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If implemented, will the privatisation of
the NHS impact on staff motivational
levels within the finance team at
Cambridgeshire Community Services
NHS Trust?
Ryan Gill
129070612
International Business & Economics
Cambridgeshire Community Services NHS Trust
5428
2
1 – Acknowledgments.......................................................................................................... 3
2 - Executive Summary........................................................................................................ 4
3 – Introduction .................................................................................................................... 5
4 - Privatisation in the United Kingdom................................................................................ 6
5 - Analysis on the privatisation of the NHS......................................................................... 7
6 - Staff motivation throughout the NHS .............................................................................. 9
7 - Staff motivation within the finance team at Cambridgeshire Community Services....... 10
8 - Ideologies on what can impact and influence staff motivation...................................... 13
9 - A method finance managers can use to motivate employees ...................................... 22
10 - Recommendations to improve employee motivation .................................................. 23
11 - Evaluation of sources used......................................................................................... 25
12 - Conclusion .................................................................................................................. 27
13 - Bibliography ................................................................................................................ 28
14 - Appendix..................................................................................................................... 31
3
1 – Acknowledgments
I would like to express my appreciation to Michail Karoglou for his valuable suggestions
throughout the preparation of this placement report. His enthusiasm to give his time so
open-handedly has been much respected.
I would also like to thank the staff at Cambridgeshire Community Services for enabling me
to observe their daily operations:
- Louisa Ellington – Head Of Finance
- Paul Spencer – Senior Management Accountant
4
2 - Executive Summary
The report will be based on how staff motivational levels will be affected when an issue
such as privatisation is present. The NHS emphasises its core values on providing good
quality of care to its patients but if an issue like privatisation is implemented within the NHS
this can create change positively and negatively. Primary and secondary research was
conducted to measure how motivated employees with the NHS and the finance team at
Cambridgeshire Community Services are. To evaluate what managers within the finance
team could do to improve employee motivation, an in depth analysis of two motivational
theories was conducted. Maslow’s hierarchy of needs theory describes motivation through
a hierarchy system of five needs, physiological, safety, loving, and self-actualisation
whereas Herzberg two-factor theory explains the factors in the form of hygiene and
motivators in regards to satisfying and dissatisfying employees. Aspects of both factors
play an important role in increasing employee job satisfaction, which is particularly
important when such issues like privatisation surround the NHS. Once applied,
organisations will see a rise in productivity levels, positive staff morale and improved
communication amongst colleagues. Having a motivated workforce is a valuable asset,
which creates value for any organisation in terms of strengthening its position and net
worth. Managers can use various tools in alliance with the two motivational theories to
motivate staff such as social events, weekly team lunches and flexible working hours. The
report also explores the limitations of the two motivational theories, which is key in
deciding which theory to use with the Cambridgeshire Community Services finance team.
5
3 – Introduction
I am currently a placement student at Cambridgeshire Community Services NHS Trust,
located in St Ives, Cambridgeshire. It forms one of many Trusts part of the NHS that looks
after health services across East Anglia. All of the finance operations are conducted
through one office, which is based in St Ives and is responsible for the running of smooth
processes in a variety of health services and health centres associated with the Trust. The
Trust employs 3500 staff and has a turnover of £151m. Employees range from doctors in
health centres, nurses in the community to management accounts in the finance team.
The finance team consists of 25 people comprising of a finance Director, finance
managers, and management accounts all of who are involved with the financial logistics of
the Trust. Since joining the Trust, it has been growing at a steady rate. As a result positive
actions have occurred such as the radius of where the Trust provides services to has
expanded, although during my time the Trust has lost out on bids it placed for services it
currently provides leading to some employees being transferred to other organisations.
Teamwork and positive staff morale play a pivotal role in dealing with the efficiency of
everyday operations at Cambridgeshire Community Services NHS Trust. As my time has
passed here I began to notice how staff morale could be interrupted. This is due to the
Trust trying to achieve a cost efficiency saving because of reduced funding from the
Government. We hear on a regular basis, how privatisation has been beneficial to many
companies but also how it has made them worse off. As a result I have decided to look
into how staff motivational levels within a finance team can be affected by such an issue of
privatisation.
6
4 - Privatisation in the United Kingdom
Privatisation can be defined as the transfer of assets from a public sector organisation to a
privately owned organisation (Sloman, 2012). In the UK, many large firms once belonged
to the Government, however in the 1980s the conservative Government decided to sell
publically owned organisations such as British Airways, British Telecom, British Gas and
this period was called Thatcherism (Johnson, 1988). An example of a successfully
implemented privatisation in the UK was British Telecom. This was because it benefited
from improved efficiency due to competition within the telecoms industry as many firms
embraced competitive pricing strategy. However an example of an industry where
privatisation didn’t work was the rail industry. This is because efficiencies existed through
competitive prices but for successful competition to occur there had to be an open market,
which didn’t in this industry thus a monopoly, was created.
7
5 - Analysis on the privatisation of the NHS
The NHS is the only major publically owned organisation belonging to the Government and
on several occasions been considered to be privatised. The first advantage that
privatisation would bring to the NHS is improved efficiency. This is because efficiency in
public sector organisations relates to hierarchal structure and general expenditure, which
is poor, as it isn’t making a profit. An example was in 2014, where the NHS was quoted for
wasting “£2bn on unnecessary treatments” (The Guardian, 2014). This fuels the argument
for privatisation as the first thing a profit incentive firm would do change the structure of an
organisation to create savings. Secondly, privatisation would bring better quality of service
through competition, as patients would have choice. Currently within the NHS, quality of
care is criticised regularly by patients for poor treatment and in certain hospitals poor food
being offered. In 2014, a report found that “poor quality NHS care kills 10,000 people a
year” (The Guardian, 2014). If privatised the market leader in the healthcare industry is the
one who provides the best quality of care, which will attract customers, as the organisation
will be operating for profit. Thirdly, privatisation would bring raised revenue from the sale. If
the Government sells the NHS it could raise a significant amount of revenue from it, which
can be used to fund aspects of the UK economy to improve its current economic position.
Privatisation also has its disadvantages. Firstly a natural monopoly could transpire which is
when the number of firms in a particular industry is just one. Privatisation can negatively
impact the healthcare industry because if there is no competition it will lead to a monopoly
being created because within the healthcare sector internal competition exists between
Trusts but if a privatised firm takes over it has the ability to charge a high price for the
service being provided. Secondly the Government will lose out on future dividends
8
because once it sells a public organisation, any revenue made by the private firm after the
sale belongs solely to them. If taken over, the NHS will raise large amounts of revenue, as
the nation is dependent on healthcare. Finally industries such as healthcare are not
usually profit driven because employees work to help people. However privatising the NHS
this could change meaning profit incentive firms will alter employee mind-sets as they will
want to work for money and not to help people which questions if quality of care will
actually improve.
9
6 - Staff motivation throughout the NHS
To be motivated, employees have to be listened to, acknowledged and recognised. An
article by Belinda Finlayson (2002) showed motivational levels of staff within the NHS. The
article shares an example of how employees were motivated through the chairman of a
NHS Trust spending time with employees by asking questions about their role and offering
advice, which made them feel wanted. Next, the main concern within the NHS is staff
shortages which had left staff feeling stressed, overwhelmed and as a result, quality of
care began to drop. Another issue within the NHS is workloads are constantly changing
due to the variance in decisions made by the Government. A nurse stated the amount of
work “to be covered in a given time had increased in every clinical area she knew”
(Finlayson, 2002. p5). Staff said that with increased workloads they expected a reward but
in fact they were, “inadequately rewarded” (Finlayson, 2002. p6). Also some staff left
private sector organisations to work for the NHS and had taken a drop in wages with the
hope of advancement in their respective NHS organisation, which had rarely been the
case. Whenever pay related issues surrounding the NHS were mentioned, the main
reason staff felt unmotivated and decided to leave the organisation was due to the lack of
recognition by managers (Kaur, 2014).
Figure 1 – results of a NHS survey on staff wanting to change jobs whilst working within
the NHS. (Finlayson, 2002).
Staff wanting to change jobs
Yes	
  
No	
  
10
7 - Staff motivation within the finance team at Cambridgeshire Community Services
To understand how motivated employees are in the finance team at Cambridgeshire
Community Services, I devised a short questionnaire, which is in the appendix of this
report. The results are displayed below:
The first question I asked was to get a sense of how employees within the finance team at
Cambridgeshire Community Services felt within in their job role. The results showed that
all 10 of the people asked enjoyed working at Cambridgeshire Community Services, which
led me to believe they were all happy and motivated within their job role.
0%	
  
20%	
  
40%	
  
60%	
  
80%	
  
100%	
  
Yes	
   No	
  
Do you enjoy working at CCS?
Do	
  you	
  enjoy	
  
working	
  at	
  CCS?	
  
Within your job do you feel as if there
is job advancement?
Yes	
  
No	
  
11
Job advancement was the topic for the second question. I felt this was important to ask
because it is a pivotal aspect of motivation. This time 70% felt like they had some sort of
job advancement opportunity whereas 30% felt they didn’t.
The first two questions were asked to understand how employees felt at present so I
reversed the topic area in the third question to get an understanding of how motivated
employees felt if privatisation was to be implemented. The results were as I expected
because 80% felt they felt unmotivated about their job role and the final 10% felt neutral on
this and 10% still felt motivated.
0	
  
10	
  
20	
  
30	
  
40	
  
50	
  
60	
  
70	
  
80	
  
90	
  
UnmoCvated	
   Neutral	
   MoCvated	
  
How motivated would you feel if
privatisaton was implemented?
How	
  moCvated	
  would	
  
you	
  feel	
  if	
  privaCsaton	
  
was	
  implemented?	
  
Would you be affected by change that
privatisation would bring?
Yes	
  
No	
  
12
Prior to asking these questions I had an idea that the results of the fourth question would
be how they were purely because of the general negativity around privatisation. Some
people like change whereas others don’t and the results of the fifth question showed this
as 90% of employees felt they would be affected by change and 10% felt they wouldn’t.
Relationships with colleagues are an important part of life at work. At Cambridgeshire
Community Services the work environment is very friendly and all employees get along
with each other and the results reflect this because 70% of staff said they would feel
unhappy if their colleague lost their job, 20% said they would be unaffected if someone lost
their job and 10% said they were happy.
I then decided to come back to the job advancement topic again with the seventh question
but with the issue of privatisation added to it. This time the results were split 50/50 proving
that staff feel like they wont have chance to advance in their job due to privatisation.
How would feel if one of your colleagues
lost their job?
Unhappy	
  
Not	
  Affected	
  
Happy	
  
0	
  
10	
  
20	
  
30	
  
40	
  
50	
  
60	
  
Yes	
   No	
  
Would	
  you	
  feel	
  as	
  if	
  you	
  have	
  job	
  advancement	
  if	
  changes	
  
due	
  to	
  priva8sa8on	
  took	
  place?	
  
Would	
  you	
  feel	
  as	
  if	
  you	
  
have	
  job	
  advancement	
  if	
  
changes	
  due	
  to	
  
privaCsaCon	
  took	
  place?	
  
13
8 - Ideologies on what can impact and influence staff motivation
Sadri and Bowen defined motivation as “the physiological processes that guide an
individual towards a specific goal and causes that person to pursue that particular goal”
(Sadri and Bowen, 2011. p45). Conversely, French said motivation is “the forces within an
individual that account for the level, direction and persistence of effort expected at work”
(French, 2011. p158).
Within the Cambridgeshire Community Services finance team; each employee is different
in regards to their personality or work ethic hence they are motivated in different ways.
This means aspects of one strategy cant be used to motivate all employees. On the other
hand if managers don’t implement any motivational strategies they could lose staff all
together. To see which strategies works best for the finance team at Cambridgeshire
Community Services, a critical analysis of two motivational theories, Maslow’s Hierarchy
Of Needs and Herzberg’s Two-Factor theory has been conducted.
Maslow (1954) outlined five basic needs that contribute to motivation in the workplace;
physiological needs, safety needs, loving needs, esteem needs and self-actualisation
needs. He said that individuals are always becoming, not always stationary within
themselves and when one of the needs is met they drive to fulfil the next one.
Physiological needs are at the bottom of the hierarchal structure and include employees
having access to food, water, shelter, air and sleep. Kaur (2013) said if a hungry employee
were present within an organisation they would not be able to make an adequate
contribution within their job. For example currently within the Cambridgeshire Community
14
Services finance team physiological needs aren’t being met because there isn’t enough
funding to employee staff on the full time basis meaning employees are having work
longer hours to complete work causing them to have less sleep. Maslow also said that
monetary value plays an important role within physiological needs, which Sadri and Bowen
backed up by stating, “80% of what companies spend is due to employee wages” (Sadri
and Bowen, 2011. p45). This proves employee’s work for money and companies have to
spend their earnings to keep their workforce motivated through providing reasonable
wages. If privatisation occurred, the Cambridgeshire Community Services finance team
would feel demotivated because private firms strive to make a profit by minimising costs,
which would affect employees, as redundancies will occur.
Safety needs are the need for employees to feel safe and secure. Kaur (2013) said for
employees to feel safe, organisations have to provide acceptable salaries that will allow
them to live reasonably. Furthermore, the less income they receive the more likely they are
to live in an area with less safety and vice versa. Privatisation will again impact on this
need because of the profit motive, as jobs will be cut leading to redundancies. Employees
will lose out, as they know they wont feel safe and secure both internally and externally
within their job.
Loving needs is the wish to be loved and have a sense of belonging within an
organisation. This is seen as a major motivator for employees and one that employers
have to target when devising plans on how to motivate their workforce. Kaur said for loving
needs to be met organisations should “encourage social events such as picnics and
bowling” (Kaur, 2013. p1062) as employees will feel accepted by others. Sadri and Bowen
took this further by saying “individuals who are looking to satisfy their loving needs are
15
more likely to join or continue working at a company based on relationships” (Sadri and
Bowen, 2011. p47). Privatisation can impact on this need because cost cutting will lead to
job losses, friendships broken and employees will not feel like they have a sense of
belonging.
Maslow’s esteem need includes the need for responsibility, reputation, recognition and
respect from others. If met it leads to the increase in self-confidence and improves an
employees motivation. Sadri and Bowen (2011) said the lack of recognition towards
employees is one of the fundamental reasons why employees leave their job, which; if this
need is met the opposite occurs. Privatisation can impact on this need because currently
within the Cambridgeshire Community Services finance team there a lot of managers who
oversee staff and compliment staff for good work. The main goal of a private company is to
change the hierarchal structure to cut the amount of managers there are. As a result this
can lead to more senior staff, such as directors not recognising good work from lower lever
employees.
The final tier of Maslow’s hierarchy is self-actualisation, which is the need for self-fulfilment
and for an employee to become the best in what they are capable in becoming. Self-
actualisation needs are described as “reaching one’s full potential, and it is self-
perpetuating because it has no predetermined end point” (Reid-Cunningham, 2008. p15).
Currently within the Cambridgeshire Community Services finance team, senior managers
push staff to attend courses to build knowledge and skills set so they understand their job
role better. Privatisation can impact on this because the change it brings through for
example job losses will interrupt the goals of motivation an employee may have.
16
Maslow’s theory has proved popular which means it does have its benefits but also some
criticisms. The first beneficial aspect of the theory is that it recognises potential in different
employees. For example highly paid employees are not exempt from needing to be
motivated at some stage of their career therefore higher needs from this theory can be
used to do so. Another benefit is the theory focuses solely on individuals and doesn’t get
side tracked from this. It is a benefit because when managers come to applying the theory
in the work place they will be in the mind-set of motivating individuals and have no reason
to use external factors to assist them.
Moving on to criticisms, the first is that some employees, as they move up the managerial
hierarchy begin to ignore lower order needs and focus on higher order needs as
employees feel these motivate them more in pursuing career goals. This is a criticism
because Maslow assumed that all employees start from the bottom and work their way up
to the top but he didn’t take into account that each individual is different. This also shows
when Maslow devised his theory he didn’t place enough significance on lower order
needs, which as a consequence, employees are able to easily skip them and apply ones
relevant to them. French (2011) supported this as he recognised employees base their
needs on their career stage and geographic location, which are factors Maslow didn’t
analyse. Another criticism is based on Maslow’s assumption that everyone is the same, as
he stated an individual’s behaviour relates to all needs. This is a false conjecture because
individuals are different in terms of their performance levels therefore it cannot be
assumed everyone is the same. The second criticism of the theory is that it doesn’t apply
to one particular culture. This is because in western culture employment is readily
available meaning employees focus on higher order needs as they want to pursue career
paths, but ignore lower order needs as these are already in place due to laws and
17
regulations. However in developing countries they appreciate lower order needs, as they
are harder to come by because things such as clean water and food are not as accessible
as they are in the west. Finally a criticism made by Reid-Cunningham outlined self-
actualisation as a need that didn’t exist because she stated, “self actualisation is
considered to be nothing but a romantic notion based on hopeful wishes about human
nature” (Reid-Cunningham, 2008. p23) which shows Maslow’s theory is too adventurous.
Herzberg’s two-factor theory is another of many motivation theories and was devised by
Fredrick Herzberg. The two-factor theory focussed primarily on job satisfaction of
employees in a workplace. Herzberg started by asking a range of questions to understand
what motivates employees but also what doesn’t motivate employees. Hyun & Oh (2011)
suggested within the two-factor theory there were two factors driving employee motivation,
one, motivation factors and two hygiene factors. Hyun & Oh (2011) also said motivators
are purely for personal growth, passion for the job and an opportunity for personal
advancement whereas Herzberg himself said that the role of hygiene factors were to avert
employee discontent and didn’t lead to higher levels of motivation but without them
employee dissatisfaction would exist.
Motivators are known as satisfiers and relate to job content, which is what an individual
does in their job (French, 2011). To improve employee job satisfaction, employers must
use a range of motivators, which include methods for analysing achievement, recognition
of good work, type of work offered and level of responsibility given to an employee.
Herzberg’s theory stated that if any of the motivators were missing then employees weren’t
satisfied and wouldn’t perform well in their job. If privatisation was implemented within the
NHS, the motivators would need to be reviewed and analysed. This is because as shown
by the questionnaire results, staff at would feel demotivated if privatisation occurred,
18
therefore to keep staff satisfied managers would need to carefully implement the a range
motivators to keep productivity levels high.
Hygiene factors are known as dissatisfiers and are linked with job context, which refers to
a persons work setting (French, 2011). These factors don’t associate with a person’s job
but include conditions surrounding the job such as company policy, relationships
colleagues and relationships with managers (Gibson, 2000). Having hygiene factors
prevent people from feeling dissatisfied at work. For instance, if there are good
interpersonal relations within the team, Herzberg said these don’t motivate employees
alone it keeps them satisfied within their job. In regards to the issue of privatisation,
hygiene factors would need to be considered because employees wont be motivated with
just motivators they need to feel satisfied but also not dissatisfied with their job which
comes from hygiene factors, meaning managers must use both factors. An argument by
Simons and Enz (1995) said that hygiene factors such as job security were more important
than motivators like interesting work when satisfying hotel employees. I agree with this
based on my questionnaire results because job security was seen as a tool of stability that
employees want within the finance team at Cambridgeshire Community Services.
Table 1: How employees feel when both motivators and hygiene factors are combined.
Low Hygiene Factors High Hygiene Factors
Low
Motivators
Unmotivated workforce with
lots of complaints.
Employees have few objections
but are not highly motivated.
High
Motivators
Employees are motivated but
still have a lot of complaints.
Employees are highly motivated
and have no complaints.
19
The two-factor theory has been used globally by organisations due to the benefits it
presents. Firstly it is beneficial because it recognises extensive issues that need to be
tackled in the workplace. For example, if employees feel unconvinced about their job
security, managers can try to diminish the demotivating effect by being accessible and
reassuring employees about the situation. Another benefit is in terms of pinpointing factors
that motivate and demotivate employees as some are in the control of managers whereas
others are outside their control. The clear distinction between motivating and demotivating
factors allows managers to focus on ones within their control meaning outside factors will
not impact on employee performance negatively. For example if a manager provides an
employee with more responsibility, something in their control, they will be happy within
their job role and this will positively impact on their personal life, something out of their
control.
There has been much debate about the validity of the two-factor theory, which has
generated the following criticisms. Initially the theory is criticised through the unclear
differentiation between motivators and hygiene factors. This is applicable to money
because some individuals say this is a motivator factor whereas others say it is a hygiene
factor. French (2011) stated employees who have low salaries felt dissatisfied but by
paying them more doesn’t actually motivate them, it is other surrounding factors that
improve job satisfaction. He elaborated this further by saying that money is a motivator, in
return for hard work. Dartey-Baah on the other hand identified money to be a hygiene
factor by saying “economic conditions and family members make money a big issue for
employees” (Dartey-Baah, 2011. p6). By having this misunderstanding between what is a
motivator factor or hygiene factor means people have different opinions so no one knows
whose is accurate. Another criticism of the two-factor theory is Herzberg didn’t take into
20
account factors such as age, sex, social status and occupational levels. Such factors
impact on what level of importance is placed on motivator and hygiene factors in regards
to job satisfaction. For example in respect to a persons age the younger they are the more
likely they are to want recognition from their manager for good work whereas the older
they are the more likely they are to want job advancement. Lastly the two-factor theory is
criticised as there is no balance between motivators and hygiene factors. Nowadays
employees strive to want responsibility within their job but if managers give too much of
this it keeps employees happy but they may not be prepared for such responsibility leaving
them feeling overwhelmed and eventually demotivated. With no clear balance identified
between the factors in Herzberg’s theory managers can be mislead into thinking they are
doing good for their workforce but in actual fact to much good can be bad.
Both theories are content theories hence they are alike. Firstly they link together as both
stress on the needs of individuals. Maslow identified needs in a hierarchical structure
whereas Herzberg outlined needs through motivators and hygiene factors. French (2011)
said that hygiene factors are associated with a persons work setting, which compliments
Maslow’s physiological, safety and loving needs as they include elements of an individuals
work setting through food, water, safety, and relationships at work. Another way in which
these two theories compliment each other is in the criteria as to how individuals are
motivated. Maslow does this through stating what each of the needs compromise of and
Herzberg did this through stating what hygiene and motivators consist of, which is
beneficial to managers at Cambridgeshire Community Services as they can easily apply
either of the theories to issues within the company.
21
The models also have their differences. Maslow said that each stage is seen as a
motivator when employees move up the hierarchal scale, whereas Herzberg said the
hygiene stage only results in a employee being satisfied in their job not actually being
motivated as this comes from the motivator stage in the theory. This shows that Maslow’s
theory is clearer for managers as they can easily distinguish between types of employees
in regards to how they are driven to go to each stage whereas with Herzberg’s two factor
theory, the cross over between hygiene factors and motivators are unclear meaning
managers will find it harder to implement this ideology. A final difference is that Maslow
developed the model based on personal experience whereas Herzberg based his theory
on empirical research. This therefore proves Maslow’s theory is more valid whereas with
Herzberg creating it on based research generates an argument as to how accurate it is.
22
9 - A method finance managers can use to motivate employees
Having done an analysis on two commonly used motivational theories; I believe the most
suited one for the finance team at Cambridgeshire Community Services is Maslow’s
hierarchy of needs theory. The reason I have chosen to use this theory is because of the
more in depth emphasis it places on the needs of individuals over Herzberg’s two-factor
theory. By placing an importance on individuals needs it allows managers within the
finance team to easily tailor each stage of the theory to employees depending on their job
role. For example a general employee within the Trust like a administrative assistant,
managers are able to focus on correcting lower order needs to keep them motivated
because these are more important to them whereas management accountants seek more
promotion opportunities which allows managers to place emphasis on higher order needs.
It is this easy distinction between the needs of the theory and how they are applicable to
an employee that makes it so attractive to use.
23
10 - Recommendations to improve employee motivation
In the tough and unknown times ahead for the Cambridgeshire Community Services
finance team, it is important managers act as leaders and role models to their staff. As a
result this will provide staff with assurance within their job role, which will then positively
reflect on their performance. Below I have provided four recommendations for the
Cambridgeshire Community Services finance team to keep staff motivation levels high
based on what I feel is missing from the team.
The first recommendation I have outlined is for managers to take the finance team out of
weekly Friday lunches. I see this as a good motivational strategy because not only will it
be held on a day every employee looks forward to, Friday, it get employees out of the
office. It also allows the whole team to bond together, discuss issues and relax but
additionally it enables them to feel like they are on the same level. I also see this as a
good strategy because it gives employees something to look forward to so they are driven
to complete their work by Friday.
The second recommendation is for free food to be provided by managers. Offering free
food and snacks goes a long way in motivating employees because it makes them feel
happy about their job. An example of how this recommendation can be taken further is
every fortnight, the finance management team at Cambridgeshire Community Services
providing lunch. By doing this, employees will feel as though they are part of the team but
also it is something for them to look forward to.
24
Newcombe, T. (2012), said that an employees voice is important to a successful business.
I agree with this because employees that make their voice heard regarding issues within a
business, makes a business aware of this and it can be eradicated. This ties to my third
recommendation, which is monthly mentoring of employees. It is essentially a manager
within the Cambridgeshire Community Services finance team assigning themselves to an
employee, meeting with them one to one, and allowing employees to raise any issues they
may have. By doing this on the monthly basis, managers can see what issues exist within
the team and then they can try to eliminate them. From an employee’s perspective, by
managers doing this they will feel assured and confident to talk about anything they want,
as they know the manager is listening to them.
Barton, T. (2013), said it is important for employees to have a work life balance. Kaur took
this further by stating “socialisation is one of the factors that keep employee feel the spirit
of working in a team” (Kaur, 2013. p1063). The final recommendation is to introduce social
events outside of work because it is proven to reduce stress levels, encourages team
bonding and boosts overall health and wellbeing. In regards to Cambridgeshire
Community Services I recommend a weekly five a side football match or netball match
being held. By doing this, again it gives employees something to look forward to, it allows
them to unwind from work, but more importantly it is a topic of conversation within the
office, which encourages the team to communicate with each other.
25
11 - Evaluation of sources used
Throughout this whole report I have used a range of varied studies. Some have allowed
me to understand the foundations of privatisation along with the theories of Maslow and
Herzberg whereas others have allowed me go deeper and look at the issue of privatisation
both positively and negatively.
Some studies I researched allowed me understand that privatisation isn’t new in the United
Kingdom. Johnson, C (1988) backed this up because his report was written when major
industries were being privatised. This consequently allowed me to recognise how the
telecoms industry was privatised which enabled me to understand what goes into the
decision making for this process to privatise an industry and why it is being discussed for
the NHS.
To get an understanding of motivation throughout the NHS I used a report by Finlayson
(2002). This report was useful as it linked to my questionnaire results. Kaur (2014) allowed
me to understand employee motivation within the NHS more recently which enabled me to
compare it to how it was in 2002 in reference to Finlayson’s analysis. By doing this I was
able to build up a broad analysis of motivational levels within the NHS so that when it
came to applying the theories of Maslow and Herzberg to Cambridgeshire Community
Services, it could be done easily.
On the other hand some studies were conducted internationally. For example Hyun (2011)
was conducted in Korea but this article allowed me to understand the Herzberg two-factor
26
theory from an international perspective. As a result I was able to stretch my knowledge of
how this theory has been used both nationally and internationally.
I found it very difficult to find various studies relating directly to the NHS and privatisation.
This was surprising because such an issue has been around for a very long time and if
these sources were available it would’ve given me a clearer and direct understanding as to
why the privatisation of the NHS has not taken place.
27
12 - Conclusion
Many clashing views have been discussed on the issue privatisation and how staff
motivation levels will be affected if it was implemented. There is an evident and underlying
reason why the Government today hasn’t taken this decision purely because it isn’t viable.
To have a successful workforce, techniques to motivate staff have to be carefully applied
because each individual is motivated differently. Strategies to do so must be prioritised
within the finance team at Cambridgeshire Community Services because the future of the
Trust remains uncertain and this uncertainty impacts on employees. From my personal
experience within the finance team at Cambridgeshire Community Services, uncertainty
doesn’t agree with employees as they begin to feel anxious and stressed, meaning
motivational measures to eradicate this need to be considered.
Privatisation is an issue of much debate. In my opinion I think it shouldn’t even be
considered because the NHS has been providing a service funded by tax payers money
for many years which has been relatively successful therefore this shouldn’t change. By
shifting the way the NHS is run, in the short term there will be implications such as job
losses but looking long term it would turn the NHS into an unproductive monopoly.
For managers within Cambridgeshire Community Services to enjoy good productivity
levels, accurate financial results and deadlines being met they have to ensure the correct
motivational methods are implemented because a motivated workforce leads to low staff
turnover and a loyal workforce.
28
13 - Bibliography
Barton, T. (2013). The motivational impact of sports and social clubs. Available:
http://www.employeebenefits.co.uk/benefits/staff-motivation/the-motivational-impact-of-
sports-and-social-clubs/102923.article. Last accessed 15th March 2015.
Campbell, D. (2014). NHS wastes over £2bn a year on unnecessary or expensive
treatments. Available: http://www.theguardian.com/society/2014/nov/05/nhs-wastes-over-
2-bn-on-unnecessary-treatment. Last accessed 10 February 2015.
Campbell, D. (2014). Poor NHS care kills up to 10,000 people a year, CQC chief claims.
Available: http://www.theguardian.com/society/2014/sep/16/poor-nhs-care-kills-10000-
people-a-year-cqc-head-david-prior. Last accessed 10 February 2015.
Finlayson, B (2002). Counting The Smiles, morale and motivation in the NHS. London:
Kings Fund. p1-8.
French, R. (2011). Motivation And Empowerment. In: Schermerhorn Jr, J and Hunt, J.
Organisational Behaviour. 2nd ed. West Sussex: John Wiley & Sons Ltd. p161-170.
Gibson, J., Ivanevich, L., John, M. & Donnelly, J. H. (2000), “Organisations-Behaviour-
Structure-Processes”’ 10th Edition. Boston. McGraw-Hill.
29
Hyun, S and Oh, H. (2011). Reexamination of Herzbergs Two Factor Theory of Motivation
in the Korean Army Foodservice Operations. Journal of Foodservice Business Research.
14 (3), p100-121.
Johnson, C (1988). Lloyds Bank Annual Review Privatisation And Ownership. London:
Pinter Publishers Limited. p1-7.
Kaur, A. (2013). Maslow’s Need Hierarchy Theory:. Global Journal of Management and
Business Studies. 3 (10), p1062-1064.
Kaur, K. (2014). Staff motivation and morale issues in the NHS. Available:
http://www.employeebenefits.co.uk/benefits/staff-motivation/kuljit-kaur-staff-motivation-
and-morale-issues-in-the-nhs/103812.article. Last accessed 8th February 2015.
Maslow, A. H. (1954). Motivation and personality. New York: Harper. p97 – 99
Newcombe, T. (2012). "Employee voice" is a key to a successful business, says Nita
Clarke. Available: http://www.hrmagazine.co.uk/hro/news/1075669/-employee-voice-key-
successful-business-nita-clarke. Last accessed 14th March 2015.
Reid-Cunningham, A. (2008). Maslow’s Theory of Motivation and Hierarchy of Human
Needs:. Running Head: Human Needs. 1 (1), p15-24
30
Sadri, G and Bowen Clarke, R (2011). Meeting employee requirements: Maslow's
hierarchy of needs is still a reliable guide to motivating staff. Industrial Engineer. 43 (10),
p44-48.
Simons, T & Enz, C. (1995). Motivating Hotel Employees: Beyond the Carrot and the Stick.
Cornell Hotel and Restaurant Administration Quarterly. 36 (1), p20-27.
Sloman, J (2012). Economics. 8th ed. London: Pearson Education. p391-400.
31
14 - Appendix
Appendix A - Questionnaire on motivation in Cambridgeshire Community Services
1) Do you enjoy working in the finance team here at Cambridgeshire Community
Services?
Yes No
2) Within your job role do you feel there is a chance for job advancement?
Yes No
3) If privatisation were implemented within the NHS how motivated would you feel within
your job role? (1= Not Motivated, 2= Neutral, 3= Motivated)
1, 2, 3
4) Would you feel affected by the change that privatisation would bring?
Yes No
5) How would you feel if a work colleague lost their job due to privatisation changes?
(1=Unhappy 2=Unaffected 3= Happy)
1, 2, 3
6) Would you feel as if you have job advancement if changes due to privatisation were
took place?
Yes No

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If implemented, will the privatisation of the NHS impact on staff motivation levels within the finance team a Cambridgeshire Community Services NHS Trust?

  • 1. If implemented, will the privatisation of the NHS impact on staff motivational levels within the finance team at Cambridgeshire Community Services NHS Trust? Ryan Gill 129070612 International Business & Economics Cambridgeshire Community Services NHS Trust 5428
  • 2. 2 1 – Acknowledgments.......................................................................................................... 3 2 - Executive Summary........................................................................................................ 4 3 – Introduction .................................................................................................................... 5 4 - Privatisation in the United Kingdom................................................................................ 6 5 - Analysis on the privatisation of the NHS......................................................................... 7 6 - Staff motivation throughout the NHS .............................................................................. 9 7 - Staff motivation within the finance team at Cambridgeshire Community Services....... 10 8 - Ideologies on what can impact and influence staff motivation...................................... 13 9 - A method finance managers can use to motivate employees ...................................... 22 10 - Recommendations to improve employee motivation .................................................. 23 11 - Evaluation of sources used......................................................................................... 25 12 - Conclusion .................................................................................................................. 27 13 - Bibliography ................................................................................................................ 28 14 - Appendix..................................................................................................................... 31
  • 3. 3 1 – Acknowledgments I would like to express my appreciation to Michail Karoglou for his valuable suggestions throughout the preparation of this placement report. His enthusiasm to give his time so open-handedly has been much respected. I would also like to thank the staff at Cambridgeshire Community Services for enabling me to observe their daily operations: - Louisa Ellington – Head Of Finance - Paul Spencer – Senior Management Accountant
  • 4. 4 2 - Executive Summary The report will be based on how staff motivational levels will be affected when an issue such as privatisation is present. The NHS emphasises its core values on providing good quality of care to its patients but if an issue like privatisation is implemented within the NHS this can create change positively and negatively. Primary and secondary research was conducted to measure how motivated employees with the NHS and the finance team at Cambridgeshire Community Services are. To evaluate what managers within the finance team could do to improve employee motivation, an in depth analysis of two motivational theories was conducted. Maslow’s hierarchy of needs theory describes motivation through a hierarchy system of five needs, physiological, safety, loving, and self-actualisation whereas Herzberg two-factor theory explains the factors in the form of hygiene and motivators in regards to satisfying and dissatisfying employees. Aspects of both factors play an important role in increasing employee job satisfaction, which is particularly important when such issues like privatisation surround the NHS. Once applied, organisations will see a rise in productivity levels, positive staff morale and improved communication amongst colleagues. Having a motivated workforce is a valuable asset, which creates value for any organisation in terms of strengthening its position and net worth. Managers can use various tools in alliance with the two motivational theories to motivate staff such as social events, weekly team lunches and flexible working hours. The report also explores the limitations of the two motivational theories, which is key in deciding which theory to use with the Cambridgeshire Community Services finance team.
  • 5. 5 3 – Introduction I am currently a placement student at Cambridgeshire Community Services NHS Trust, located in St Ives, Cambridgeshire. It forms one of many Trusts part of the NHS that looks after health services across East Anglia. All of the finance operations are conducted through one office, which is based in St Ives and is responsible for the running of smooth processes in a variety of health services and health centres associated with the Trust. The Trust employs 3500 staff and has a turnover of £151m. Employees range from doctors in health centres, nurses in the community to management accounts in the finance team. The finance team consists of 25 people comprising of a finance Director, finance managers, and management accounts all of who are involved with the financial logistics of the Trust. Since joining the Trust, it has been growing at a steady rate. As a result positive actions have occurred such as the radius of where the Trust provides services to has expanded, although during my time the Trust has lost out on bids it placed for services it currently provides leading to some employees being transferred to other organisations. Teamwork and positive staff morale play a pivotal role in dealing with the efficiency of everyday operations at Cambridgeshire Community Services NHS Trust. As my time has passed here I began to notice how staff morale could be interrupted. This is due to the Trust trying to achieve a cost efficiency saving because of reduced funding from the Government. We hear on a regular basis, how privatisation has been beneficial to many companies but also how it has made them worse off. As a result I have decided to look into how staff motivational levels within a finance team can be affected by such an issue of privatisation.
  • 6. 6 4 - Privatisation in the United Kingdom Privatisation can be defined as the transfer of assets from a public sector organisation to a privately owned organisation (Sloman, 2012). In the UK, many large firms once belonged to the Government, however in the 1980s the conservative Government decided to sell publically owned organisations such as British Airways, British Telecom, British Gas and this period was called Thatcherism (Johnson, 1988). An example of a successfully implemented privatisation in the UK was British Telecom. This was because it benefited from improved efficiency due to competition within the telecoms industry as many firms embraced competitive pricing strategy. However an example of an industry where privatisation didn’t work was the rail industry. This is because efficiencies existed through competitive prices but for successful competition to occur there had to be an open market, which didn’t in this industry thus a monopoly, was created.
  • 7. 7 5 - Analysis on the privatisation of the NHS The NHS is the only major publically owned organisation belonging to the Government and on several occasions been considered to be privatised. The first advantage that privatisation would bring to the NHS is improved efficiency. This is because efficiency in public sector organisations relates to hierarchal structure and general expenditure, which is poor, as it isn’t making a profit. An example was in 2014, where the NHS was quoted for wasting “£2bn on unnecessary treatments” (The Guardian, 2014). This fuels the argument for privatisation as the first thing a profit incentive firm would do change the structure of an organisation to create savings. Secondly, privatisation would bring better quality of service through competition, as patients would have choice. Currently within the NHS, quality of care is criticised regularly by patients for poor treatment and in certain hospitals poor food being offered. In 2014, a report found that “poor quality NHS care kills 10,000 people a year” (The Guardian, 2014). If privatised the market leader in the healthcare industry is the one who provides the best quality of care, which will attract customers, as the organisation will be operating for profit. Thirdly, privatisation would bring raised revenue from the sale. If the Government sells the NHS it could raise a significant amount of revenue from it, which can be used to fund aspects of the UK economy to improve its current economic position. Privatisation also has its disadvantages. Firstly a natural monopoly could transpire which is when the number of firms in a particular industry is just one. Privatisation can negatively impact the healthcare industry because if there is no competition it will lead to a monopoly being created because within the healthcare sector internal competition exists between Trusts but if a privatised firm takes over it has the ability to charge a high price for the service being provided. Secondly the Government will lose out on future dividends
  • 8. 8 because once it sells a public organisation, any revenue made by the private firm after the sale belongs solely to them. If taken over, the NHS will raise large amounts of revenue, as the nation is dependent on healthcare. Finally industries such as healthcare are not usually profit driven because employees work to help people. However privatising the NHS this could change meaning profit incentive firms will alter employee mind-sets as they will want to work for money and not to help people which questions if quality of care will actually improve.
  • 9. 9 6 - Staff motivation throughout the NHS To be motivated, employees have to be listened to, acknowledged and recognised. An article by Belinda Finlayson (2002) showed motivational levels of staff within the NHS. The article shares an example of how employees were motivated through the chairman of a NHS Trust spending time with employees by asking questions about their role and offering advice, which made them feel wanted. Next, the main concern within the NHS is staff shortages which had left staff feeling stressed, overwhelmed and as a result, quality of care began to drop. Another issue within the NHS is workloads are constantly changing due to the variance in decisions made by the Government. A nurse stated the amount of work “to be covered in a given time had increased in every clinical area she knew” (Finlayson, 2002. p5). Staff said that with increased workloads they expected a reward but in fact they were, “inadequately rewarded” (Finlayson, 2002. p6). Also some staff left private sector organisations to work for the NHS and had taken a drop in wages with the hope of advancement in their respective NHS organisation, which had rarely been the case. Whenever pay related issues surrounding the NHS were mentioned, the main reason staff felt unmotivated and decided to leave the organisation was due to the lack of recognition by managers (Kaur, 2014). Figure 1 – results of a NHS survey on staff wanting to change jobs whilst working within the NHS. (Finlayson, 2002). Staff wanting to change jobs Yes   No  
  • 10. 10 7 - Staff motivation within the finance team at Cambridgeshire Community Services To understand how motivated employees are in the finance team at Cambridgeshire Community Services, I devised a short questionnaire, which is in the appendix of this report. The results are displayed below: The first question I asked was to get a sense of how employees within the finance team at Cambridgeshire Community Services felt within in their job role. The results showed that all 10 of the people asked enjoyed working at Cambridgeshire Community Services, which led me to believe they were all happy and motivated within their job role. 0%   20%   40%   60%   80%   100%   Yes   No   Do you enjoy working at CCS? Do  you  enjoy   working  at  CCS?   Within your job do you feel as if there is job advancement? Yes   No  
  • 11. 11 Job advancement was the topic for the second question. I felt this was important to ask because it is a pivotal aspect of motivation. This time 70% felt like they had some sort of job advancement opportunity whereas 30% felt they didn’t. The first two questions were asked to understand how employees felt at present so I reversed the topic area in the third question to get an understanding of how motivated employees felt if privatisation was to be implemented. The results were as I expected because 80% felt they felt unmotivated about their job role and the final 10% felt neutral on this and 10% still felt motivated. 0   10   20   30   40   50   60   70   80   90   UnmoCvated   Neutral   MoCvated   How motivated would you feel if privatisaton was implemented? How  moCvated  would   you  feel  if  privaCsaton   was  implemented?   Would you be affected by change that privatisation would bring? Yes   No  
  • 12. 12 Prior to asking these questions I had an idea that the results of the fourth question would be how they were purely because of the general negativity around privatisation. Some people like change whereas others don’t and the results of the fifth question showed this as 90% of employees felt they would be affected by change and 10% felt they wouldn’t. Relationships with colleagues are an important part of life at work. At Cambridgeshire Community Services the work environment is very friendly and all employees get along with each other and the results reflect this because 70% of staff said they would feel unhappy if their colleague lost their job, 20% said they would be unaffected if someone lost their job and 10% said they were happy. I then decided to come back to the job advancement topic again with the seventh question but with the issue of privatisation added to it. This time the results were split 50/50 proving that staff feel like they wont have chance to advance in their job due to privatisation. How would feel if one of your colleagues lost their job? Unhappy   Not  Affected   Happy   0   10   20   30   40   50   60   Yes   No   Would  you  feel  as  if  you  have  job  advancement  if  changes   due  to  priva8sa8on  took  place?   Would  you  feel  as  if  you   have  job  advancement  if   changes  due  to   privaCsaCon  took  place?  
  • 13. 13 8 - Ideologies on what can impact and influence staff motivation Sadri and Bowen defined motivation as “the physiological processes that guide an individual towards a specific goal and causes that person to pursue that particular goal” (Sadri and Bowen, 2011. p45). Conversely, French said motivation is “the forces within an individual that account for the level, direction and persistence of effort expected at work” (French, 2011. p158). Within the Cambridgeshire Community Services finance team; each employee is different in regards to their personality or work ethic hence they are motivated in different ways. This means aspects of one strategy cant be used to motivate all employees. On the other hand if managers don’t implement any motivational strategies they could lose staff all together. To see which strategies works best for the finance team at Cambridgeshire Community Services, a critical analysis of two motivational theories, Maslow’s Hierarchy Of Needs and Herzberg’s Two-Factor theory has been conducted. Maslow (1954) outlined five basic needs that contribute to motivation in the workplace; physiological needs, safety needs, loving needs, esteem needs and self-actualisation needs. He said that individuals are always becoming, not always stationary within themselves and when one of the needs is met they drive to fulfil the next one. Physiological needs are at the bottom of the hierarchal structure and include employees having access to food, water, shelter, air and sleep. Kaur (2013) said if a hungry employee were present within an organisation they would not be able to make an adequate contribution within their job. For example currently within the Cambridgeshire Community
  • 14. 14 Services finance team physiological needs aren’t being met because there isn’t enough funding to employee staff on the full time basis meaning employees are having work longer hours to complete work causing them to have less sleep. Maslow also said that monetary value plays an important role within physiological needs, which Sadri and Bowen backed up by stating, “80% of what companies spend is due to employee wages” (Sadri and Bowen, 2011. p45). This proves employee’s work for money and companies have to spend their earnings to keep their workforce motivated through providing reasonable wages. If privatisation occurred, the Cambridgeshire Community Services finance team would feel demotivated because private firms strive to make a profit by minimising costs, which would affect employees, as redundancies will occur. Safety needs are the need for employees to feel safe and secure. Kaur (2013) said for employees to feel safe, organisations have to provide acceptable salaries that will allow them to live reasonably. Furthermore, the less income they receive the more likely they are to live in an area with less safety and vice versa. Privatisation will again impact on this need because of the profit motive, as jobs will be cut leading to redundancies. Employees will lose out, as they know they wont feel safe and secure both internally and externally within their job. Loving needs is the wish to be loved and have a sense of belonging within an organisation. This is seen as a major motivator for employees and one that employers have to target when devising plans on how to motivate their workforce. Kaur said for loving needs to be met organisations should “encourage social events such as picnics and bowling” (Kaur, 2013. p1062) as employees will feel accepted by others. Sadri and Bowen took this further by saying “individuals who are looking to satisfy their loving needs are
  • 15. 15 more likely to join or continue working at a company based on relationships” (Sadri and Bowen, 2011. p47). Privatisation can impact on this need because cost cutting will lead to job losses, friendships broken and employees will not feel like they have a sense of belonging. Maslow’s esteem need includes the need for responsibility, reputation, recognition and respect from others. If met it leads to the increase in self-confidence and improves an employees motivation. Sadri and Bowen (2011) said the lack of recognition towards employees is one of the fundamental reasons why employees leave their job, which; if this need is met the opposite occurs. Privatisation can impact on this need because currently within the Cambridgeshire Community Services finance team there a lot of managers who oversee staff and compliment staff for good work. The main goal of a private company is to change the hierarchal structure to cut the amount of managers there are. As a result this can lead to more senior staff, such as directors not recognising good work from lower lever employees. The final tier of Maslow’s hierarchy is self-actualisation, which is the need for self-fulfilment and for an employee to become the best in what they are capable in becoming. Self- actualisation needs are described as “reaching one’s full potential, and it is self- perpetuating because it has no predetermined end point” (Reid-Cunningham, 2008. p15). Currently within the Cambridgeshire Community Services finance team, senior managers push staff to attend courses to build knowledge and skills set so they understand their job role better. Privatisation can impact on this because the change it brings through for example job losses will interrupt the goals of motivation an employee may have.
  • 16. 16 Maslow’s theory has proved popular which means it does have its benefits but also some criticisms. The first beneficial aspect of the theory is that it recognises potential in different employees. For example highly paid employees are not exempt from needing to be motivated at some stage of their career therefore higher needs from this theory can be used to do so. Another benefit is the theory focuses solely on individuals and doesn’t get side tracked from this. It is a benefit because when managers come to applying the theory in the work place they will be in the mind-set of motivating individuals and have no reason to use external factors to assist them. Moving on to criticisms, the first is that some employees, as they move up the managerial hierarchy begin to ignore lower order needs and focus on higher order needs as employees feel these motivate them more in pursuing career goals. This is a criticism because Maslow assumed that all employees start from the bottom and work their way up to the top but he didn’t take into account that each individual is different. This also shows when Maslow devised his theory he didn’t place enough significance on lower order needs, which as a consequence, employees are able to easily skip them and apply ones relevant to them. French (2011) supported this as he recognised employees base their needs on their career stage and geographic location, which are factors Maslow didn’t analyse. Another criticism is based on Maslow’s assumption that everyone is the same, as he stated an individual’s behaviour relates to all needs. This is a false conjecture because individuals are different in terms of their performance levels therefore it cannot be assumed everyone is the same. The second criticism of the theory is that it doesn’t apply to one particular culture. This is because in western culture employment is readily available meaning employees focus on higher order needs as they want to pursue career paths, but ignore lower order needs as these are already in place due to laws and
  • 17. 17 regulations. However in developing countries they appreciate lower order needs, as they are harder to come by because things such as clean water and food are not as accessible as they are in the west. Finally a criticism made by Reid-Cunningham outlined self- actualisation as a need that didn’t exist because she stated, “self actualisation is considered to be nothing but a romantic notion based on hopeful wishes about human nature” (Reid-Cunningham, 2008. p23) which shows Maslow’s theory is too adventurous. Herzberg’s two-factor theory is another of many motivation theories and was devised by Fredrick Herzberg. The two-factor theory focussed primarily on job satisfaction of employees in a workplace. Herzberg started by asking a range of questions to understand what motivates employees but also what doesn’t motivate employees. Hyun & Oh (2011) suggested within the two-factor theory there were two factors driving employee motivation, one, motivation factors and two hygiene factors. Hyun & Oh (2011) also said motivators are purely for personal growth, passion for the job and an opportunity for personal advancement whereas Herzberg himself said that the role of hygiene factors were to avert employee discontent and didn’t lead to higher levels of motivation but without them employee dissatisfaction would exist. Motivators are known as satisfiers and relate to job content, which is what an individual does in their job (French, 2011). To improve employee job satisfaction, employers must use a range of motivators, which include methods for analysing achievement, recognition of good work, type of work offered and level of responsibility given to an employee. Herzberg’s theory stated that if any of the motivators were missing then employees weren’t satisfied and wouldn’t perform well in their job. If privatisation was implemented within the NHS, the motivators would need to be reviewed and analysed. This is because as shown by the questionnaire results, staff at would feel demotivated if privatisation occurred,
  • 18. 18 therefore to keep staff satisfied managers would need to carefully implement the a range motivators to keep productivity levels high. Hygiene factors are known as dissatisfiers and are linked with job context, which refers to a persons work setting (French, 2011). These factors don’t associate with a person’s job but include conditions surrounding the job such as company policy, relationships colleagues and relationships with managers (Gibson, 2000). Having hygiene factors prevent people from feeling dissatisfied at work. For instance, if there are good interpersonal relations within the team, Herzberg said these don’t motivate employees alone it keeps them satisfied within their job. In regards to the issue of privatisation, hygiene factors would need to be considered because employees wont be motivated with just motivators they need to feel satisfied but also not dissatisfied with their job which comes from hygiene factors, meaning managers must use both factors. An argument by Simons and Enz (1995) said that hygiene factors such as job security were more important than motivators like interesting work when satisfying hotel employees. I agree with this based on my questionnaire results because job security was seen as a tool of stability that employees want within the finance team at Cambridgeshire Community Services. Table 1: How employees feel when both motivators and hygiene factors are combined. Low Hygiene Factors High Hygiene Factors Low Motivators Unmotivated workforce with lots of complaints. Employees have few objections but are not highly motivated. High Motivators Employees are motivated but still have a lot of complaints. Employees are highly motivated and have no complaints.
  • 19. 19 The two-factor theory has been used globally by organisations due to the benefits it presents. Firstly it is beneficial because it recognises extensive issues that need to be tackled in the workplace. For example, if employees feel unconvinced about their job security, managers can try to diminish the demotivating effect by being accessible and reassuring employees about the situation. Another benefit is in terms of pinpointing factors that motivate and demotivate employees as some are in the control of managers whereas others are outside their control. The clear distinction between motivating and demotivating factors allows managers to focus on ones within their control meaning outside factors will not impact on employee performance negatively. For example if a manager provides an employee with more responsibility, something in their control, they will be happy within their job role and this will positively impact on their personal life, something out of their control. There has been much debate about the validity of the two-factor theory, which has generated the following criticisms. Initially the theory is criticised through the unclear differentiation between motivators and hygiene factors. This is applicable to money because some individuals say this is a motivator factor whereas others say it is a hygiene factor. French (2011) stated employees who have low salaries felt dissatisfied but by paying them more doesn’t actually motivate them, it is other surrounding factors that improve job satisfaction. He elaborated this further by saying that money is a motivator, in return for hard work. Dartey-Baah on the other hand identified money to be a hygiene factor by saying “economic conditions and family members make money a big issue for employees” (Dartey-Baah, 2011. p6). By having this misunderstanding between what is a motivator factor or hygiene factor means people have different opinions so no one knows whose is accurate. Another criticism of the two-factor theory is Herzberg didn’t take into
  • 20. 20 account factors such as age, sex, social status and occupational levels. Such factors impact on what level of importance is placed on motivator and hygiene factors in regards to job satisfaction. For example in respect to a persons age the younger they are the more likely they are to want recognition from their manager for good work whereas the older they are the more likely they are to want job advancement. Lastly the two-factor theory is criticised as there is no balance between motivators and hygiene factors. Nowadays employees strive to want responsibility within their job but if managers give too much of this it keeps employees happy but they may not be prepared for such responsibility leaving them feeling overwhelmed and eventually demotivated. With no clear balance identified between the factors in Herzberg’s theory managers can be mislead into thinking they are doing good for their workforce but in actual fact to much good can be bad. Both theories are content theories hence they are alike. Firstly they link together as both stress on the needs of individuals. Maslow identified needs in a hierarchical structure whereas Herzberg outlined needs through motivators and hygiene factors. French (2011) said that hygiene factors are associated with a persons work setting, which compliments Maslow’s physiological, safety and loving needs as they include elements of an individuals work setting through food, water, safety, and relationships at work. Another way in which these two theories compliment each other is in the criteria as to how individuals are motivated. Maslow does this through stating what each of the needs compromise of and Herzberg did this through stating what hygiene and motivators consist of, which is beneficial to managers at Cambridgeshire Community Services as they can easily apply either of the theories to issues within the company.
  • 21. 21 The models also have their differences. Maslow said that each stage is seen as a motivator when employees move up the hierarchal scale, whereas Herzberg said the hygiene stage only results in a employee being satisfied in their job not actually being motivated as this comes from the motivator stage in the theory. This shows that Maslow’s theory is clearer for managers as they can easily distinguish between types of employees in regards to how they are driven to go to each stage whereas with Herzberg’s two factor theory, the cross over between hygiene factors and motivators are unclear meaning managers will find it harder to implement this ideology. A final difference is that Maslow developed the model based on personal experience whereas Herzberg based his theory on empirical research. This therefore proves Maslow’s theory is more valid whereas with Herzberg creating it on based research generates an argument as to how accurate it is.
  • 22. 22 9 - A method finance managers can use to motivate employees Having done an analysis on two commonly used motivational theories; I believe the most suited one for the finance team at Cambridgeshire Community Services is Maslow’s hierarchy of needs theory. The reason I have chosen to use this theory is because of the more in depth emphasis it places on the needs of individuals over Herzberg’s two-factor theory. By placing an importance on individuals needs it allows managers within the finance team to easily tailor each stage of the theory to employees depending on their job role. For example a general employee within the Trust like a administrative assistant, managers are able to focus on correcting lower order needs to keep them motivated because these are more important to them whereas management accountants seek more promotion opportunities which allows managers to place emphasis on higher order needs. It is this easy distinction between the needs of the theory and how they are applicable to an employee that makes it so attractive to use.
  • 23. 23 10 - Recommendations to improve employee motivation In the tough and unknown times ahead for the Cambridgeshire Community Services finance team, it is important managers act as leaders and role models to their staff. As a result this will provide staff with assurance within their job role, which will then positively reflect on their performance. Below I have provided four recommendations for the Cambridgeshire Community Services finance team to keep staff motivation levels high based on what I feel is missing from the team. The first recommendation I have outlined is for managers to take the finance team out of weekly Friday lunches. I see this as a good motivational strategy because not only will it be held on a day every employee looks forward to, Friday, it get employees out of the office. It also allows the whole team to bond together, discuss issues and relax but additionally it enables them to feel like they are on the same level. I also see this as a good strategy because it gives employees something to look forward to so they are driven to complete their work by Friday. The second recommendation is for free food to be provided by managers. Offering free food and snacks goes a long way in motivating employees because it makes them feel happy about their job. An example of how this recommendation can be taken further is every fortnight, the finance management team at Cambridgeshire Community Services providing lunch. By doing this, employees will feel as though they are part of the team but also it is something for them to look forward to.
  • 24. 24 Newcombe, T. (2012), said that an employees voice is important to a successful business. I agree with this because employees that make their voice heard regarding issues within a business, makes a business aware of this and it can be eradicated. This ties to my third recommendation, which is monthly mentoring of employees. It is essentially a manager within the Cambridgeshire Community Services finance team assigning themselves to an employee, meeting with them one to one, and allowing employees to raise any issues they may have. By doing this on the monthly basis, managers can see what issues exist within the team and then they can try to eliminate them. From an employee’s perspective, by managers doing this they will feel assured and confident to talk about anything they want, as they know the manager is listening to them. Barton, T. (2013), said it is important for employees to have a work life balance. Kaur took this further by stating “socialisation is one of the factors that keep employee feel the spirit of working in a team” (Kaur, 2013. p1063). The final recommendation is to introduce social events outside of work because it is proven to reduce stress levels, encourages team bonding and boosts overall health and wellbeing. In regards to Cambridgeshire Community Services I recommend a weekly five a side football match or netball match being held. By doing this, again it gives employees something to look forward to, it allows them to unwind from work, but more importantly it is a topic of conversation within the office, which encourages the team to communicate with each other.
  • 25. 25 11 - Evaluation of sources used Throughout this whole report I have used a range of varied studies. Some have allowed me to understand the foundations of privatisation along with the theories of Maslow and Herzberg whereas others have allowed me go deeper and look at the issue of privatisation both positively and negatively. Some studies I researched allowed me understand that privatisation isn’t new in the United Kingdom. Johnson, C (1988) backed this up because his report was written when major industries were being privatised. This consequently allowed me to recognise how the telecoms industry was privatised which enabled me to understand what goes into the decision making for this process to privatise an industry and why it is being discussed for the NHS. To get an understanding of motivation throughout the NHS I used a report by Finlayson (2002). This report was useful as it linked to my questionnaire results. Kaur (2014) allowed me to understand employee motivation within the NHS more recently which enabled me to compare it to how it was in 2002 in reference to Finlayson’s analysis. By doing this I was able to build up a broad analysis of motivational levels within the NHS so that when it came to applying the theories of Maslow and Herzberg to Cambridgeshire Community Services, it could be done easily. On the other hand some studies were conducted internationally. For example Hyun (2011) was conducted in Korea but this article allowed me to understand the Herzberg two-factor
  • 26. 26 theory from an international perspective. As a result I was able to stretch my knowledge of how this theory has been used both nationally and internationally. I found it very difficult to find various studies relating directly to the NHS and privatisation. This was surprising because such an issue has been around for a very long time and if these sources were available it would’ve given me a clearer and direct understanding as to why the privatisation of the NHS has not taken place.
  • 27. 27 12 - Conclusion Many clashing views have been discussed on the issue privatisation and how staff motivation levels will be affected if it was implemented. There is an evident and underlying reason why the Government today hasn’t taken this decision purely because it isn’t viable. To have a successful workforce, techniques to motivate staff have to be carefully applied because each individual is motivated differently. Strategies to do so must be prioritised within the finance team at Cambridgeshire Community Services because the future of the Trust remains uncertain and this uncertainty impacts on employees. From my personal experience within the finance team at Cambridgeshire Community Services, uncertainty doesn’t agree with employees as they begin to feel anxious and stressed, meaning motivational measures to eradicate this need to be considered. Privatisation is an issue of much debate. In my opinion I think it shouldn’t even be considered because the NHS has been providing a service funded by tax payers money for many years which has been relatively successful therefore this shouldn’t change. By shifting the way the NHS is run, in the short term there will be implications such as job losses but looking long term it would turn the NHS into an unproductive monopoly. For managers within Cambridgeshire Community Services to enjoy good productivity levels, accurate financial results and deadlines being met they have to ensure the correct motivational methods are implemented because a motivated workforce leads to low staff turnover and a loyal workforce.
  • 28. 28 13 - Bibliography Barton, T. (2013). The motivational impact of sports and social clubs. Available: http://www.employeebenefits.co.uk/benefits/staff-motivation/the-motivational-impact-of- sports-and-social-clubs/102923.article. Last accessed 15th March 2015. Campbell, D. (2014). NHS wastes over £2bn a year on unnecessary or expensive treatments. Available: http://www.theguardian.com/society/2014/nov/05/nhs-wastes-over- 2-bn-on-unnecessary-treatment. Last accessed 10 February 2015. Campbell, D. (2014). Poor NHS care kills up to 10,000 people a year, CQC chief claims. Available: http://www.theguardian.com/society/2014/sep/16/poor-nhs-care-kills-10000- people-a-year-cqc-head-david-prior. Last accessed 10 February 2015. Finlayson, B (2002). Counting The Smiles, morale and motivation in the NHS. London: Kings Fund. p1-8. French, R. (2011). Motivation And Empowerment. In: Schermerhorn Jr, J and Hunt, J. Organisational Behaviour. 2nd ed. West Sussex: John Wiley & Sons Ltd. p161-170. Gibson, J., Ivanevich, L., John, M. & Donnelly, J. H. (2000), “Organisations-Behaviour- Structure-Processes”’ 10th Edition. Boston. McGraw-Hill.
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  • 31. 31 14 - Appendix Appendix A - Questionnaire on motivation in Cambridgeshire Community Services 1) Do you enjoy working in the finance team here at Cambridgeshire Community Services? Yes No 2) Within your job role do you feel there is a chance for job advancement? Yes No 3) If privatisation were implemented within the NHS how motivated would you feel within your job role? (1= Not Motivated, 2= Neutral, 3= Motivated) 1, 2, 3 4) Would you feel affected by the change that privatisation would bring? Yes No 5) How would you feel if a work colleague lost their job due to privatisation changes? (1=Unhappy 2=Unaffected 3= Happy) 1, 2, 3 6) Would you feel as if you have job advancement if changes due to privatisation were took place? Yes No