More and better management is the key to fixing the NHS

doi:10.1136/bmj.333.7563.358

BMJ 2006;333:358 (12 August), doi:10.1136/bmj.333.7563.358

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More and better management is the key to fixing the NHS

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

Recently Paul Miller, chairman of the BMA's consultants' committee,accused my profession of being a "large part" of the NHS's problems(www.timesonline.co.uk/article/0,,8122-2215070.html). His commentstypify the arguments of those against reforming the NHS. Tothese people all problems—deficits, long waiting lists,infection control problems—result from lack of resources,bureaucracy, government interference in clinical judgment, andthe "greedy" private sector. Things would be much better ifwe didn't waste money on big IT systems, independent treatmentcentres, management consultants, and private finance initiativesand instead spent it on "frontline" staff. This sums up theattitude of the leadership of the medical profession to NHSreform, but the underlying assumption is that the only thingthat matters is how many doctors and nurses we have.

This assumption is demonstrably untrue and pernicious—distractingthe NHS from seeking easily achievable improvements that derivefrom better organisation (which might—horror of horrors—requiremore . . . [Full text of this article]

Stephen Black

management consultant, PA Consulting, London stephen.black@paconsulting.com

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This article has been cited by other articles:

Thorpe, P. L (2006). Fixing the NHS: we need fewer and better managers.. BMJ 333: 447-447 [Full text]
Kirkham, S. R (2006). Fixing the NHS: NHS is undermanaged, but overadministered.. BMJ 333: 447-447 [Full text]

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Brave New World of the NHS: Alan A Woodall
bmj.com, 11 Aug 2006 [Full text]
Better NOT more management is key to the NHS: Michael J. Walton
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Managers, not bean counters.: Dermot Ryan
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Efficiency requires investment: Stephen G. Costa
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An illustration of why the NHS is not working: Andrew Beggs
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Good Management needs Good managers not More Managers: Peter H L Aitken
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Management is not the key to fixing the NHS: Costa Repanos
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More Management Please: Andrew E Blewett
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Processes can only be changed by people who know them well: Tom Billyard
bmj.com, 12 Aug 2006 [Full text]
imagine.....: benjamin dean
bmj.com, 12 Aug 2006 [Full text]
Why the polarisation?: Paul L Thorpe
bmj.com, 12 Aug 2006 [Full text]
Doctors' Leaders should do MBAs: Paul E Shannon
bmj.com, 12 Aug 2006 [Full text]
Black - Quietly confident of his own unsurpassed humility.: Steven Ford
bmj.com, 12 Aug 2006 [Full text]
NHS is under-managed, but over-administered: Stephen R Kirkham
bmj.com, 12 Aug 2006 [Full text]
Just what do management consultants know?: Peter G. Davies
bmj.com, 12 Aug 2006 [Full text]
Quality or quantity?: Chris Booth
bmj.com, 13 Aug 2006 [Full text]
Management does not heal patients: Franz J Eigenmann
bmj.com, 14 Aug 2006 [Full text]
Better Management but no more Management: Pushpinder S Sidhu
bmj.com, 14 Aug 2006 [Full text]
Evidence-based management, preferably by medically qualified managers would be much better: Adam R. Greenbaum
bmj.com, 14 Aug 2006 [Full text]
Management techniques: Joan McClusky
bmj.com, 15 Aug 2006 [Full text]
An opportunity lost: Joseph Mathew
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Better Management, Fewer Unskilled Managers: David Dawson
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Stephen Black should remember that patients and doctors are people too: Cliona M Ni Bhrolchain
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Communication is the key: Andrew C Sherley-Dale
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So what are our current NHS managers doing?: Jeremy E Oates
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Better, not more, management will help to fix the NHS: Ruben D Trochez-Martinez
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NHS need more medically oriented managers: Hany Wisa
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Capacity with some to spare: S. Michael Crawford
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Better, not more, managers: Geoffrey M K Schrecker
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A plea for more thinking: William J. Lang
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Clinicians and managers work better together: David L Wallace
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Medical management is different: Michael Paul
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Second Law of Thermodynamics: Luke J Ball
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Audit Commission Report on bed numbers: David O'Hagan
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Good management and appropriate staffing : mutually exclusive?: Sunil Nair
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Straw man argument: Anjan Chakraborty
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Missed Management: John A Anderson
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Violent Agreement?: Jim Easton
bmj.com, 24 Aug 2006 [Full text]
Re: Violent Agreement?: stephen black
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A Fix For The NHS: Imogen C Felton
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Re: A Fix For The NHS: A F Goodman
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Re: A Fix For The NHS: Thomas de Albuquerque
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