ABSTRACT
A Community Health Council was established in each District to act as a public watchdog, patients’ friend, and constructively critical commentator on the Service’s plans and performance. To the staff, the problems are not just promises, or receding promises, of adequate resources to do a good job for the public they serve. To the observer the problems of the NHS are often seen as the problems of politics. There is a direct conflict between long-term planning and the pressures of the political arena. These are potentially powerful factors militating against the sustained application of the corporate planning approach as outlined here to the development of the NHS. The service examined is the Accident and Emergency Department, but the problems of patient access and efficient service reflect the problems facing much of the NHS generally.
