A formal report, written by the State Hospital Inspectors, concluded that the City Hospital's performance was falling well behind the national performance indicators and targets set for all hospitals. The report's conclusion stated that the hospital was failing its patients. It said that the organisation's bureaucratic structure prevented it from achieving its objective, which was to be far more customer-orientated.
It stated that the hospital's preoccupation with formal procedures hindered its ability to be flexible when responding to the needs of the patients. Too many policies and too much form filling were imposed by the senior management on the operational staff such as nurses and doctors. The consequences of this extra paperwork resulted in fewer patients being treated as quickly and as competently as they could have been. To enable the hospital to reduce its waiting lists for patients needing an operation, the Inspectors suggested that a more flexible organisation structure was required. They said that one possible way to achieve this objective would be for the hospital to empower its front line staff by decentralising and delegating decision-making to the doctors and nurses.
The senior management had serious reservations regarding the recommendations in the Inspector's report. They commented that a hospital was very different to a private enterprise, because its main concern is the welfare of the patients and not profit. They also stated that a bureaucratic system of organisation and specialisation was the most appropriate way to organise a hospital. This, they suggested, was because of the need for tried and tested procedures, implemented by well-trained specialist professionals. Bureaucracy ensured that mistakes seldom occur and consequently did not put the welfare of the patients at risk.

Questions

As independent business adviser, produce a report for the management of the City Hospital which answers the following questions.
(a) Explain the limitations of bureaucratic organisational systems.
(b) Identify the strengths of the bureaucratic system that is used and supported by the hospital’s senior management.
(c) The Inspectors recommended empowering the front line staff. How would this improve the efficiency of the hospital?
(d) Provide recommendations on how the hospital can increase its efficiency to give its patients a better service.