Service Productivity in the Healthcare Sector

Healthcare is a core service field, not least because all of us will be involved at least in consumption if not service delivery. It has improved dramatically over the past century and benefitted from a range of innovations, both technological and organizational. But in the process healthcare delivery has become a very complex process with many different stakeholders involved such that the process and outcomes of these service operations attract intense, often critical, public interest. In this chapter John Bessant looks at one possible route drawing on experiences under ‘extreme’ or ‘crisis’ conditions where the lack of availability of financial and human resources is forcing a radical rethink of approaches to healthcare delivery. In this context there is certainly a need for improvement to service productivity. But this may not be achieved through incremental innovation alone. ‘Doing what we do but better’ is certainly an important part of the prescription and the adoption, for example, of ‘lean’ practices testifies to a constant search for process innovations to improve efficiency. However the challenge is serious enough to require more radical solutions and this raises the question of where and how such solutions might be identified and explored. There are demonstrable examples in places like India, Latin America and Africa and these models owe much to the systematic application of lean principles similar to those which enabled such spectacular productivity gains in the low cost airline industry. The chapter looks both at the how-question but also at the implications for diffusion to more established healthcare systems. It highlights the problems of a ‘not invented here’ response and suggests a process through which learning and transfer of these ideas might take place.