Leadership or management … the challenge of making decisions

I have been reflecting on the challenges President Ramaphosa faces in dealing with the COVID-19 pandemic and his struggle to match the need to consult widely and the need to take decisive decisions that have and will affect the lives of so many. Leadership, irrespective of position, requires the ability to motivate people and take an organisation in a given direction possibly different from that which it had previously taken. Management on the other hand involves systems and processes that allows an organisation to function efficiently and achieve its goals and objectives. Both expect those involved to act in an ethical and honest manner.

This lead me to think about my experiences in leadership and management in my professional career in the health sector. I progressed from a clinically orientated paediatrician ultimately heading an academic department to thereafter spend nearly 20 years heading two provincial departments of health in South Africa. Having spent years achieving various medical degrees and professional qualifications and in clinical practice, I had no formal management training when I was catapulted, with little preparation, into a senior government managerial position in 1995. Subsequent to 1995 while I read widely on management a major part of my steep managerial learning curve came from doing. On the other hand I had gravitated naturally into leadership positions in the sport, social and professional organisations in which I had been involved up to that time.

It is my contention that while great emphasis is placed on strategic leadership which is clearly an important aspect of senior management, far too little emphasis is placed on a key aspect of management, the taking of a difficult decision. In my experience when faced with difficult decisions there is a tendency for issues to be easily lost in the comfort of process. Comfort is taken in the need for decisions to follow a participatory process and the need to involve as many people and constituencies before a decision is reached in the ideally by consensus.

It is important to obtain as much information as possible before making a difficult decision, but the onus rests on the leader and senior management to take the decision. Nothing is more demotivating and indeed paralysing for an organisation than prevarication and procrastination when faced with an important decision. A leader takes the decision and then provides the motivation and impetus to see it through. Leadership and senior management are lonely places and is the reason that people in these positions are remunerated at higher levels than their subordinates.

I am aware that I may be out of step with much of current management dogma and that my management style has in the past been criticised as autocratic. However, faced with the challenges that I faced at the time it was necessary to act decisively to close a hospital or prioritise resources and reduce a budget allocation. My advice to others is to take decisions boldly and rather modify or reverse the decision, as I have done on more than one occasion, should it prove an error. To remain trapped in indecision is a debilitating state both for an individual and an organisation.

So what is needed to be able to take that bold decision? The answer is firstly information. Data is the basis for rational decision-making and in my career I placed great emphasis on the development of systems and processes that provided me with as much data as possible to be able to make the best decision possible. But secondly, courage and conviction as once all the data and all the options have been honestly and rigorously evaluated … a decision must be taken. A leader must then inspire and motivate the organisation to embrace the consequences of the decision.

History will judge President Ramaphosa and his cabinet colleagues on the decisions that they have taken to address the COVID-19 pandemic and the manner in which they were implemented. To do so it will be necessary to understand on what data and information the decisions were based and further the consequences, either negative or positive, of these decisions for the people of South Africa. I have my opinions but for the present I will leave that to historians in the future.