UNIT 2 LEADERSHIP

2.0

Objectives

2.1

Introduction

2.2

Importance of Leadership and its Definition

2.3

Trait Approaches to Leadership

2.4

Leadership Styles
2.4.1
2.4.2
2.4.3
2.4.4

Continuum of Leadership Behaviour

Managerial Grid Style
Life Style or Situational Approach to Leadership
Four Systems of Management Leadersip

2.5

Roles and Functions of Leadership

2.6

Leadership Skills

2.7

Let Us Sum Up

2.8

Self-assessment Test

2.9 ,Further Readings

2.0 OBJECTIVES
After going through this unit, you should be able to:
describe .the importance of leadership in the health organisations;
identify the major leadership styles;
explain the situational approaches to leadership;
discuss the main functions of a leader; and
explain the leadership skills required for a hospital administrator.

2.1 INTRODUCTION
The previous unit on "Motivation" discussed the importance for health administrator1
manager to have mastery over the concept and process of work motivation to fully
understand employee behaviour. This present chapter on leadership is linked to the
previous one in the sense that an administrator/manager requires leadership skill to
empower employees and motivate them to work in an efficient manner to achieve
health organisation's goal. Moreover, motivating employees and developing positive
attitude towards them is one of the crucial skills that the leader needs to develop. This
present unit on leadership would enable you to understand importance of leadership,
leadership behaviour. The thrust of this unit would be to discuss and analyse the
widely recognised styles of leadership. This is followed by an examination of roles
and functions of leadership. The last part of this unit gives description of the
leadership skills which are increasingly being recognised as crucially needed for today's
changing and demanding health organisations. The difference between styles, roles and
functions and skills which are the main parts of this unit, are that leadership styles
deal with the way leaders influence followers; Roles and Functions are What leaders
do, and skills are concerned with how leaders can be effective.

2.2 IMPORTANCE OF LEADERSHIPAND ITS

DEFINITION
,

For the health care organisations/hospitals, to achieve the goal of quality of patient care
and health for all in the next millenium, the twenty-first century require a generation of

Human Resoume Management

leaders. For the health organisations to endure and quality patient care to be provided,
effective leadership is required. The simple reason for this is that an important part of
management consists of dealing with and working through people. Further more, some
one must determine, initiate, coordinate, influence, and over see work activities of other
individuals.
We all must have observed that every group of people that performs near to its total
capacity has some person as its head who is skilled in the art of leadership. This skill
seems to be a compound of at least four major ingredients:
the ability to use power effectively and in a responsible manner,
the ability to comprehend that human beings have different motivation forces at
different times and in different situations,
the ability to inspire, and
The ability to act in a manner that will develop a climate conducive to responding
to and assuring motivations.
Leadership is the process of encouraging and influencing people to direct their efforts
towards the achievement of some particular goal(s). It is the human factor that helps a
group identify where it is going and then motivate it towards its goals. In fact,
Leadership transfornis potential into reality. Leadership is the ultimate act that
identifies, develops, and uses the potential that is in an organisation and its people.

The Fundamental Principles of Leadership

Since people tend to follow those who, in their view, offer them a means of satisfying
their own personal goals, the more managers understand what motivates their
subordinates and how these motivations operate, and the more they reflect this
understanding in carrying out their managerial actions, the more effective they are
likely to be as leaders.
Leadership can be formally defined as "The process of influencing the activities of an
individual or a group in efforts towards the achievement of some particular goals in a
given situation." Another definition defines leadership as "Interpersonal influence
exercised in a situation and directed through the communication process towards the
attainment of a specialised goal(s)". Besides influence, leadership has been defined in
terms of group processes, personality, power, goal achievement, interaction, role
differentiation etc.
People have been concerned about the nature of leadership since the beginning of
history.

2.3 TRAIT APPROACHES TO LEADERSHIP

Prior to 1949, studies of leadership were based largely on an attempt to identify the
traits that leaders possess, starting with the "Great man" theory that leaders are born
and not made, a belief dating back to the ancient Greeks and Romans researchers have
tried to identify the physical, mental and personality traits of various leaders. But this
"Great man" theory lost much of its acceptability with the rise of the behaviourist
school of psychology.
Various researchers identified specific traits related to leadership ability; five physical
traits (such as energy, appearance, and weight), four intelligence and ability traits,
sixteen personality traits (such as adaptability, aggressiveness, enthusiasm, and selfconfidence), six task-related characteristics (such as achievement drive, persistence, and
initiative), and nine social characteristics (such as cooperativeness, interpersonal skills,
and administratse ability). More recently the following key leadership traits were
identified: drive (including achievement, motivation, energy, ambition, initiative, and
tenacity), leadership motivation (the aspiration to lead but not to seek power as such),
honesty and integrity, self confidence (including emotional stability), cognitive ability,
and an understanding of the task.

Leadership

But in general and practically, the study of leader's traits has not been a very fruitful
approach to explaining leadership. Not all leaders possess all the traits. The trait
approach gives no guidance as to how much of any trait a person should have. Most
of these so-called traits are really patterns of behaviour.
Much of the recent emphasis has shifted away from traits and towards identification of
leadership behaviours. As per this view, successful leadership depends upon appropriate
behavicjurs, skills and actions, and not on personal traits. This agreement is very
significant and practically true also since behaviours can be learned and changed, while
traits are relatively fixed. Leadership behaviour, to be precise, is the way or the style
the leaders actually carry out their jobs.

2.4 LEADERSHIP STYLES

Leadership styles make a difference. The total pattern of leader actions as perceived by
their employees, is called Leadership Style. It represents the leader's philosophy; skills
and attitudes and behaviour towards others. The styles differ on the basis of
motivation, power, or orientationafowards people and tasks. Many different
classifications of leadership styles have been proposed over the years.
Four important styles of leadership behaviour which are widely recognised to be highly
useful and relevant for today's organisations are discussed here:
Continuum of leadership behaviour
Managerial grid style
Life-cycle or situational approach
Four systems of management leadership

2.4.1 Continuum of Leadership Behaviour

In 1958, Robert Tannenbaum and Warren H-Schmidt formulated a continuum describing
the decision-making authority dimension of leadership. It has two polar ends with
varying amounts of leader-subordinate decision-making authority. At one extreme the
leader makes the decisions, tells his or her subordinates, and expects them to carry out
that decision. At the other extreme, the leader fully shares his or her decision making
power with subordinates, allowing each number of the group to cany an equal voice
one person, one vote. Between these two extremes of autocratic to laissez-faire fall a
number of leadership styles, with the style selected dependent upon forces in the leader.
the operating group, and the situation. As shown in Fig. 2.1, there is a relationship
between the degree of authority used and the amount of fredom available to
subordinates in reaching decisions. This continuum is seen as a zero-sum game; as one
gains, the other loses, vise versa.

i)

Autocratic: In the continuum of leader authority presented in Fig. 2.1, the autocratic
end represents the manager who makes decisions and announces them to the group.
The total interacting relationship and work setting have been determined by the manager
and he or she provides hardly any opportunity for a subordinate to participate.

ii) Consultative: This style is characterised by description 2 and 3 in the continuum.

Here the manager sells or makes the decision concerning the work activity, its purpose,
how it is to be done, when and by whom, and invites questions from subordinates.
iii) Participative: This style indicates that the manager identifies purposes, problems and
means by which activities should be carried out; presents a tentative decision already
made, that is subject to change or presents the problem to subordinates, gets suggestions,
and then makes the decision. This represents the participative style of leader decision
authority wherein the area of decision making freedom for subordinates is much greater
and use of authority by the manager is much smaller than with autocratic and consultative
style.
This participative leadership style is a very powerful motivator enabling employees to
have some measure of influence and control over work related activities.

- ~ a e b o ~ r rManagement
r
Boss Centred
Leadership

Subordinate Centred
Leadership

Use of Authority by the Manager

Area of Freedom fur Subordinates

Manager
makes
decisions &
Announces
it

Manager
"Sells"
decisions.

Manager
presents
ideas and
invites
questions

Manager
presents
tentative
decisions
subject to
change

Manager
presents
problems, gets
suggestions
makes
I 11. . .-ion

-1

Manager
permits
subordinates
to function
within
defined
limits

(6)

(7)

-(1)

Autocratic

(2)

(3)

Consultative

(4)

(5)

Participative

Manager
defines
limits; asks
group to
make
decision

Democratic

LaissezFaire

Range of Behaviour
Fig.Z.l: Leadership Behaviour Continuum by Tannenbaum and Schmidt

iv) Democratic: In the democratic style of leadership, the manager defines the limits of
the situation and problem to be solved and asks the group to make decisions, the
subordinates have a relatively large area of decision freedom.
V) Laissez-Faire: This style at the far end of the continuum is called free rein, wherein
subordinates are permitted to function within limits set by the manager's superior.
There is no interference by the manager, who may participate in decision-making, but
attempts to do so with nd mor6 influence than any other member of the group.
Interpreting Autocratic to Democratic-which

is correct?

Research and experience has shown that no single decision authority style is correct all
the time. The leader needs to change and adopt the style to fit the situation. In the
hospital, in the operating room, the physician or the surgeon uses the autocratic style,
but while dealing with other professionals in the meeting room or in problem solving
situation, the democratic style may be more appropriate.
Factors Affecting Style
The leader decision authority style adopted by the manager depends a great deal on
factors such as:
Importance of results,
Nature of the work,
Characteristics of workers, and
Personal characteristics of the manager.
If there is a disaster or crisis situation emerges and the task has to be performed
immediately, the health services manager needs to adopt an autocratic style of the
continuum. But, if time is available with the manager and other people are equally
creative and empowered, the manager needs to adopt a participative or democratic style.
Subordinates characteristics-their training, education, motivation, and experience can
influence the leader authority style adopted by the manager. This factor is closely
related to type of work. If subordinates are skilled professionals, as opposed to
unskilled, the manager may seek opinions more readily and use a consultative or
participative style. But in the case of unskilled or inexperienced employees the
manager may have to make the decisions unilaterally. Moreover, personal characteristic

of the manager can affect the leader authority style adopted. Some individuals, by
reason of their personality, previous experiences, values, and cultural background,
function better under one style or another may find it difficult to change with the
situation. For example in the health care organisations when a physician becomes an
administrator, he may find it difficult to adjust styles because of previous training and
experience because in the doctor-patient relationship the doctor has always been the
primary decision maker.. But as a manager, participative approach is often more
appropriate particularly when working with other professionals.
But, it must be kept in mind that no one style is appropriate at all times. Which style
is more appropriate depends upon the situation which includes work environment, what
is to be done, the nature of employees, and the organisational climate.

2.4.2 Managerial Grid Style

One very popular approach to identifying leadership style'of practicing managers is a
graphic portrayal of a two-dimensional view as developed by Blake and Mouton. They
proposed a managerial grid consisting of two dikensions: concern for production and
concern for people. The grid, depicted in Fig. 2.2 has 9 possible gradients or degrees
associated with each dimension, on each of axis, creating 81 possible combinations of
concern for production on the horizontal axis and concern for people on the vertical
axis. A1 represents low concern for the dimension and A9 presents high concern.
Rather than try to direct attention to all 81 combinations, grid development practitioners
tend to focus on 5 "Critical Combinations". The combinations are usually referred to
by number, and when people become familiar with the grid they know what the
numbers mean. Although, they are briefly described in Fig. 2.2. Let us examine each
combination in more detail:

High

Thoughtful attention to needs of

people for satisfying relationships
leads to a comfortable friendly
organisation atmosphere and work

Adequate organisation
performance is possible through
balancing the necessity to get out
work with maintaining morale of
people at a satisfactory level.

Exertion of minimum effort

to get required work done is
appropriate to sustain
organisation membership

Efticiency in operations results from

ananging conditions of work in such
a way that human elements interfere
to a minimum degree.

Low

Low

Concern for Production

High

Fig. 22: The Managerial Grid

i)

The 1,l Managerial Style is often referred to as Impoverished Management.. In this

style, the manager tends to put people in jobs and then leave them alone. He or she
does not check upon their work (no concern for production) or try to interact with them
by offering praise and encouraging them to keep up the good work (no concern for
people).

ii) The 9,l Managerial Style is often referred to as Task Management. This manager has
a high concern for production and a low concern for people: He or she plans the work
and pushes to get it out, similar to the autocratic style, little interest is shown for
people, if they can not fulfil the task they are replaced by others who can.

Leadership

Human Resource Management

iii) The 1,9 Managerial Style is called as Country Club Management because of high
emphasis given to concern for people's feelings, comfort, and needs. The manager is
basically interested in obtaining loyality from the subordinates and tries to motivate
them to do their work without putting pressure on them.
iv) The 5 3 Managerial Style is often referred to as Middle-of-the-road Management.
The manager assumes that there is an inherent conflict between the concerns for
production and people. Therefore, he or she tries to compromise and balance the two
dimensions.
v) The 9,9 managerial style is referred to as Team Management. It is regarded by many
as the best and the ideal style, as the one that both managers in particular and the
organisation in general should employ. This style focuses on people's higher level
needs, involves subordinates in decision making and assumes that the goals of the
people and the goals of the organisation are in harmony. As a result the 9,9 manager
believes that maximum concern for both dimensions will result in the greatest overall
efficiency.
Which one of these basic styles is best? The answer will depend on the needs of the
subordinates, the manager, and the organisation.
Activity 1
Interview a representative sample of managers in an organisation and try to find' out
their preference for various managerial styles.

2.4.3 Life Style or Situational Approach to Leadership

One of the most widely practiced leadership models is Paul Hersey and Ken
Blanchard's situational leadership theory. This very popular approach to management
style training and development has been used as a major training device at such
Fortune 500 companies as Bank of America, IBM, Mobile Oil, a d Xerox and it has
also been widely accepted in all the military services.
Situational leadership, an extension of the managerial grid approach is a contingency
theory based on an interplay among:
the amount of guidance and direction (task behaviour) a leader gives,
the amount of socio-emotional support (relationship behaviour) a leader provides,
and
The readiness levels that follower's exhibit in performing a specific task, function
or objective. This concept was developed to help people attempting leadership,
regardless of their role, to be more effective in their daily interactions with others.
It provides leadership with some understanding of the relationship between an
effective style of leadership and the level of readiness of their followers.
Successful leadership is achieved by selecting the right leadership style, which
Hersey and Blanchard argue is contingent on the level of the followers maturity.
It must be noted here that situational leadership is a model, not a theory. Its
concepts, procedures, actions, and outcomes are based upon tested methodologies
that are practical and easy to apply.

r-

Leadership

Leader shares
ideas/problems
and mutually
makes decisions
with followers

and explains
dechiom
provide
opportunity for
dialogue md

Turn over
responsibility
for decisions

decisiins and
provides
specific
instructions
and closely

implementation
over to
followers
High

Moderate
M4

Able and wllling

or
Confident

M3
Able but unwilling
or
Insecure

Low

M2
Uaable but willing
or
Confident

M1
Unable and unwilling
or
Insecure

Pig. 2.3: Situational Leadership Style

Basic Concepts of Situational Leadership

According to this model, there is no best way to influence people, which leadership
style a person should use with individuals or groups depends on the readiness level of
the people the leader is attempting to influence. Fig. 2.3 summarises the situational
leadership approach which identifies the following styles:

i)

Task Style: The leader organises and defines roles for members of the work-group; the
Jeader explains the tasks that members are to do and when, where, and how they are
to do them.

ii) Relationship Style: The leader has close, personal relationships with'the members of
the group, and there is a two-way communication along with psychological and emotional
support.
iii) Maturity Level: The level of maturity is defined by three criteria:
8

Degree of achievement motivation

Willingness to take on responsibility

Amount of education andlor experience

According to Hersey and Blanchard, it has two components; Job maturity and
psychological maturity. The first encompasses one's knowledge and skills and the
individuals high on this have the knowledge, ability, and experience to perform their
job tasks without direction from others. Psychological maturity relates to the
willingness or motivation to do something. Individuals high in psychological maturity
don't need much external encouragement; they are already intrinsically motivated.
Activity 2
Interview several people asking them to describe situations where someone's attempt to
influence them was successful or unsuccessful.

Human Resource Management

Situational leadership model uses r NO leadership dimensions i.e. relationship and task
and by considering each as either high or low combines them into four specific
leadership styles: Authoritative or telling; consultative or selling; participative or
supportive; and delegating. They are described as follows:
a) Authoritative or Telling Style: This is a high task, low relationship style and is
effective when followers are at a very low level of maturity. The leader defines roles
and tells other what, how, when and where to do various tasks. It emphasises
authoritative or directive behaviour.
b) Consultative o r Selling Style: This is a high task, high relationship style and is
effective when followers are on the low side of maturity. Sere the leader provides both
directive and supportive bbhaviour.
c) Participative o r Supportive Style: This is a low task, high relationship style and is
effective when followers are on the low side of maturity. Here the leader and follower
share in decision-making, with the main role of the leader being facilitative and
communicating.
d) Delegating Style: This is a low-task, low-relationship style and is effective when
followels are at a very high level of maturity. The leader provides little direction or
support.
The final component in Hersey and Blanchard's theory is defining four stages of
maturity:
MI: People are both unable and unwilling to take responsibility to do something.
They are neither competent nor confident, so they need clear and specific
directions.
M2: People are unable but willing to do the necessary job tasks. They are
motivated but currently lack the appropriate skills. The high task behaviour
compensates for the followers lack of ability, and the high relationship behaviour
tries to get the followers psychologically to "buy into" the leaders desires.

M3: People are able but unwilling to do what the leader wants. This stage
creates motivational problems that are best solved by a supportive, non-directive,
participative style.
M4: People are both able and willing to do what is asked to them and so the
leader at this stage does not have to do much.

The Fig. 2.3 integrates the various components into the situational leadership models.
As followers reach high leveb of maturity, the leader responds by not only continuing
to decrease control over activities, but also by continuing to decrease relationship
behaviour as well.
You might have noticed that the high similarity between Hersey and Blanchard's four
leadership styles and the four extreme "corners" in the managerial grid.

2.4.4 Four Systems of Management Leadership

Rensis Likert proposed four basic systems, or styles, of organisational leadership that
evolved from the many years of research by the Michigan group. Table 2.1 summarises
these four styles, called Systems of Management Leadership.
The manager who operates under system 1, approach is very authoritarian and actually
mes to exploit the subordinates. In system 2, the manager takes a paternalistic
approach while still being autocratic. Behaving as a benevolent autocrat the leader.
maintains strict control over the subordinates .and never delegates authority to work
group members, but he or she "pats them on the head" and "does it for their best
interests". In system 3, me p a g e r uses a consultative approach; that is, though, the
leader consults the subordinam and receives participative input from work group
members, but helshe still mhntains the right to make final decisions. Finally, in system
4, the manager uses a democratic style; this manager gives some directions to work
group members but provides far total participation and takes decisions by consensus
and majority.

Table 2.1: Linker's Four Systems of Management Leadership

Leadership

To have an empirical research back up to support which style is more effective, Likert
and his colleagues asked thousands of managers to describe on an expanded version of
the format shown in Table 2.1, the highest and lowest producing departments with
which they had experience. Quite consistently, the high-producing units were described
according to systems 3 and 4, and the low-producing units fell under systems 1 and 2.
This led Likert to conclude that the best way for all organisations to manage employees
is to move towards system 4.
Leadership Styles in Today's Perspective

Tanenbaum's continuum of leadership behaviour, Blake and Mouton's managerial grid,

Hersey and Blanchard's life cycle, and Likert's four systems represent the established
approaches to leadership style. They have been practically applied and tested for a
number of years and are still relevant in the perspective sense of what leaders should
do, more so in today's demanding and emerging organisations.
There is accumulating evidence that a leader's style can make a difference. For
example, recent studies have concluded that the leader's style is the key to the
formulation and implementation of strategy and also plays an important role in work
group members creativity. In other words, there is little doubt that the way (style)
leaders influence work group members can make a difference in their own and their
people's performance.
This immense concern and impact of the styles of leadership have given way to
importance of the roles and functions of leadership and skills required for effective
leaders. Now in the following sections, in this Unit, you will appreciate and learn
what (Roles and Functions) and how (Skills) of leadership.

2.5 ROLES AND FUNCTIONS OF LEADERSHIP

Now we turn to the roles acd functions of leaders by answering the question, "What
are many tasks that the leader
do effective leaders do on a day-to-day basis?-ere
must perform. The many functions listed out, with behavioural descriptions, in
Table 2.2 can be conceptually collapsed in to the four managerial functions shown as
follows:
29

Human Resource Management

i)

Communication: Leaders are effective and successful not only because of what they
do but also because of how their acts are interpreted. They need to be able to tell,
show, write and listen so that they can convey to others what they are doing and want
to be done. The leader of an organisation spends about 60 to 90 per cent of the
working day on communication. This also includes exchanging routine information
and processing paper work. The leaders need versatility in role behaviour in order to
deal with people in terms of their individual expectations. Different roles call for
different communications behaviour.

ii) Traditional Management: This role consists of performing functions like planning,
decision-making, and controlling. Its observed role behaviours include setting goals
and objectives, defining tasks needed to accomplish goals, scheduling employees,
assigning tasks, producing routine instructions, defining problems, handling day-today operational crises that usually emerge in hospital kind of organisations, deciding
what to do, developing new procedures, inspecting work, walking around inspecting
and supervising the work, monitoring performance data, and doing preventive
maintenance.
iii) Human Resource Management: This function contains the most behavioural
categories, motivatinglreinforcing, disciplining, staffing, training and development
and most importantly building effective t e a l s for goal achievement. The observed
behaviours of this activity includes allocating formal rewards, asking for input,
conveying appreciation, giving credit where due, listening to suggestions, giving
positive feedback, developing job descriptions, reviewing applications, orienting
employees, arranging for training, clarifying roles, coaching, etc. And under this
category the most important function is developing team work which requires special
attention and discussion.
Developing Team Work: One of the most important functions of leadership is to
deve!op team work. This is most likely to develop when the leader builds a supportive
environment for it. Supportive measures taken by the leader help the group to take the
first necessary steps towards team work and these steps become the basic trust, and
compatibility. Studies have shown that greater the trust and compatibility in a team,
the greater their effectiveness tends to be; so leader will seek to develop an
organisational climate that build's these conditions. There are three key factors in the
development of team work: the leader, the subordinates, and the environment as shown
in Fig. 2.4 below. They are interdependent. For example if the leader cannot get along
with the subordinates, the group members do not like the leader or the environment is
not conducive to effective team work, over all group efficiency suffers.

LEADER

/\

ENVIRONMENT ,

4
Fig. 2.4: Team-work Determinants

,-

SUBORDINATES

iv) Networking: This activity consists of socialisinglpoliticking and interacting with

outsiders. The observed behaviours associated with this activity include non work
related interactions,informal joking around; dealing with consumers, clients, suppliers.
attending external meetings, and doingfattending community service events.

What do Effective Leaders Do?

Comprehensive studies have been conducted to understand what d~ effective real
managers and leaders do, and it was found that communication and human resource
management functions, described above, made by far the largest relative contribution to
the leader's effectiveness, and that the traditional management activities, and especially
the networking activities, made by far the least relative contribution (Luthans, et al,
1985). Luthans and his associates explained that if effectiveness is defined as the
perceived quantity and quality of the performance of a manager's unit and his or her
work group member's satisfaction and commitment, then the biggest relative
contribution to le~dershipeffectiveness comes from the human oriented activities
communication and human resource management.

Table 2.2: Leadership Activities and Behavioural Descriptors

2) Staffing

1) Planninglcoordinating

a) Developing job descriptions for position

openings

a) Setting goals and objectives

b) Defining tasks needed to accomplish

goals
c) Scheduling employees. time-tabla
d) Assigning tasks and providing routine

b) Reviewing applications

c) Interviewing applicants

d) Hiring
e) "Filling in" where needed

e) Coordinating activities of each work

group member to keep work running
smooth1y.

f ) Organising the work

I
4) Decision MakingIProblem Solving

3) TraininglDeveloping

a) Orienting employees, arranging for

training seminars, etc.

a) Defining problems

b) Clarifying roles, duties, job descriptions

b) Choosing between two or more alternatives

or strategies

C) Coaching, mentoring, walking work

group members through task

C) Handling day-to-day operational crises as

they arise

d) Helping work group members with

personal development plans

I
I

II

I/

d) Weighing the trade-offs; cost benefit

analyses
e) Actually deciding what to do

5) Processing Paper work

f)

a) Answering routine procedural questions

b) Reading reports, in-box

b) Receiving and disseminating requested

information

C) Writing reports, memos, letters. etc

C) Conveying results of meetings

d) Giving or receiving routine information
over the phone

e) General desk work

I
7) MontoringJControlling Performance

a) Inspecting work

e) Staff meetings of an informational nature

8) Motivatinglreinforcing

a) Allocating formal organisational rewards

b) Walking around and checking things

out, touring-

b) Asking for input, participation

c) Monitoring performance data (e.g.

computer printouts, production,
financial reports)

d) Giving credit Where due

d) Preventive maintenance

f ) Giving positive performance feedback

c) Conveying apprecition, compliments

e) Listening to suggestions
g) Increasing job challenge
h) Delegating responsibility and authority

i) Letting work group members determine

how to do their own work
j) Sticking up for the group to managers and
others, backing a work group member
9) ~ i s c i ~ l i d n g h n i s h i n ~

a) Enforcing rules and policies

b) Demotion, firing, layoff

6) Exchanging Routine Information

a) Processing mail

d) doutine financial reporting and

bookkeeping

Developing new procedures to increase

efficiency

I
(

10) Interacting with Outsiders

a) Public relations
b) Customen
c) Contacts with suppliers

C) Any formal organisational reprimand or

notice

d) External meetings

e) Community-service activities

I
I

Haman Resource Management

11) Developing Team Work

12) Socialisin~oliticking

a) Create an environment in which

team work can happen.
b) Creating trust, cooperation and
compiitibility with the subordinates
d) Define tasks and motivate the team
members towards goal attainment.

a) Nonwork related chitchat (e.g. family

or personal matters)
b) Informal "joking around"
c) ~
~external~meetings/
~
conferences/seminars
d)

Attending community service events.

Human oriented leadership skills may be of considerable value in meeting the

challenges of global competition, and of providing the quality of health care services.
The last section in this unit now focusses on these leadership skills.

2.6 LEADERSHIP SKILLS

As the above section indicates, there is now recognition in both leadership theory and
practice of the importance of skills, how leaders behave and perform effectively the
various functions. Both styles and roleslfunctions are closely related to skillsand can
be used as a point of departure for the discussion of skills. The results of various
research studies have combined into the following four categories of effective
leadership skills:

i)

Participative and Human Relations: These includes supportive interpersonal

communication and team building.

ii) Competitiveness and Control: which include being assertive and gaining power and
influence.
iii) Innovativeness and Enterpreneurship: includes creative problem solving.
iv) Maintaining Order and Rationality: includes managing self, stress, conflicts, and
time; and doing rational decision making.
These skills categorised into the four groups are interrelated and over lapping. Effective
leaders do not perform one skill or one set of skills independent of others. In fact,
effective leaders are multiskilled.
With this background two models are developed to identify skills as personal and
ilrterpersonal leadership skills. These are summarised in Fig. 2.4. and 2.5.
Developing

Managing
Stress and
Time

Solving
Pmblems

Fig. 2.4: Model of Personal Leadership Skills

I1

In the end, we must discuss the very important managerial skills required for leader, as
they move in the hierarchy in the organisations.
Managerial Skills
It is generally agreed that there are at least three areas of skill necessary for carrying
on the various functions of management, technical, human and conceptual (see Fig.
2.6). Though they are interrelated in practice, they can be considered separately.
a) Technical Skill: Ability to use knowledge, methods, techniques and equipment necessary
for the performance of specific tasks acquired from experience education, and training.
Examples are the skills learned by medical doctors and pharmacists. This skill is the
distinguishing feature of job performance at the operating level; but as employees are
promoted to leadership responsibilities, their technical skills become proportionately
less important as shown in Fig. 2.6. They increasingly depend on the technical skills
of their subordinates and in many cases never practice some of the technical skills that
they ,*pervise.
-.

i
'

Leadership
Exercising influence
Empowering others

Communicating

Managing
conflict

Identifying causes
Selecting appropriate
strategies
Resolving
confrontations

Diagnosing poor
performance
Creating a motivating
environment
Rewarding
accomplishment

Fig. 2.5: Model of Personal Leadership Skills

b) Human Skills: This is the ability to interact and work effectively with people and to
build team work. This skill which includes an understanding of motivation and an
application of effective leadership is very important for middle level managers who
must lead others. Without a solid understanding of such behavioural areas as
interpersonal communication, motivation, counselling and directing, rniddle level
managers would be ineffective in leading their subordinates.
c)

Conceptual Skills: This skill becomes increasingly important in higher managerial

jobs. This skill is the ability to understand the complexities of the overall organisations
and covers many activities, from formulating organisational objectives, policies and
procedures, to developing techniques for handling office work flow. The appropriate
mix of these skills varies as an individual advices in management from supervisory to
top management positions as illustrated in Fig. 2.6. The leaders place in the hierarchy
determines the degree of managerial skill he or she must have. As leaders prove their
effectiveness and begin moving up the higher levels in organisation need to learn and
use more human and conceptual skills to be effective less technical skill tend to be
needed as one advances from lower to higher levels in the organisation. It needs to
be noted that while the amount of technical and conceptual skills needed at these
different levels of management varies, the common denominator that appears to be
crucial at all levels in human skill.

All the styles and roles and functions discussed are very relevant and effective in our
health care organisations. How our health care managers and administrators apply these
skills and techniques can make a difference in the challenges that lie in the health
organisations.

2.7 LET US SUM UP

This unit is concerned with leadership styles (the way leaders influence followers/
subordinates); functions of leadership (what leaderstmanagers do in their day-to-day
jobs; and leadership skills how leadership styles were the main focus which includes
Tannenbaum's leadership continuum; Blake and Monton's managerial grid; Hersey and
Blanchard's situational leadership model; and Likert's four systems. Each of these

33

Human Skill

Lower Supervisw level

Middle Management

Top Management

Management Level
Fig. 2.6: Managerial Skills needed at different Hierarchical Levels

styles have implications for the practice of leadership. The shift in attention from
styles to.roles and functions reflects a more empirical emphasis on what leaders really
do.
The last part of the unit is concerned with leadership skills, how leaders behave and
perform effectively the personal and interpersonal skills. Models are especially
comprehensive and useful. Managerial skills for leadership emphasise the importance
of human skill at all levels from learner to top management.

2.8 SELF ASSESSMENT TEST

1) Identify the importance of leadership for health care organisations.
2) How do Hersey and Blanchard define maturity? Is this variable included in other
models of leadership.
3) How does perspective leadership behaviour differ from, 1aissez:faire leadership
behaviour?
4) What are some of the needed leadership skills fcr leaders to be effective?

5) What are the three types of managerial skills every leader must have? Explain.

2.9 FURTHER READINGS

H0dgetts;R.M. and Cascio, D.M. (1983), Modem Health Care Administration,
Academic Press, INC. New York.
Luthans, F. (1989), Organisational Behaviour, 5th ed., Mc Graw-Hill Series in
Management.
- - e
Rakich, J.S., et al. (1985), Managing Health Services Organisations, 21?d ed., W.B.
Sounders Company.