Focus: London: The year that manpower controls finally crumble

“Initiative fatigue” was one symptom afflicting the NHS last year. The civil servants working on the Jenkins review of functions and manpower (the review that spelt the end of regions) calculated that the NHS was being presented with one new initiative from the top every working day. No wonder the review team detected a mismatch between the “command economy” of the management executive and the regions and the need of the new market NHS for a light touch.

Yet 1994 may not be much different. Shortly before Christmas the minister for health, Dr Brian Mawhinney, announced that the government would implement in full the recommendations of the Calman report on specialist medical training. He also reaffirmed the commitment to …