Fixing the NHS: NHS is undermanaged, but overadministered

doi:10.1136/bmj.333.7565.447-a

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

Letter

Fixing the NHS

NHS is undermanaged, but overadministered

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EDITOR—The NHS is indeed undermanaged, and even many ofthose managers have no formal management qualification.¹ Sowhy do so many clinicians believe there are too many managers?Because, as the author points out, there is too much bureaucracy,which is performed by administrators who are called managers.If this distinction between management and administration weremade explicit, and the centre demanded less bureaucracy, managersmight be both recognised and rewarded for their skills. I havethe excellent good fortune to work with a superb manager, andif all trusts had sufficient good managers, there would be noneed for management consultants.