Rod Thomas

Information management and technology in England’s large acute NHS hospitals: national strategy versus local reality

Discusses the NHS Executives information management and technology (IM&T) strategy and its relationship to the 1991 reforms. Examines the recommendation for large acute hospitals to adopt integrated hospital information support systems (HISS). Reports that a recent census of these hospitals, undertaken by the authors, suggests that the implementation of the strategys recommendations has been slow at the local level. Attempts to diagnose the factors that are impeding implementation, using the evidence provided by the census. Identifies four main problem areas: the lack of success of past IM&T initiatives undermines confidence in the current strategy; the strategy is poorly aligned with other policy initiatives; the legacy of discrete, proprietary information systems within hospitals makes the creation of an integrative information environment difficult to accomplish without massive investment in new systems; and there are implicit contradictions between the following: the absence of a comprehensive post-implementation evaluation of the economic, technological and cultural feasibility of HISS at any of the three HISS pilot sites; the strategys advocacy of HISS as the way forward for large acute hospitals; the requirement for a comprehensive business case to support any substantial investment in IM&T. Concludes that a massive rethink of policy is required, with a much greater emphasis on research, development and independent evaluation.

Is the Viable System Model of organization inimical to the concept of human freedom

Abstract This paper examines the sensitivity of Stafford Beers Viable System Model (VSM) of organization to the concept of human freedom. The paper notes the many critics who have suggested that the VSM is inimical to human freedom and their special reference to its application to the social economy of Chile in the early 1970s. Drawing on the work of philosophers, a conceptual analysis of freedom is provided that suggests a complex ordinary language usage of the term. At least three determinants of freedom, that are logically independent of one another, are identified as being of relevance to its ordinary usage. The paper finds that these determinants are implicitly addressed and acknowledged within Beers own writings, but that they are ignored by the critics of the VSM and that this makes for a lack of clarity and precision in the debate. The paper also applies a further criterion, formulated in political philosophy, to judge whether the leadership of the government that applied the VSM to the Chilean social economy was itself hostile to political freedom or democracy. This application of the criterion suggests that they were not.

An ABC of British higher education

Purpose – This paper marks the centenary year of W. Ross Ashby (1903‐1972), one of the founders of the interdisciplinary subject of cybernetics. Its purpose is to Ashbys cybernetics to construct a framework for understanding some of the features that presently characterise British higher education.Design/methodology/approach – The contents of Ashbys 1956 book, An Introduction to Cybernetics, are outlined. Cybernetic concepts, principles, and laws are then applied to some of the features that presently characterise UK universities: growth in student numbers, the modularisation of curricula, concerns over academic standards, and bureaucracy.Findings – The paper finds Ashbys writings to be critical to understanding the nature of many of the contemporary debates about UK higher education. A diagnosis and critical evaluation of the policy impetus to increase student numbers and modularise curricula is supplied. A cybernetic analysis in support of the current concerns over academic standards is provided. The...

Stafford Beer in memoriam – “An argument of change” three decades on

Purpose – This paper is written in memory of the late Stafford Beer. The paper engages with only one dimension of the whole man: Stafford Beer as the diagnostician and prognostician of the social conditions that he so keenly observed.Design/methodology/approach – The paper revisits a talk that Stafford Beer gave, over three decades ago, to administrators of the UK National Health Service (NHS). It uses the content of the talk, entitled “Health and Quiet Breathing”, to diagnose the problems that have been encountered in the development of NHS information management strategies. The paper concludes with some brief personal recollections of Stafford Beer as a friend and as a teacher.Findings – The paper finds Stafford Beers managerial cybernetics to be a useful tool in understanding many of the problems that have beset NHS information management strategies: lack of operational research, problems in the commodification of information, financial scandal, and bureaucracy. In its examination of these issues, the...