Back in 2002 the new national hospital in Abuja, Nigeria, built with the aim of running to international standards, was losing money hand over fist. Medical staff were being used to handle the commercial operation, which resulted not only in the business end of the hospital being managed inefficiently but also had the effect of taking medical care away from the patients.
It was clear that action needed to be taking to stem the losses - and that external expertise was required.
Nigel Corby, managing director of one of Europe´s leading interim management supply companies Global Executives, explains how one of his interim managers helped claw back the deficit to put the hospital back on its feet.
Lack of management expertise and experience, political tensions and financial difficulties mean operations in developing countries are often uneconomic and inefficiently run. Western expertise is sometimes required to point them in the right direction, train up existing staff and put new systems in place to enable the business to fund itself after a few years.
The national hospital in Abuja was built in 1999 with the aim of being run to international standards. By 2002 it was running at a massive deficit. It needed a massive injection of medium term western management expertise to set it on an even keel and enable it to be self managing within a few years. Cue International Hospitals Group, a specialist organisation that handles all areas of healthcare management for overseas clients.
Although IHG was appointed in the late spring of 2002 no funding was in place until October. As soon as funding became available the hospital wanted a team of directors in place immediately. The uncertainty over when or whether funding will be available means it´s just not feasible for a team of potential permanent employees to be waiting in the wings ready to swoop in and sort out the problems. The only option in the first instance is to bring in a team of interim managers who are available at the drop of a hat. IHG uses a range of different suppliers for the various specialities required - one for health professionals, another for IT experts and a third - Global Executives - for financial directors.
IHG has developed a strong relationship with Global Executives. As one of Europe´s leading IM suppliers, we have a strong reputation for supplying high level interim managers for overseas projects. Global understands how IHG works, the nature of the projects it oversees in a host of third world countries, and the need for immediate top flight, culturally and linguistically fluent managers.
Ideally IHG was after a qualified accountant with Nigerian and healthcare experience. "But," explains Paul Llewellyn; the man appointed through Global Executives as commercial director for the Abuja project, "that person didn´t exist."
"I was in Nigeria for ten years in the 80s and 90s. IHG revised their requirements to include a qualified accountant with Nigerian experience. I had spent ten years in Nigeria and quite fancied the idea of returning."
Paul implemented a number of strategies, which helped streamline the commercial side of the hospital, including installing computerised recording systems and ensuring efficient billing procedures and the hospital´s deficit was reduced by 70 per cent in the first year.
"Whatever I did had a significant impact quickly," explained Paul. "That´s the key thing with IM. There were four areas I had to look at - financial, marketing, medical records and IT. These were all fairly crucial. One of the key requirements was that the hospital became more commercial in its approach and achieved financial stability. It was very important that whatever I did had a massive impact."
IHG finance director Milind Pradhan added: "The hospital was running at a huge deficit. There were issues over the quality of patient care. Very few patients were being treated so we looked at the problems. We increased the turnover by making sure patients were billed properly, ensuring money was collected correctly, that drugs were properly charged for, that the hospital changed its procurement methods by going out to tender rather than buying things as a one off. It was run by civil servants before, and they were not necessarily the best equipped to run a hospital. The doctors ended up running the hospital which wasn´t right."
Although there are a number of people who could have handled the business side of the operation, few could have tackled the cultural side or handled the indigenous staff in the effective and non-confrontational way Paul did. Nigerian experience was critical. The knowledge of overseas culture is as vital as the technical and managerial abilities required.
One of the challenges for providing high level management staff for third world projects is that the economic situation there is such that there is often a considerable time gap between appointing an organisation to supply managers to run the project and finding funding for it. This means it´s not financially viable for a company to have a bank of top managers waiting in the wings on the offchance a project might arise. Additionally, the skills required and the range of third world countries demanding such expertise are usually so precise and so diverse that having a team ready and waiting would never provide precisely the right fit - in terms of management and sector expertise, and linguistic and cultural match - which is why IMs are a perfect solution all round.
It´s very important to be hands on, particularly in developing countries. You need the ability to alternate from a high level role such as giving a presentation to government officials to first level bookkeeping. IMs have to be flexible and adaptable.
Our unique European focus is among three key areas setting us apart from other interim management supply companies. Its determination to concentrate on supplying proactive interim managers exclusively, rather than offer a range of recruitment services, along with our personal and hands-on approach, combines effectively with our ability to interpret a client´s problems and deliver a workable executive solution in less than three weeks.
We supply interim directors, executives and managers across Europe, including the UK and beyond and have a burgeoning worldwide database. Nearly 50% of our work last year came from overseas with almost 90% of that in Europe. More than a third of the interim managers on our database are fluent in a second language, with 35% of those fluent in three or more languages.
Assignment locations so far include Romania, Holland, Kosovo, France, Spain and Germany. Vietnam and Nigeria have featured in our worldwide operating locations. It is essential that companies expanding into other countries take on someone who is not only bilingual, but bicultural. Understanding the culture of the people and how business practice operates in the host country is vital. Using culturally aware and fluent speakers boosts credibility with customers, local employees and peer group managers.
For more information on Global Executives call 01276 671535 or visit www.globalexecutives.com.
