(Article published in the Management site in the Netherlands)


Leadership is a fascinating theme full of secrets. There are numerous publications on this subject with so many interesting approaches and yet it remains in my opinion a secret, a mystery. In years of research into leadership, in which I questioned many leaders on the theme of leadership, their leadership, rarely or never they presented a theory on leadership, but each leader had a completely personal answer to this question.

Also I noticed that known authors on the leadership theme like Covey, Quinn or Kotter, but also more unknown authors, present their leadership theory or model that is based on a personally chosen starting point. They choose a base for their leadership reflections such as creating trust, communication between leadership giver and leadership taker, or leadership to create added value and achieve results, or leadership for initiating changes and innovations or concepts about the difference between being a manager and being a leader. Leadership, I concluded, is based on the private capital raised in the person. You can only lead yourself and lead others on the basis of what you have earned yourself and you can only describe it by means of a self-chosen starting point, which ultimately leads to your own leadership practice with your own concept or model.

However it struck me in retrospect that all connect leadership with the fortunes of the community and that when we speak to each other about leadership therefore directly important issues are put on the table about where the people are struggling with in their own living and working practice. A common essence of positive leadership attention from leaders is on how one person can help another person to arrive at their own initiative and take their own responsibility. In practice, however, we also see many examples of how leaders bring the community in trouble, block well-meaning people in their initiatives, frustrate cooperation and speak the word of power in appropriate and inappropriate situations.

Leadership in Healthcare

Many years I advise healthcare organizations and in the past 40 years I also held Supervisory Board functions in that field. Health care, which previously rested on the very loving power of her caregivers for patients, has now become an industry. Many specialists dominate the health process where it is now easier to get a specialized treatment in a professional culture. The basic care suffers from this and she comes short.

The leadership of these institutions has grown into a management system that is trying to keep everything in the grip. Their financiers like the government and the insurance companies enforce this. Everything has to be justified, to be shown in the statistics and this is asked by the managers of their professionals and then the professionals have an on-going administrative effort at the expense again of the care for the client. That does not promote their leadership.

An example

In a hospital the CEO is concerned about the issue of care for the client. He has the idea to go and ask how long patients stay now concretely in the hospital and why this time and not another. To his dismay there were a series of cases in which nobody exactly knew the answer to this question. Patients do not, nor doctors and nurses, nor managers. He decided that every Monday morning together with his management team they would analyse the actual cases that arose and to decide on the spot what should happen to the patient together with the responsible person. That gave a shock effect in the hospital. Everyone was so busy with everything that the patient is more or less out of sight and got lost. Then this director introduced a study on the various work processes and the co-operation between the different departments and how managers and professionals showed leadership. A surgeon, who had to be operated in his own hospital, presented terrifying images on how he, as an acquaintance of this organization, experienced the patient treatment and how there was no common vision on dealing with patients. There was no co-operation between departments, he had to manage his own process, had to make his own decisions and stand on his stripes. It became very clear that this hospital had a leadership problem. There was no clear guidance on customers from the top, the managers did their own thing and the doctors, the nursing staff they were very busy with their specialized tasks, so that the patient saw many different people appear at his bed and they knew nothing of what each one is doing there.

In this hospital this became a key issue for managers and professionals. They dialogued about their leadership and talks were held between stakeholders about where the patient remained in the story and how to improve this. There suddenly appeared opportunities to make very big steps and change the situation. It was possible then that a patient who had to spend a full day to go through the different stages of tests in the past now could pass within an hour the whole process including the process of a final judgment of the responsible doctor. Customer appointments were better planned and the doctors and other specialists were able to do their work on time. In departments where the one nurse was handing out the drugs/medicines and the other guided the patient to the toilet and tomorrow there was another nurse again at the bed for something else, the work process was changed so that patients were treated by familiar faces that care for the different actions to be taken. They could also answer any patient questions and share their concerns. If there is a mental changeover, nudged by the responsible, and people take pleasure in getting their collaboration again in tune with the patient, and managers and physicians together speak in plain language, then suddenly we see a noticeable difference and improvement for the patient, for the manager and for the professional.

Another example

In a nursing home for demented elderly people the staff has for years spoken of customer management and customer care. In a horizontally organized conversation between director, department heads, team leaders and caregiving professionals it was revealed that although there is much talk about this theme however little has been achieved in practice. The pressure on nurses in recent years has increased dramatically, the protocols for all actions have been sharpened, which leads to instructions for the professionals about how many minutes to put the patient in the shower and on the precise number of residents in this shower protocol on a single day. It seems an impossible demand in the practice to really care for the client, which leads to very strange situations in the day-to-day practice. In this conversation many measures in the recent past proved to be anti-customer. The director reflects on this policy and recognizes and expresses that he would actually like to change, but that there are other requirements made by the higher echelons.

Yet there are processes put into motion in which managers and professionals are given the opportunity to try other practices and demonstrate their own leadership. For example this leads to abandon the whole-house equal suppertime and the different departments in consultation with the kitchen can run their own program within agreed limits. This results in variety and much more focused care for clients.

The demented elderly man who gets up early is not compulsively kept in his bed, but can start immediately, while the long-dormant lady in the same department can do so safely. It leads to a noticeable relaxation of residents and staff, better cooperation, a focused look at each resident, a surprising and gratifying result for all. And it is even more effective and efficient.

Especially in the care work, we can see good leadership work. When CEO’s, managers and professionals have a genuine common focus, than there can be done with few resources beautiful things.

A wonderful example for this I read about a retirement home in India with eighty inhabitants. Established by the people themselves, everyone has a role and a task, there is concern for each other, all the processes are done by themselves and there is a fulfilled community that with their minimal resources functions excellently.

Horizontal leadership

Especially in the field of care organizations horizontal leadership can achieve a real improvement so that much of the regulations by politicians and insurance companies would not be needed and the core process of the organization, providing good service to the customers, could be strengthened.

An inspired CEO with heart for the patient and his immediate family, a collaborative management that accompanies all those involved in finding the right way, motivated professionals and therapists supporting the patient’s life but not completely take over the responsibility, this together can lead to a healthy living reality, a viable social reality for all concerned.

For over forty years I have noticed that there is a clear correlation between the functioning of an organization as a community and good leadership. There is, however, not one recipe that obviously leads to a good result. There are entirely different ways exercised as good leadership and organizations can succeed or fail by that.

All this has meant that I first went to see leadership as a process in the organization, as a particular work process and at the same time as a development process of the entire community organized, much more than a model that focuses on the performance of the leader. Leadership is something that everyone can show in his or her own way, it appears but can also disappear.

Also it has gradually become clear to me that leadership has everything to do with the moral questions that we must ask ourselves today. Moral questions are the questions of meaning and which can be especially seen as “why” questions. Why do we do this and why do we do it in this way. Everyday practice divides the people, each doing his own thing. Asking the why question brings people together. In addition moral criteria can be used: for example, the effect of our actions on the customer, on the supplier, on the collaborative community but also on the environment, the freedom and security of those involved. Leadership is a predisposing power; it is a moral force that works in the community. Leadership is in my view mainly related to meaningful questions, to why – questions, and these questions can no longer be only in the hand of the single leader who destines our fate as a community.

We see around us countless major good and bad events that affect our society and its organizations. We immediately see them as a result of good or bad leadership and especially there is the pointing of our finger to the destiny-defining leader. These leaders, however, can only exist today as members of the community when we all ourselves demonstrate leadership, none of us can actually hand over the entire responsibility to the decisive leaders any more.

We are all part of the leadership process and we all then carry moral responsibility. This is a dimension of life that no one of us can escape in organizations and in society. It is time that we start to realize this and act on this on a wide scale.

This idea, where leadership is seen as a process of the community with a moral character, has led me closer to observe the dimensions of a leadership process and the moral character of leadership as it appears in organizations of completely different nature, task and place in the world, and in organizations with a different culture and place in society.

Natural and organized leadership

First of all, I noticed that leadership is traditionally shown in the traditional natural community like a family or a nation or a religious community and that leadership today is also shown in organized contexts in which we work today and often live together with others.

In the natural community leadership is bound to the fixed laws of nature, as natural succession from father to son or mother to daughter and this leadership is keen to continue the natural community with its traditions and customs. There’s as-it-were an implicit moral dimension in secret. You do not abuse your children, for example, and when it happens we are shocked. In contrast, in the organized community this leadership is rather connected with the management and functional tasks and basically everybody can come into this leadership and take part in the leadership process of the organization. Moreover, organizations and the leadership changes constantly, it is still more changing than aiming for maintaining the same. In the organized community it is not obvious to ask the moral question. We do things we cannot really stand for and we want to justify this under the pressure of performing the given goals. The well being of people and nature is constantly under pressure in the organized community.

Then I noticed that leadership in organizations however could function well as moral processes when three conditions are met.

1 The first condition is that the final responsibility persons have an inspired vision on the future of the organization, a vision that is connected to the core task of this organization. This vision is linked to good values ​​that are largely shared in the community population and which correspond to what is pursued as moral in her area. Certain things we do not like as forgetting about the client, the manager putting unwarranted pressure on the employees, exploiting the employee, misuse of money.

2 The second condition is that the managers / leaders of the organization are able both to fulfil their functional, specialized responsibilities in a moral way and that they are willing and able to work together when it comes to changes and innovations and to become personally involved in it. It’s not only about the what- and how question but also about the why question. That question must always be asked.

3 The third condition is that the professionals of the organization are focused on their customers and they serve them with specific products and services and that they continue to do so and to improve their own work process for this to happen and to that end are in a constant learning attitude.

If these three conditions are connected, that is the inspiring vision of the top management is connected to the horizontal development practices of managers, and this is connected to the professionals who make up the core of the client process, and all are prepared to deal with the why question, then these organizations flourish in a responsible way. If they do not connect, then the organization has serious problems to find the proper next steps in its existence.

Organizations and their leaders today are all challenged to take their social responsibility and this responsibility can only be fruitfully working if each of us wants to bring in his own leadership.

Difference between theory and practice

There is in my opinion a big gap between how we think leadership works and how this is shown in all these beautiful functional management theories, and everyday practice in which moral leadership is requested for the community process and is working or not. A multitude of identical unruly life situations I experienced during more than forty years in relation to the ever-advancing comprehensive management literature in those years showed me this. We will have to urgently rise in the broad social context to a reassessment and renewal of views on leadership to overcome the often simple-strong male images on leadership or the complex functional constructs like matrix constructs which the leadership has to work with.

With this survey we tried to offer two starting points for finding and developing a more fundamental approach to leadership in organizations. This approach focusses on leadership as a community process in the organization and leadership as a moral task for any human being that is part of it. This offers us a new and extremely important leadership perspective for all who want to participate in the leadership.

On this IMO site you find the E-book by Adriaan Bekman entitled The mystery of leadership (see IMO Publications).

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