ABSTRACT
As has been discussed earlier both theory and practice suggest that the role of senior management in the process of quality management will determine the fate of the whole process. The Chief Executive’s commitment must be unquestioned and outspoken. There are too many hard things to do and too many opportunities to do something else over too long a timescale for quality improvement programmes to survive the benign neglect of the institution’s head. The strategy and its implementation must be strongly identified in the minds of the staff with a senior figure who has linked his/her reputation to the course laid out.
