ABSTRACT
At the heart of this chapter is an emphasis on the importance of process in any long-term change effort being introduced from the top. John Bull explores critically how central this must be to building the leadership and management capability now required to deal with external forces and the shaping of new purposes and practices. His own particular management challenge has been to create a new unified institution out of four previous ones that were at a distance, one from the other, not only geographically but also in terms of cultures, values and views of quality. (Readers may also wish to refer toflint's account of a merger that failed).
