ABSTRACT

At district and regional levels respectively, Ian Carruthers and Brian Edwards can fairly be said to have contributed as much as any two individuals to the future renaissance of the National Health Service (NHS). Without them and their groundwork it is hard to conceive of the conditions in which a primary care-led national policy initiative could have been conceived. As the NHS translates itself into the wider UK health care system, creative responses to internally intractable problems increasingly come from those operating at its interfaces. Health and health care leadership is more and more provided by those moving to semidetached positions, capable of combining a cluster of roles which legitimize loyalty to the NHS with construction and criticism together. The local NHS can be reborn because of the creative triumphs of Dorset and the Midlands, where Ian and Brian have been Chief Executives throughout the 1990s, and much more besides.