【明報專訊】IN recent years, the performance of the Hospital Authority and the MTR has been repeatedly criticised. Chief Executive Carrie Lam Cheng Yuet-ngor has said that in this world there is no organisation that is everlasting and never declines. Public bodies have to undergo self-renewal and, if necessary, the government is willing to help. The tarnished reputation of Hong Kong's public healthcare and railway services is closely related to the internal governance of the Hospital Authority and the MTR. Reforms can no longer be delayed. Big organisations often suffer from structural inertia and have a tendency to maintain the status quo and resist change and reform. From what has been happening in the last few years, one doubts whether the MTR and the Hospital Authority are capable of renewing themselves. Instead of playing only a passive role of helping from the sidelines, the government must assume leadership and intervene vigorously to press these organisations for reforms.
Structural inertia is a common problem facing big organisations. When an organisation develops to a stage in which its structure becomes formalised and institutionalised, negative outcomes arise and the organisation becomes rigid and resistant to change. Because of structural inertia, the organisation becomes slow in responding to change in the external environment. The power of handling emergencies and decision-making is vested in mid-and top-level managers whose communication with frontline staff is often inadequate. Since the managers are unable to understand the problems on the frontline and are not sensitive enough to changes in circumstances, cognitive inertia is common.
Many senior medical practitioners have criticised the Hospital Authority for its bureaucratic red tape and bloated structure. Matters that could have been decided in one meeting in the past often have to go through three or four meetings now before a decision is made. The exodus from public hospitals in recent years has reached one new high after another. This is actually a serious warning signal but the Hospital Authority management has failed to tackle the problem by introducing appropriate measures. As a result, it has triggered a full-blown outburst of resentment among frontline medical practitioners.
If the problem with the Hospital Authority lies in its bloated structure and bureaucratic style, the problem with the governance of the MTR lies in its positioning and orientation. The MTR management puts commercial efficiency above the needs of people in everyday life. It is more concerned about its small stockholders than serving the public. While its businesses have become increasingly complicated, it has failed to do a good job in its principal business of transportation and railway construction. Although there are a number of government officials on the board of the MTR, they have failed to play an active role in supervising and leading the company. The problems of the MTR have therefore further deteriorated.
From the serious cost overruns of the Guangzhou-Shenzhen-Hong Kong Express Rail Link to the scandals of the Shatin-Central Rail Link, the MTR management's slack supervision has shown to be a persistent shortcoming of the company. Reforms have been introduced in recent years but have not brought about any genuine change. The Steering Committee on Review of Hospital Authority published a report a few years ago and many reforms were proposed. However, the problem of governance of the Hospital Authority continues to deteriorate. The structural inertia of a big hierarchical organisation often worsens with time. It is not easy for an organisation to find the motivation for improvement unless it comes under immense external pressure. From the situation of the MTR and the Hospital Authority in the last few years, one doubts whether they are capable of self-renewal. The government must take the initiative in assuming the leading role to demand the Hospital Authority and the MTR change their ways of thinking and rectify their problems by changing their structures and culture of governance.
from the sidelines : not taking part in an activity
bloated : crammed; overgrown
hierarchical : organised into different levels of importance from highest to lowest