Making it change by leaving it alone
There is no question that there is much wrong in the organisation and
management of the NHS. The government's error is to think that it can
solve the problems with structural change. A lesson I leaned from 9 years
on a hospital board was that it is only possible for management to make
radical changes if the basic environment is stable.In our case some
radical developments took place in the way services were delivered,which
contributed to solving problems of waiting times, responsiveness to
patient needs, and quality of care. These happened with the support of
There is no perfect stucture. Function is more important than
stucture. The focus should be on making the existing arrangements work.
An important starting point is to learn to leave it alone.
Competing interests: No competing interests