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New structures of governance are needed

BMJ 2003; 326 doi: (Published 05 April 2003) Cite this as: BMJ 2003;326:764
  1. Kieran M J Walshe, director of research management (
  1. Manchester Centre for Healthcare Management, University of Manchester, Manchester M13 9PL

    EDITOR—Klein sees the “cacophony of accountabilities” for new NHS foundation hospitals as a weakness,1 but I would argue that it may be their greatest strength.

    For half a century, the NHS has been organised as an administrative bureaucracy led from Whitehall, and the many structural reforms of the past …

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