were to apply to senior levels of the health enterprise, it would be easier for everyone to know.
7. Do teachers of health leadership and management in tertiary education institutions have sufficient health leadership and management experience to relate their teaching to reality? COMMENT: There are many exceptions, but also many people engaged in education and research into health leadership and management have a "product" to promote, not necessarily real experience on how that product actually works.
Disclaimer: The foregoing questions and comments are not cited from any of Minzberg's work, but were stimulated by his opinion piece. We accept responsibility for our exercise, and hope that it may provoke interest in the future of health leadership and management.
Given the role of poorly prepared leaders and managers in the global financial crisis, it is possible that a similar crisis may be developing in health organizations.
As a “backgrounder” we supply extracts from an Opinion piece in the Globe and Mail, in which Henry Mintzberg, Cleghorn Professor of Management Studies, McGill University, took aim at “America’s monumental failure of management”. His focus on the global financial crisis and the contribution of US management teaching, including that of Harvard University, stimulated our interest in reflecting on current approaches to health leadership and management and the potential for similar failures.
Reference: Minzberg H. Globe and Mail p A11, March 16, 2009 http://www.theglobeandmail.com/servlet/story/RTGAM.20090313.wcomintzberg16/BNStory/specialComment/home
Comment: One of our concerns is that the current fashion of promoting leadership studies among health professionals early in their career development may be at the cost of first building their management skills; if so, this will eventually adversely impact the managerial competence of their organizations.
BACKGROUNDER
In his critique of American leadership and management training practices, Minzberg states: “American management is still revered across much of the globe for what it used to be. Now, a great deal of it is just plain rotten - detached and hubristic. Instead of rolling up their sleeves and getting engaged, too many CEOs sit in their offices and deem: They pronounce targets for others to meet, or else get fired.”
Further on he addresses “hubris on a massive scale” from which we extract the following:
“Management is a practice, learned in context. No manager, let alone leader, has ever been created in a classroom. Programs that claim to do so promote hubris instead. And that has been carried from the business schools into corporate America on a massive scale."
Minzberg then comments on the iconic Harvard Business School which, according to its MBA website, is ‘focused on one purpose - developing leaders.’ He states: "At Harvard, you become such a leader by reading hundreds of brief case studies, each the day before you or your colleagues are called on to pronounce on what that company should do. Yesterday, you knew nothing about Acme Inc.; today, you're pretending to decide its future. What kind of leader does that create?"
He notes that Harvard prides itself on how many of its graduates make it to the executive suites. He states: “Learning how to present arguments in a classroom… helps. But how do these people perform once they get to those suites? Harvard does not ask. So we took a look.” He then summarizes a study he carried out with a colleague Joseph Lampel:
“Joseph Lampel and I found a list of Harvard Business School superstars, published in a 1990 book by a long-term insider. We tracked the performance of the 19 corporate chief executives on that list, many of them famous, across more than a decade. Ten were outright failures (the company went bankrupt, the CEO was fired, a major merger backfired etc.); another four had questionable records at best. Five out of the 19 seemed to do fine. These figures, limited as they were, sounded pretty damning. (When we published our results, there was nary a peep. No one really cared.)”
OUR SEVEN QUESTIONS ON HEALTH LEADERSHIP AND MANAGEMENT
These questions were composed by the authors of this blog, and required only “yes” or “no” responses, a format that we recognized would severely limit the scope of the exercise. As already noted, responses were insufficient to form a basis for any comment or interpretation, so we removed the poll from this issue on March 23, and offer the same seven question (below), but now with our own commentary.
Introduction: A wide range of educational institutions (with varying capacities in health, leadership and management, from modest to substantial) have a major impact on the preparation of leaders and managers for the health field, yet health systems everywhere are creaking under the strain of expanding need and constrained budgets. We suggest therefore that the time has surely come to examine some related questions regarding leadership and management in the health sector.
The Seven Questions:
1. Like GM, are some health care organizations now “too big to fail”? COMMENT: We believe that this is very much so, and that examples exist at every level, from the World Health Organization to any number of health service entities within countries. What looms large are issues of accountability.
2. Is too much emphasis now being given to “leadership” training for health organizations at the expense of basic management skills? COMMENT: We are aware of numerous instances where individuals have been inside-tracked into leadership training, without having first gone through the process of learning much about health organizations from working within them.
3. Noting a trend towards recruiting CEOs for large health organizations from outside the health system, based on their success in unrelated fields e.g, food, energy, tourism, are such CEOs adequately prepared for the health context? COMMENT: This is a definite risk in political cultures that are more oriented towards cost containment than positive health outcomes.
4. Do such CEOs give enough philosophical commitment (comparable to that of the health professionals they lead) to health goals and objectives? COMMENT: We believe that there is a risk here, and one that needs to be studied. Just how well can "leaders" from outside health identify with health goals, or will business models dominate to the detriment of evidence based services?
5. With such CEOs is there a greater risk of remote leadership with an easy exit out of health in the event of failure? COMMENT: To the extent that health services are viewed as a business, we believe that there is a risk in relation to this trend; while career mobility and sourcing talent are important recruitment considerations, there are also downside risks in relation to loyalty to a health mission e.g, consider the greed and irresponsibility in the financial industry that has surfaced over the past year.
6. Are “leaders” of health organizations receiving disproportionate compensation, driven more by the size of their operating budgets than consistency with evidence of efficacy and positive outcomes, while extolling teamwork and sustainability? COMMENT: We dont know the answer to this, but it is a serious question: if more transparency were to apply to senior levels of the health enterprise, it would be easier for everyone to know.
7. Do teachers of health leadership and management in tertiary education institutions have sufficient health leadership and management experience to relate their teaching to reality? COMMENT: There are many exceptions, but also many people engaged in education and research into health leadership and management have a "product" to promote, not necessarily real experience on how that product actually works.
Disclaimer: The foregoing questions and comments are not cited from any of Minzberg's work, but were stimulated by his opinion piece. We accept responsibility for our exercise, and hope that it may provoke interest in the future of health leadership and management.
Wednesday, 15 October 2008
GLOBAL ECONOMIC CRISIS, FINANCIAL REFORMS & "THE BROWN DOCTRINE"
PREAMBLE: Over the past month, the world has faced an unprecedented near-collapse of its banking systems. The crisis is not over yet, and – it may fairly be stated – is due to a combination of poor political leadership in the United States (asleep at the wheel) and a combination of greed, negligence and corruption in its financial industry. This of course does not take the inaction and practices of other countries off the hook, as consequential national and global failures are documented extensively elsewhere, especially in Europe. Clearly, no country (rich or poor) has been spared, and it will take many years for individuals, families, communities and societies as a whole to recover from this crisis of greed, neglect and incompetence.
Perhaps needless to say, the necessities of life and the social fabric of all countries e.g, health and educational systems along with secure food supply, clothing and shelter depend on integrity in our financial systems. Trust must be restored in those systems.
Out of this morass some good has come in the leadership of UK Prime Minister Gordon Brown. He has put forward a 5 point plan which appears to have galvanized the world financial community around new principles, thereby giving some hope for the rest of us.
Implicit in the “Brown Doctrine” is an analysis of what is so seriously wrong with the world financial order. It forms a clear case for supra-national supervision of international finance, which clearly cannot any longer be left to the caprices of any one country.
The key features of the Brown Doctrine now follow, extracted from a media report.
Reference: Saunders D. The man who saved the world banking system. Globe and Mail Oct 15, 2008.
THE BROWN DOCTRINE
British Prime Minister Gordon Brown outlined a five-point program yesterday (October 14, 2008) to reform the world’s financial system. He hopes the principles will be the basis of a new set of global institutions to replace those that have governed international finance since 1944.
Transparency: Banks must fully disclose key information globally, not just nationally. Accounting standards will have to become international, and they must extend to the credit-insurance market, which has been heavily criticized.
Integrity: A worldwide effort is needed to end conflicts of interest, such as those involving rating agencies that receive fees from the firms they rate. Worldwide limits also need to be placed on pay and bonuses in banks, so that they reflect actual results and are no longer able to distort business practices.
Responsibility: All members of company boards must hold full responsibility for the company’s risk, and must not be able to walk away from their institutions. This will require international supervision.
Tighter Regulation: To create “a system with solvency and liquidity”, there must be “adequate protection through the economic cycle” to prevent speculators from distorting markets when they are rising and sort positions from having undue impacts when markets are falling.
New Institutions: The new system of banking cooperation will need “a new international financial architecture for the Global Age”. New institutions will provide “an effective global early warning system for the world economy, to alert us to the risks at hand”, and “globally accepted standards of regulation” and the cross-border supervision of global corporations.
Source: Saunders D. The man who saved the world banking system. Globe and Mail Oct 15, 2008.
Perhaps needless to say, the necessities of life and the social fabric of all countries e.g, health and educational systems along with secure food supply, clothing and shelter depend on integrity in our financial systems. Trust must be restored in those systems.
Out of this morass some good has come in the leadership of UK Prime Minister Gordon Brown. He has put forward a 5 point plan which appears to have galvanized the world financial community around new principles, thereby giving some hope for the rest of us.
Implicit in the “Brown Doctrine” is an analysis of what is so seriously wrong with the world financial order. It forms a clear case for supra-national supervision of international finance, which clearly cannot any longer be left to the caprices of any one country.
The key features of the Brown Doctrine now follow, extracted from a media report.
Reference: Saunders D. The man who saved the world banking system. Globe and Mail Oct 15, 2008.
THE BROWN DOCTRINE
British Prime Minister Gordon Brown outlined a five-point program yesterday (October 14, 2008) to reform the world’s financial system. He hopes the principles will be the basis of a new set of global institutions to replace those that have governed international finance since 1944.
Transparency: Banks must fully disclose key information globally, not just nationally. Accounting standards will have to become international, and they must extend to the credit-insurance market, which has been heavily criticized.
Integrity: A worldwide effort is needed to end conflicts of interest, such as those involving rating agencies that receive fees from the firms they rate. Worldwide limits also need to be placed on pay and bonuses in banks, so that they reflect actual results and are no longer able to distort business practices.
Responsibility: All members of company boards must hold full responsibility for the company’s risk, and must not be able to walk away from their institutions. This will require international supervision.
Tighter Regulation: To create “a system with solvency and liquidity”, there must be “adequate protection through the economic cycle” to prevent speculators from distorting markets when they are rising and sort positions from having undue impacts when markets are falling.
New Institutions: The new system of banking cooperation will need “a new international financial architecture for the Global Age”. New institutions will provide “an effective global early warning system for the world economy, to alert us to the risks at hand”, and “globally accepted standards of regulation” and the cross-border supervision of global corporations.
Source: Saunders D. The man who saved the world banking system. Globe and Mail Oct 15, 2008.
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