Intended for healthcare professionals

Feature Health service management

The rise of the doctor-manager

BMJ 2007; 335 doi: (Published 02 August 2007) Cite this as: BMJ 2007;335:230

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  1. Michael Day, freelance journalist
  1. London
  1. M Day miday{at}

    Will shifts in policy lead to more doctors managing the NHS? Michael Day reports

    It's not just patients who might benefit from more doctors but the service itself, according to the UK National Health Service's chief executive, David Nicholson. He told the annual conference of staff grade and associate specialist doctors in June, “Within two years, we want a doctor applying for every chief executive post advertised. Where clinicians and managers work together,” he said, “There is almost nothing you can't achieve.”

    Leading doctors have welcomed the call for more clinical input in the running of the NHS, although many have raised doubts about whether Mr Nicholson's two year deadline for getting medical applications for all chief executive posts is remotely realistic.

    None the less, after the Conservative party's pledge to do away with central NHS targets, the pressure on the government has increased to give local clinical concerns higher priority.

    Mr Nicholson is relying on the appointment within the next two or three weeks of the first NHS medical director, to speed up the process. He is understood to be reluctant to comment further until the medical director has had a chance to establish his or her position on what has become a key policy area for the NHS.

    Doctors prioritise safety

    Other senior figures in the NHS have praised David Nicholson's calls for more medical chief executives, however. Gill Morgan, a former doctor and chief executive of the NHS Confederation, the representative body for NHS organisations, said, “It would be very good indeed to have more doctors in NHS chief executive positions.”

    According to Dr Morgan, “Doctor-managers that I've known tend to prioritise patient safety and see the importance of engaging other clinicians in management decisions.”

    Another doctor, Jennifer Dixon, head of policy at the King's Fund, an independent think tank, …

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