ABSTRACT
In 1974, with the pretext of introducing coherent local planning within the framework of the National Health Service (NHS), the service was given a new corporate structure designed by management consultants. Doctors are the most educated and highly trained of the NHS workforce. Doctors and patients are the reasons for the existence of the NHS. The new NHS reforms have left the workforce confused and demoralized. There is a need for leadership to help people cope. The new NHS management has had deleterious effects on the NHS without delivering the cultural changes predicted for it. The essence of general management is that professional hierarchies are subsumed and thereby cease to exist altogether. General practice was akin to a small business and each practitioner was, in the main, independent of the hospital service. Medical care was of the highest technical quality and was available to all at a very low cost, and the numbers of patients treated increased year-on-year.
