Intended for healthcare professionals

Education And Debate

Building a successful partnership between management and clinical leadership: experience from New Zealand

BMJ 2003; 326 doi: (Published 22 March 2003) Cite this as: BMJ 2003;326:653
  1. Laurence Malcolm, professor emeritus (,
  2. Lyn Wright, consultanta,
  3. Pauline Barnett, senior lecturerb,
  4. Chris Hendry, postgraduate midwifery lecturerc
  1. a Aotearoa Health, RD1, Lyttelton, New Zealand
  2. b Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, Christchurch
  3. c Otago Polytechnic, Dunedin
  1. Correspondence to: L Malcolm

    Recent New Zealand studies have shown important progress in addressing a key issue facing all health systems: the gap between clinical culture and governance or managerial culture. 1 2 The key terms in this progress are partnership, quality, clinical leadership, and professionalism.

    Three factors have been important. Firstly, New Zealand—with a national per capita income some 20% below the mean for member countries of the Organisation for Economic Co-operation and Development—has had to make difficult choices about health priorities. This has compelled greater collaboration between clinicians and management. In primary care, major budget management—of drugs, for example—is being seen …

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