BMJ  2003;326 (21 June), doi:10.1136/bmj.326.7403.0-g

Editor's choice

Changing the "leadership" of the NHS

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

Britain's National Health Service, one of the world's largest public sector organisations, is highly unusual in not having a leader. Most organisations—and certainly all major corporations—have a leader. Tony Blair is the leader of Britain. Greg Dyke leads the BBC, and that huge organisation—comparable in some ways to the NHS—has changed dramatically since Dyke took over from John Birt. One of the best ways to change an organisation is to change its leader. This is not a cult of personality. But it does seem to be important—perhaps simply because people prefer people to abstractions—to have somebody who embodies power and accountability.

So who is the leader of the NHS? One immediate problem is that there are four NHSs—in England, Scotland, Wales, and Northern Ireland. Who then is the leader in England? Is it Sir Nigel Crisp, the chief executive of the NHS in England and also permanent secretary in the . . . [Full text of this article]

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• Berwick, D., Ham, C., Smith, R. (2003). Would the NHS benefit from a single, identifiable leader? An email conversation. BMJ 327: 1421-1424 [Full text]  

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