A dose of Occam's Razor?

Abstract

It is the nature of great bureaucracies — and can there be any greater bureaucracy than the British National Health Service? — for the specific tasks and roles of individuals and departments to be perceived as ends in their own rights rather than as contributions to the pursuit of the objectives of the organisation as a whole. Characteristically, no single person, body or department has an overall view of what the organisation is trying to achieve and where it is going although, since the introduction of general management in 1984, there is evidence that this integrating and visionary function is starting to be fulfilled by at least some general managers. However, when general managers start to do this, and it is entirely appropriate that they should do so, they come face to face with the conundrum that the overall aims and objectives of the National Health Service have never been spelt out except in the broadest possible terms in the original National Health Service Act 1946, in subsequent amending legislation and in the very few central policy statements that have been published, for example the ‘Priorities Document’, the ‘Way Forward’ and ‘Care in Action’.