ABSTRACT
Administration in the National Health Service (NHS) can be viewed as operating at two levels. There is a policy and strategy level which, in the context of the many consultative and administrative constraints put upon it, seeks to ensure not only that a service is provided, but that the optimum service is provided and that improvements are facilitated. The NHS Reorganisation Consultative Document wished to establish an atmosphere based on ‘effective management’. It is a pledge which is in danger of causing jaundice in that the management arrangements that emerged after expert study may progressively render the administrator less rather than more effective. The relationship between appointed members and administrators has also changed now that the number of public representatives involved has increased. Common sense suggests otherwise: that such sensitivity is to be found in lay administrators with their overview of hospital situations, but not in the functional managers with their circumscribed duties.
