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London: Chapman & Hall. , Marnoch, G. and Pollitt, C. (1992) Just Managing:Power and Culture in the National Health Service,Basingstoke: Macmillan. Heginbotham, C, (1993) Healthcare Priority Setting: A Survey of Doctors,Managers and the General Public,London: King’s Fund College. Hoffenberg, R. (1987) Clinical Freedom,London: The Nuffield Provincial Hospitals Trust. Hoggett, P. (1991) ‘A new management in the public sector’, Policy and Politics,19 (4): 243–56. Hood, C. ’, Public Administration,69: 3–19.

Et al. (1973) Hospital Organisation,London: Heinemann. Scrivens, E. ’BritishMedical Journal,296:1, 754–6. — (1988b) ‘The management of clinicians in the NHS’, Social Policy andAdministration,22:22–34. , Morrison, E. and Friedman, B. (1990) Strategic Choices for America’sHospitals,New York: Jossey Bass. Smith, R. (1992) ‘A shared future’, address to NAHAT Conference, 24 June, Harrogate. , Grabbam, A. and Chantler, C. (1989) ‘Doctors becoming managers’, British Medical Journal,298:311. Stewart, J.

G. Kogan et al. 1978; Griffiths 1983; Strong and Robinson 1990). Many of these features are being challenged, as a result of the 1991 reforms, and a number of commentators would argue that this has been a good thing for the NHS (Klein 1993; Strong and Robinson 1990). The move to change the culture of a service that had by a wide measure of agreement become dominated by traditions of administration, hierarchy and professionalism has, these analysts argue, some positive features. While the diagnosis of the NHS’s ills may invite wide support, the prescription, with its emphasis on markets and consumerism, has been greeted with a great deal of suspicion and concern over the likely outcome of what amounts to a huge social experiment.

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