Doctors and managers: NHS is unmanageable corporate mess

doi:10.1136/bmj.326.7400.1213-b

BMJ 2003;326:1213 (31 May), doi:10.1136/bmj.326.7400.1213-b

Letter

Doctors and managers

NHS is unmanageable corporate mess

The first 150 words of the full text of this article appear below.

EDITOR—Conflict between doctors and managers results from the NHS's unmanageability.^{1
2} Corporate governance requiresthat product, strategy, customer, and share-holder are clearly identified, but the NHS's product and strategy are dictatedexternally and changed daily by politicians, patients, managers,media, royal colleges, pressure groups, health professionals(including doctors), employees, Europe, and lawyers.

These make ever burgeoning demands for products that includehealth provision, disease management, illness prevention, deathpostponement, social engineering, lifestyle improvement, transport,education, and board and lodging, and the NHS seems powerlessto refuse.

Smith is incorrect—patients are not customers.² The purchaser is the customer, and NHS patients are manifestly notpurchasers. The government is the paying customer, demandingtarget hitting satisfaction, but it is also the sole shareholderproviding the investment and appointing the boards. Is thiscorporate governance?

The NHS is an unmanageable corporate mess. Doctors see the effectsof this and blame the managers. . . . [Full text of this article]

Peter G Hope, consultant orthopaedic surgeon

Lister Hospital, Stevenage, Hertfordshire SG1 4AB peter.hope@which.net

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

Technorati What's this?

Relevant Articles

Doctors and managers: a problem without a solution?: Nigel Edwards, Martin Marshall, Alastair McLellan, and Kamran Abbasi
BMJ 2003 326: 609-610. [Extract] [Full Text] [PDF]