Uppdaterat: Även idag skriver Sydsvenskan om situationen på Universitetssjukhuset i Lund – här och här.
I dagens Sydsvenskan skriver man om att sjukhuset i Lund har slimmat produktionen till den grad att personalen inte hinner springa iväg på toan eller raster utan att patientsäkerheten hotas. Fyra skyddsombud har i ett brev protesterat till sjukhusledningen. En artikel ur DN skriver om ett ”angränsande” ämne. Nämligen hur man med piller och medicin ”botar” stress och överarbetning.
Förende vårdare har skrivet en längre artikel där man analyserar produktionsförändringarna och vilka konsekvenser det får. Mycket läsvärt:
Den 7 januari hade Sydsvenskan en artikel om förändringarna i organiseringen av arbetet på universitetssjukhuset i Lund. Det konstateras att det behövs allt mer vård i Sverige och sjukhusledningen tacklar inte detta genom att anställa mer personal utan att omorganisera personalgrupperna till sk. Lean Production. Detta ska enligt deras egen utsago ge ”effektivare” vård och kortare väntetider. Modellen har redan införts på flera andra vårdenheter i Sverige bla. på barnmottagnigen i Eslöv och i större delen av sjukvården i Jönköpings län. Dessa, och de omorganiserade enheterna i Lund, påvisar ett enormt språng i produktivitet. ADHD-utredningen på Lunds Universitetssjukhus har tex. ökat sin produktivitet med 50% sedan modellen infördes. Men likt Sydsvenskans artikel lyfter fram finns det utbredd kritik mot Lean Produktion-modellen.
Lean Production kommer ursprungligen från Toyotas bilfabriker i slutet av 60-talet. Istället för den fordistiska produktionsmodellen med rullande band och bestämda stationer för arbetarna där de genomförde ett visst specifikt moment, så organiserade man istället produktionen i team där hela arbetslaget byggde en bil. Modellen infördes i LSS-verksamheten redan under 90-talet. Vi har skrivit en längre artikel om produktionsförändringarna i handikappsvården som du kan läsa här. Vad vi framhåller i den artikeln är att den toyotistiska modellen med Lean Production ger personalgruppen en större autonomi samtidigt som den förlägger allt fler administrativa arbetsuppgifter på vårdarbetarna. Det innebär alltså en större arbetsbelastning. Samtidigt öppnar denna autonomi upp för nya former av kamp som vårdcheferna sedan försöker kväsa genom att föra in kontrollmekanismer från massindustrin på den självstyrande enheten (som tex. stämpelklockor, förmän, datoriserad övervakning osv).
Likt det konstateras i Sydsvenskans artikel är sjukhusen, i motsats till LSS-produktionen, organiserade som massproduktion. De olika avdelningarna utför sina bestämda arbetsmoment (likt stationerna vid det fordistiska rullande bandet). Nu ska de olika avdelningarna på sjukhuset sammanföras i team. Detta innebär att man motiverar grupperna med med ideologiska kurser och uppmaningar att arbetarna ska hålla koll på varandra. Sedan ska resurserna inom teamet ses över och effektiviseras. I förlägningen innebär det att allt fler arbetsuppgifter förläggs på teamet och att man slutligen börjar skära ner på personalen. Förra året sparkades några hundra vårdarbetare från sjukhuset i Lund. I och med omorganiseringen av vårdproduktionen så kommer inte nedskärningarna att avta och istället öka, genom Lena Production inte bara med formella avsked utan också genom stopp på nyanställningar. Framtidens större vårdbehov kommer inte att mötas med mer personalresurser.
Vad innebär då Lean Produktion i det praktiska arbetet? Forskaren Per-Ola Börnfelt säger till Sydsvenskan: Det är mycket retorik om Lean Production, men jag har studerat praktiken. Det handlar om att slimma organisationen. Det handlar inte om att jobba smartare utan att jobba mer intensivt. Att springa istället för att gå. Genom att göra personalgrupperna självstyrande förflyttar cheferna mer ansvar och administration till vårdarbetarna för att sedan få detta att fungera tvingas vårdarbetarna att arbeta intensivare. Börnfelt fortsätter: Det är en tillbakagång till löpande bandet. Visst är det teambaserat – teamet har stort ansvar för produktionen och att komma med förbättringsförslag. Det finns inga pauser, utan under en minut måste man jobba 60 sekunder. Det påvisas även att arbetskadorna ökat sedan Lean Production införts i industrin.
Universitetssjukhusets ledning störde sig så mycket på Per-Ola Börnflets uttalanden i Sydsvenskan att de några dagar efter artikeln skrev en debattartikel där de för ADHD-teamets talan och berättar hur nöjda de är med produktionsmodellen och hur mycket de anser att stressen har minskat. Förenade Vårdare tror att utvecklingen på sjukhuset kommer följa utvecklingen inom LSS, alltså att vi kommer att få det sämsta från båda modellerna: slimad personalgrupp med större ansvar (alltså fler arbetsuppgifter) kombinerat med övervakningen från massproduktionsmodellen. Allt detta för att få produktiviteten att öka och minska utgifterna. Då dröjer det inte länge innan teamen börja protestera.
Läs Sydsvenskans artikel från i januari – Industrin inspirerar vården. . Minus i budget har man på Universitetssjukhuset i Lund.
Saxat från Förenade Vårdare.
Konflikt: Slutstadium skriver om det liberala mörkret, Petter är flitig.
Tycker du att detta är intressant? Tryck då här så får fler läsa det
Läs även andra bloggares åsikter om vården, jobb, politik, lund, sjukhus, skyddsombud, facket, lean production, toyotism
februari 8, 2008 at 4:16 e m
Dagens Arbete hade en intressant artikelserie om mean production förra året:
http://www.dagensarbete.se/home/da/home.nsf/unid/B76F2C8ED0FD2F5EC125736B0031B685?OpenDocument
(Längst ner under ”Läs mer” finns resten av artiklarna i ämnet).
februari 9, 2008 at 12:03 f m
Var finns vår tids Chaplin? Alltså vem kan göra en satir som motsvarar Chaplins ”Moderna tider” för vår tid? En massa människor som jobbar förtvivlat samtidigt som de kvävs därför att teknokraterna tagit bort all ”luft i organisationen”. Luft behöver man för att kunna andas…
februari 10, 2008 at 10:06 f m
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februari 10, 2008 at 7:03 e m
De avdelningar som infört Lean Production som koncept är enligt tidigare rapportering mycket nöjda med detta! De som enligt Sydsvenskans artikel inte hinner gå på toaletten har _inte_ infört Lean Production.
I nuvarande läge på Usil handlar det verkligen om att springa, inte gå – mellan avdelningarna!!!
Läs på!
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