I was asked to write about improving efficiency in the health Service. As someone who has never run a hospital you might well ask what is the point of reading what I have to say.

Have I done anything that is relevant? I spent ten years as a full time senior manager in business before entering Parliament, rising to Chairman of a main Stock Exchange listed industrial group. I spent ten years as a full time senior public sector employee, reaching Cabinet and Shadow cabinet level. My role as Secretary of State for Wales included responsibility for the NHS is Wales. I have also spent ten years as a backbench MP, chairing four different types of business on a part time basis(not all at the same time).

I have found going into various parts of the public sector and into various companies that there are common themes to make something work better, and some common rules on how you can turn round an underperforming activity if that is what you face. The similarities in the leadership challenge are often more striking than the differences or special problems.

Good management is about using the minimum of resource to deliver the best of service or product. It is about continuously striving for improvement. It is about getting the morale of your workforce up and keeping it up. A strong leader defines what success is, makes sure that success is stretching, but then helps his or her team achieve it. Higher efficiency comes from the full engagement of the whole team in achieving that success.

You may by now be switching off. This is just more motherhood and apple pie, or a less jargon filled version of management speak that cascades through the modern NHS. Not so. It is the distilled conclusions I have come to after being involved with success and with failure in delivering more for less in many different organisations.

Let me now shock you. You can have too many managers. You will not get that unity of purpose unless managers free and liberate their reports to get on and do the job. You will not achieve success if you allow targets to multiply, objectives to become complex and for a meetings culture to develop. You need a can do culture, a culture where the senior managers steps in only when things are going badly wrong to rescue them, or to praise and reward and demand more when they are going well.

The check list of areas to improve and the issues where costs can be cut and quality raised is the easy bit. If your senior managers do not know that already then you have the wrong senior managers. I remember some examples that I initiated when I was looking after the Welsh Health Service.

I started with a top heavy structure. I had reporting to me both a Permanent Secretary and his team, and a Chief Executive and his team. I abolished the CEO job and the office that went with it, and concentrated on the one top management structure through the department. We didn’t have the time or the money for the luxury of competing centres.

I asked about stock levels and supplies. I discovered there were three levels of stocks for the hospitals – some were held in a central warehouse at our expense, some at hospital level and some at ward level. Why? Hadn’t they heard of just in time? I was told drugs can perish so they need careful storage, and they needed buffer stocks. I called in the pharmaceutical companies and asked if they could supply the drugs at the same prices into each hospital directly when needed instead of into our central warehouse., They said fine. Out went the expensive and cumbersome central warehouse, and down went our working capital.

Running a hospital is like running a hotel, with a medical activity attached. Just as some hotels exist to book people into their spa or health farms, so hospitals are hotels to book people into an operating theatre. The patient will judge their experience mainly by the hotel, as they are usually asleep when in the operating theatre. The surgery only becomes an issue for them if it goes wrong.

Cleanliness and quality is even more important in a hospital than a hotel, as the combination of cutting people open and dealing with people who are seriously ill increases the dangers of infection. Any hospital manager should make patient safety the number one issue all the time. In a good factory these days every line manager knows safety comes first and processes are designed to get rid of the risk of accident. Machines and procedures are idiot proofed to stop disaster. Good factories also stress cleanliness, as dirt can contaminate parts and equipment as well as being unpleasant for employees. If I were a hospital manager I would want to get on top of all cleaning and secondary infection issues first. The complaints department could then be cut, and there would less remedial work.

Thereafter is the usual grind, reducing administrative headcount, simplifying forms and paperwork, banning needless meetings and doing with fewer outside consultants, cutting energy use, and concentrating everyday on getting things right first time.