Fixing the NHS: We need fewer and better managers

doi:10.1136/bmj.333.7565.447

BMJ 2006;333:447 (26 August), doi:10.1136/bmj.333.7565.447

Letter

Fixing the NHS

We need fewer and better managers

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

EDITOR—Black's article embodies the problem in the NHSat the moment—a polarised position with government, Departmentof Health, NHS Executive, and managers often on one side, andhealthcare professionals on the other.¹ To the author, anyonewho criticises the current direction of the NHS is "anti-reform."

Many points in the article show the problem that managementconsultants have in oversimplifying the processes of the NHS—forexample, I visit my inpatients every day, including weekendswhen not on call. But how am I to discharge them into a systemwhere social service provision and even transport home or pharmaciesare not available at the weekend? To help me discharge patientsappropriately, the whole system of community care has to adjustas well.

The statement that doctors do not have the management expertiseto know how to organise process well is not true. Doctors havebeen the driving force behind . . . [Full text of this article]

Paul L Thorpe, spinal surgeon

Musgrove Park Hospital, Taunton TA1 3PX plpjt@doctors.org.uk