Intended for healthcare professionals


This House believes doctors are neglecting their duty to lead health service change: Opposer

BMJ 2009; 338 doi: (Published 21 April 2009) Cite this as: BMJ 2009;338:b1577
  1. James Cave, GP, Berkshire West Primary Care Trust
  1. drjcave{at}

    Doctors have never neglected their duty and have, throughout history, led health service change. It is fanciful to suggest otherwise. Our major teaching hospitals and the specialty of general practice owe their existence to doctors of a different age leading transformational change in service delivery. More recently doctors have shown this ability to lead at the highest levels, championing the calls for bans on smoking, landmines, and torture among other issues.

    Successive organisational changes within the NHS in the 1970s and 1980s—particularly the 1983 Griffiths report, which essentially introduced the idea of general management into the NHS—have, however, marginalised doctors from their role in management and have adversely affected their ability …

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