In September, the students had the special opportunity to welcome Barrie Dowdeswell, a longtime faculty member as a guest lecturer. Barrie Dowdeswell was formerly the CEO of the Royal Victoria Infirmary in Newcastle and, after his tenure there, moved to the University of New South Wales in Sydney before returning to Europe as the Executive Director of a research organization. He also advised the European Commission and several member states on healthcare issues.
Barrie Dowdeswell opened the course "Fundamentals of Management & Strategic Thinking" with two inspiring lectures on leadership and management in healthcare. Known for his successful reforms in hospital management, he shared valuable experiences with the students. Here are some key points he addressed:
In today’s rapidly evolving healthcare landscape, leadership has never been more crucial—or more complex. The new generation of leaders faces unprecedented challenges, from advancing technologies and changing patient needs to the ongoing demand for cost efficiency and quality care. Traditional top-down management models are giving way to more dynamic, collaborative approaches that emphasize innovation, adaptability, and patient-centered care. As the healthcare sector continues to transform, forward-thinking leaders must embrace these evolving models and cultivate environments where teamwork, responsible autonomy, and creativity thrive.
The future of healthcare leadership is about balancing expertise with empathy, ensuring that both clinical excellence and human connection remain at the heart of care. Barrie explained that during his time as CEO of the Royal Victoria Infirmary he brought clinical staff to the centre of planning and decision-making. This opened the way to adoption of a new strategic plan to reconfigure service strategy and infrastructure investment to improve value and quality of care for the local population.
The first part of this lecture focused on the impact of bureaucratic systems, particularly within healthcare and examined the failures of bureaucratic governance. On this topic, how bureaucracies, originally designed for administrative efficiency, can lead to rigid rule-following, stifling innovation and risk management was also discussed. Reference was made to Henry Mintzberg's theory on organizational structures to highlight how technostructures dominate healthcare. Barrie also took the opportunity to reflect on the future of bureaucracies in healthcare, questioning whether renewal or redundancy is the next step for these large systems. The role of AI (Artificial Intelligence) and its integration into healthcare is seen with skepticism, given the current limitations and risks associated with its implementation.
The succeeding part of the lecture explored the complexities and challenges of hospital management, highlighting the issues faced by administrators within the National Health Service (NHS) and beyond. Managing a hospital is more complex than running a typical corporation due to diverse challenges, including balancing doctors, nurses, patients, families, politicians, funders, and technologies. The shift towards integrated management models, such as Holocracy, involves empowering professionals with responsible autonomy, fostering teamwork, and creating adaptable systems. This approach is seen as necessary for modern hospital management.
To sum, it was emphasized that managing a hospital requires more than administrative skills – it demands an understanding of the interplay between culture, governance, and community dynamics. Thus, fostering "communityship" through open forums and transparent communication with local stakeholders is vital for maintaining trust and support. There is a need to develop internal talent, with fast-track development programs and mentorship being crucial for preparing the next generation of hospital managers.
Eager to contribute to an up and coming topic in public health? Join us in developing such conversations for the health sector in our next Best Practice or Distinguished Guest Lectures! Register for ‘Estimating the Economic burden of healthcare – Associated Infections and antimicrobial resistance’ by Dr. Hao Li (School of Public Health, Wuhan University) here.
Guest lecture by Barrie Dowdeswell for master's students of International Health & Social Management ©Schaar
Barrie Dowdeswell talks about bureaucracy in healthcare management ©Schaar
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