PT - JOURNAL ARTICLE AU - Graham Winyard TI - Doctors, managers and politicians AID - 10.7861/clinmedicine.3-5-465 DP - 2003 Sep 01 TA - Clinical Medicine PG - 465--469 VI - 3 IP - 5 4099 - http://www.rcpjournals.org/content/3/5/465.short 4100 - http://www.rcpjournals.org/content/3/5/465.full SO - Clin Med2003 Sep 01; 3 AB - Doctors and politicians have rarely seen eye to eye on what a health service should provide and how it should be managed. The introduction of general management in 1984, while initially successful, created new fault-lines between doctors, managers and politicians that were compounded by a succession of NHS reorganisations. These changes brought politics too close to front-line management, highlighted the incompatibility of managerially determined targets with the essence of professional practice, and have led to the development of a management agenda disconnected from healthcare. Remedies are suggested here that reflect the particular roles and contributions of each group that could restore a sense of shared purpose in the running of the NHS.