Structure of the NHS mirrors feudal society

BMJ 2003; 326 doi: (Published 15 February 2003) Cite this as: BMJ 2003;326:353
  1. Roger Dobson
  1. Abergavenny

    Feudalism under William the Conqueror may seem to have been a time of evil barons, brave knights, and downtrodden peasants, but in management terms it was a very model of the NHS.

    At its heart was a complex system of subcontracting and delegation similar to that operating in today's health service, with knights instead of consultants, henchmen not senior house officers, and peasants rather than nurses.

    King William I (reigned 1066-87) has been succeeded by the health secretary, Alan Milburn (1999-), and lesser barons have become …

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