There aren’t a lot of novels about hospital management. A “business novel about a struggling hospital, Pride and Joy takes the reader through a journey of discovery into why good people with good intent struggle to achieve a breakthrough in performance”. Alex Knight is a management consultant who uses the Theory of Constraints; “a belief that inherent simplicity exists: in any goal-oriented system there are only ever a few places that have the power to affect the performance of the whole system—the system’s constraint(s)”. The theory seems quite convincing, and a welcome antidote to the perverse effects of targets on the NHS.
The novel – well I read the whole thing, but mostly for its novelty value. A novel about NHS managers is a bit like a woman preaching, as Dr Johnson would say. The main character suddenly finds herself Acting Chief Executive of a struggling NHS hospital and calls on her friend with whom she studied for her MBA for advice on how to turn it round. The Theory of Constraints is expounded at some length and our heroine abandons the old ways in order to enthuse the entire organisation with its principles. Amazingly length of stay and complaints go down, patient satisfaction and profitably go up. Our heroine is interviewed for the substantive post of Chief Executive but is not appointed, because of lack of experience, but is recruited to implement a change programme across the NHS by the Minister. She doesn’t get into bed with her MBA colleague, or indeed with anyone. Her life seems a bit reminiscent of our own dear Chief Executive, though she doesn’t seem to succumb to so much temptation and she seems healthier. But she doesn’t seem to have any private life – gets to work very early and leaves late.
Alex Knight is an evangelist, and not the first to use a work of fiction to elaborate the principles of his gospel. Its certainly more fun to read, and more digestible, than a management textbook, but perhaps a little too predictable.
316 pages Published by Never Say I Know (NSIK), Church Farm, Station Road, Aldbury, Herts HP23 5RS, England £15.99