The Thursday Question 2:22: Pierre-proofing?

Bureaucratic resilience at work, again

Every large organization, no matter how brittle it appears to be, has ways to insulate itself from outside pressures for change.

Take healthcare organizations. Veterans of healthcare reform can tell you tales that would make your blood run cold. Centralizing and decentralizing, aligning and realigning, firing boards and replacing them, firing CEOs and replacing them - nothing ever seems to reduce wait times or get more people a family doctor (1). Healthcare organizations are reformed so often that they evolve very deep resilience to outside pressure.

Bureaucracies build their resilience against reform in many ways. By insulating their mechanisms for allocating resources. By creating professional colleges and spawning strong unions. By creating new domains of expertise and institutionalizing demand for that expertise. By cooperating with international counterparts to set global standards for professional training and organizational operations. Again, take healthcare. The thicket of health disciplines, professional colleges, unions, health authority processes, and standard setting through WHO and other international bodies all makes local reform more difficult. As one veteran told me, it takes years to find out the problem is embedded in the fifth or sixth layer of an organization’s management, and by the time you get there the premier fires you.

This issue isn’t restricted to healthcare. Academic freedom serves many good purposes, like protecting conservative academics from the dominant culture of the campus (tenure saved my career). It also protects the autonomy of academic processes from outside influence. While in most provinces a university’s board of governors is appointed by cabinet, academic affairs are not under board control. The arrangement insulates academic operations from external reform pressures.

I have recently been looking for reports of federal agencies that are “Pierre-proofing” themselves by taking steps to head off what they anticipate a new government might want to do.