![\"Martin](\"http:\/\/www.bmj.com\/site\/blog\/icons\/martin_mcshane.jpg\")
I was at a conference, struggling with one of those sharp sticks on which a bit of chicken was impaled whilst holding a plate of food in the other hand, when I noticed a short, bald bloke checking out the conference buffet. It was Greg Dyke.\u00a0 He had come to talk to about 250 managers from across the East Midlands. We had a chat until the conference organisers realised he had arrived and then I returned to my efforts to separate the chicken and the stick.<\/p>\n
When he spoke, I listened.\u00a0 He didn\u2019t use slides and his style was, I would describe as, conversational.\u00a0 I didn\u2019t make notes but he told stories that made me think about leadership, especially in the public sector.<\/p>\n
When he left the BBC (a.k.a. got sacked) staff protested en-masse and he received over six thousand emails of support. He talked to us about what he had done and his view of leadership. Right at the start he said you can\u2019t manage in a culture of fear.\u00a0 The era of \u2018telling\u2019 people what to do is over. Society has changed. He talked about inclusive leadership. Leaders also need to be themselves; don\u2019t try and be something else. If you are eccentric, then be eccentric, if you like a joke, then have a joke and if you are a miserable sod, then they shouldn\u2019t have appointed you.<\/p>\n
What caught my attention most though was his advice about money.\u00a0 Don\u2019t leave the money to the accountants, he said.\u00a0 Accountants like to complicate it.\u00a0 At the BBC they tried to make out it was a business. It isn\u2019t.\u00a0 The BBC takes the licence fee and spends it.\u00a0 What he wanted to know was if the BBC was spending more than it received.<\/p>\n
Nothing could be more relevant to the NHS right now. For a lot of clinicians and even a few managers, the money is something someone else has to worry about, usually the Director of Finance.\u00a0 We can\u2019t afford that attitude now. As commissioners the Treasury has given us a budget to improve health and health services and we are ruled by the Micawber principle.\u00a0<\/p>\n
Commissioners, to a great extent, have little direct control over how that money is spent.\u00a0 The people who spend it are professionals.\u00a0 They can\u2019t leave managing the budget to the accountants. Everyone is responsible and has to take responsibility.<\/p>\n
Collectively we need to know how much we have to spend, how we are spending it and whether it is being spent in the best way possible.\u00a0 The NHS is not that different from the BBC.\u00a0 We have a fixed sum of money. If one professional is spending unnecessarily, inappropriately or ineffectively then they are denying someone, somewhere in the system, necessary, appropriate and effective health care.<\/p>\n
As Mr Dyke says, we all need to understand the money and make it work to best effect.<\/p>\n