We have been following the anecdotal unfolding of a cost-cutting suggestion put forward by the procurement department of a UK hospital. The idea is to change supplier of surgical gloves and achieve an estimated 20 or so thousand pounds savings a year by using a different grade of latex. While the discussion is private and can’t be unpacked in too much detail, it points to a very important cultural indicator that can be overlooked at times of transition and management in a downturn. So we’d like to spend a moment reflecting on that fine line between what can be reconsidered and what is crippling.
The surgeons’ reaction to the glove change suggestion was vivid, visceral. This from a group who have been under cost reduction pressures and doing more with less for quite a while now. What we find fascinating is how Glovegate has become a turning point in the ongoing discussion with management on how to deliver a service, maintain quality, and do so with less. It has shifted the tone of discussions, surgeons banding together against the antibody, and it has all got rather emotional for such a scientific group.
Basically, that latex glove is where the hand touches the patient, it’s the familiar that needs to stay familiar, the skill bit, and where introducing a variable is not associated with innovation and new ground but causes stress and risk. It’s tactile, real, and right in hand.
We have been doing quite a lot of thinking over the last years around the role of corporate functions, and procurement in particular, in shifting their role away from their day-to-day job (say, getting gloves at a better price) towards more advisory, strategic territory such as facilitating innovation and breaking new ground by bringing different points of view together. To do this successfully, functions need to understand the glove point and pick their battles accordingly.
What is just latex to procurement is the contact point between us and our patients. Would the patient want us to save 50p on their (3 hour plus ie 17p per hour) case and not do their operation with the sense that we were at our best, if not ready for our Olympics, at least ready for the patient’s. Surely even the taxpayer, or the Daily Mail would not begrudge us the best gloves!
Beyond the numbers, what is ‘too far’, what gets emotional, what will become the tipping point of permission for change resistance? We’d venture that for this particular hospital, it’s now the glove, an emblem that enables the surgeons to convey “we’ve had enough” through raising a professional issue, one that helps re-empower them. Listen to what is not said.
And each organisation has its glove point when latex is more than just stuff we buy but is core to how key players perceive and deliver their role and profession. Knowing that is close to knowing the essence of the business or organization a function supports and knowing what to let lie.
This brings us onto the importance of understanding where an organization is now, and equipping individuals to see their part in a system, taking responsibility for their role in relation to the measures set by an organisation in a broad rather than small sense. Patient outcome versus saving a few pounds. When we need both, where is the glove point that, once crossed, hinders the system as a whole?