Another reorganisation involving unhappy managers can only worsen the service

The NHS is being reorganised—again. Having declared on taking office in 1997 that it recognised that the NHS had suffered too much structural reform, the re-elected Labour government has embarked on the largest, and least debated, reorganisation of the NHS for two decades.1 A consultation document, “Shifting the balance of power in the NHS: securing delivery,”2 published in July proposed abolishing the executive regional offices of the NHS and two thirds of health authorities and creating new primary care trusts to take on a raft of responsibilities from health authorities. Only the acute NHS trusts emerge from these changes relatively unscathed. The consultation, which lasted six weeks, closed in early September and the government has yet to publish its results. But the reorganisation is steaming ahead regardless, with the aim of completing all the changes by April 2002. Few people outside the NHS management community seem to be aware of the exact nature and implications of these changes, which have their roots in growing public and political impatience with the quality of NHS services.

From two recently published surveys 3 4 it appears that …