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Dear Jim

I agree with your concerns. I also agree with your sources. I think we need to try to get to a 'YES AND' position here.

The story of VM is well documented. It is clearly authentic. Their learning could be truly invaluable to the NHS.

My contribution would be that, Toyota were hugely influenced by Edward Deming's PRINCIPLES. He called this his system of profound knowledge. It had five principles:

1. Constancy of purpose
2. Take a System's Perspective
3. Improve through reducing Variation - focus of strategic areas of poor quality and high cots
4. Improve via Experimentation - PDSA
5. Trust and exploit the workforces' intrinsic motivation.

If the program recognises this (as VM clearly did) and then deploys the tools of LEAN in a way consistent with these principle the TDA program and your concerns becomes a YES AND.

Lets hope both sides embody these principles and commit to learn from one another, we need both elements

BW

Steve