Purchasing decisions in the NHS: Made by managers ignorant of health care

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6924.344b (Published 29 January 1994) Cite this as: BMJ 1994;308:344
  1. J G Palmer
  1. Caldew Hospital, Carlisle CA2 5NW.

    EDITOR, - I suggest that the reason why decisions on purchasing in the NHS are still not explicit three years after the introduction of the NHS reforms1 is that all too often those making the decisions are not appropriately qualified. On Thursday 18 November an advertisement appeared in the appointments section of the Times for a general manager for the Greater Glasgow Health Board.2 The advertisement pointed out that the board is one of the largest purchasers of health care in Britain with an annual expenditure in excess of £750 000 000. A brief description of the board and the position was followed by a stipulation of the qualifications required. Applicants were expected to be: Already operating at head of a large organisation; of proven success in general management, finance and strategic planning; innovative with presence, flair and ability to communicate effectively at all levels, lead and manage change and develop people. The last sentence under the heading qualification read: Experience of the NHS is not essential.

    One week later the Times featured an advertisement for a general manager of manufacturing in a high paced, high volume, high quality food manufacturing business in the north of England.3 This advertisement also valued a leadership style that generates continuous performance enhancement, but, in contrast to Glasgow Health Board, this company regarded experience at managerial level in a sizable food business as essential.

    It has yet to be proved that commercial style management is of any benefit to the delivery of health care in the NHS, but if we must mimic our industrial counterparts we should at least do it accurately. Surely no commercial institution would entrust a £750 000 000 budget to a manager, however charismatic, who did not have experience of the field of operation.


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