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Where are the Churchills of the NHS?

As medical director in a large acute trust, I used to hear over and over again that clinical leadership is the panacea to the problems of the NHS. When serious problems have come under scrutiny—such as at Mid Staffordshire NHS Foundation Trust and Maidstone and Tunbridge Wells NHS Trust—lack of clinical leadership is always identified as a key issue. But is this a 21st century solution? After all, in the early 1980s we were all assured by the Griffiths report that it was good management that would cure, once and for all, the problems of the NHS.1

As I sat in my very nice office I reflected on my personal role as a leader in moving my organisation forward. As the medical director of a merged trust in financial turnaround with a private finance initiative, an associated independent treatment centre, recruitment issues, medical performance issues, a reconfiguration agenda, an interim chairman, a high turnover in executives, seven MPs in our vicinity, and trying to achieve targets under the gaze of the strategic health authority, I wondered what …