Intended for healthcare professionals

Editor's Choice

Looking for leaders

BMJ 2006; 332 doi: (Published 11 May 2006) Cite this as: BMJ 2006;332:0-f

Leadership in medicine in the NHS: an under recognised perspective

Dear Editor - I read with interest the editorial by Fiona Godlee1
which is quite relevant, but does not represent the true perspective of
the leadership issue in medicine in the UK. I fully disagree with
comments in the editorial, such as the lack of leadership, the presence of
leadership vacuum and the NHS in the UK suffering from having no single
identifiable leader.

The NHS consultants, unquestionably, are the most important cohort of
doctors responsible for providing the most needed day to day service at
all levels and they have dedicated their whole life in learning the art
and crafts of their specialties to provide an up to date care to their
patients. They have always shown clinical leadership by introducing new
modalities of treatment in the NHS through research and technology
transfers by visiting centres of excellence, which involves enormous
amount of hard work. Majority of them have been sacrificing every single
aspect of their personal and family lives for the sake of their patients,
without caring for any recognition and rewards, which is based solely on
their conscientiousness and gratification from their achievements.
Despite several limitations in the NHS, endeavours are being made to
provide excellent care to the patients, which is the result of their
leadership at primary care and hospital levels. The leadership in
medicine differs completely from political leadership, instead, they have
to solve individual patient’s problem without failure and this takes most
of their time in the current system, which has been significantly affected
by the introduction of European Working Time Directives in the training
scheme as consultants have to carry extra responsibility now in order to
maintain safety of their patients. The consultants in NHS are well
equipped to lead and advance medicine, unfortunately, they are crippled by
the enormous pressure of day to day service commitments and lack of
recognition of the basic problems encountered in health care delivery,
particularly by the administrative bureaucrats who control the resources
to run the service. Leadership in medicine in the NHS is best appreciated
by the personnel deeply involved in providing health care and very
sparsely by others.

1. Fiona Godlee. Looking for leaders. BMJ 2006;332,

Competing interests:
None declared

Competing interests: No competing interests

17 May 2006
BM Shrestha MS MPhil FRCS
Consultant Surgeon
Northern General Hospital, Sheffield, S5 7AU