Intended for healthcare professionals

Rapid response to:

Analysis And Comment NHS reorganisation

Who's kicking who?

BMJ 2006; 333 doi: (Published 21 September 2006) Cite this as: BMJ 2006;333:645

Rapid Response:

Doctors and managers

Doctors have always had to do some management including time
management. If the current trend continues in the NHS those with pure
clinical/academic accomplishments will find themselves more and more
side lined in favour of career medical managers who are experts in
committees but not so expert in some of the fields they are
representing.Most of these managers have the right to
overrule you even in matters of vital interest to your departments. It
is time we looked at this for the future of those who are mere frontline
staff. There have always been several good and bad models for management.

One is the Japanese model where employees feel they belong to a large
family and every one works towards its improvement. They are rewarded
by being looked after. The fault with this style is that many may
just stumble along without need for improvement. There is then the US
model where merit is rewarded and you stand or fall by your
accomplishments. Here individual talents are nurtured. This is
generally what is followed in the private industry.

The NHS however is developing its own ethos of picking those who
follow the line and rewarding them and ruthlessly eliminating other
voices. Such a system would strangle intellectual vibrancy and those
who want to improve themselves and their departments may find
themselves seeking askance elsewhere. This is a man made or manager
made tragedy of the modern NHS.

Jayaprakash A Gosalakkal

Competing interests:
None declared

Competing interests: No competing interests

10 October 2006
Jayaprakash Ayillath Gosalakkal
Consultant Paediatric Neurology
UHL Leicester