Leadership, clinical freedom and costcontainment: lessons from recent history

Abstract

Public Health provision, free at the point of contact, is espoused in many countries within the European Union. The method of funding, whether by direct taxation, or via insurance companies, is not so much a problem as the ever increasing cost of medical advances and are. Clearly structures need to be in place to manage this service, and the modern doctor is called upon to play an ever- increasing role. The British National Health Service has served as a template for our local health service, albeit with various divergences along the way. This article highlights the central role of the doctor, as leader and manager, in effecting constant change within the service.