The Management of Clinicians in the National Health Service

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Abstract
The Griffiths Report recommended that doctors be looked on as natural managers in the National Health Service, and recommended that general managers should make renewed attempts to bring clinicians into the management process. Many attempts had been made in the past to commit doctors to management. A survey was conducted of District General Managers in England to find out what mechanisms they are devising to encourage clinicians to become involved in management. The survey results indicate that two mechanisms dominate general management thinking. One method is to increase clinician participation and involvement in discussions of policy and resource use. The other is to allocate budgets to clinicians and to encourage them to become financially accountable for their actions. The latter view is the most commonly held, though it is not clear what precise purpose the budgets are to serve. The paper concludes that the success of devolved budgets as a management tool will depend upon understanding the factors which motivate clinicians.

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