Chris Lancelot on ... An NHS of many talents

I was intrigued (and secretly thrilled) by Gordon Brown's announcement that he was seeking 'a government of all the talents', because it is something I have believed in for a very long time.

I detest the naive party politicking which does so much for petty politicians' egos and so little for the good of the country; and I welcome any government that seeks to use the very best of the nation's talent.

So I'm delighted to see that various experts have been drafted into the new government. These include a prominent surgeon, Professor Sir Ara Darzi, who has been named as a health minister.

Nevertheless, we must not fall into the trap of assuming in general that just because someone is a good doctor they will necessarily make a good manager or a wise politician. The talents, experience and personality that make for a good practitioner won't automatically make that same person into a competent manager or political leader.

Unfortunately we can sometimes hold to the quaint idea that being a doctor makes us omniscient, or entitles us to greater respect in other areas of life. It isn't true. Good doctors will be good at medicine: but they have to prove their worth in other fields. We would never say to an administrator: 'You're an excellent manager, how would you like to become a ward sister?'

Why then do we think we can automatically do it the other way round: 'You're a good ward sister, how about becoming a manager?'

Doctors make excellent managers, if nothing else because we are accustomed to thinking carefully, weighing up the evidence, and living with uncertainty.

Crucially, doctor-managers also bring a clinical understanding to the situation. But doctors don't automatically make good executives, because a good manager needs separate talents: the ability to think creatively and constructively, to create simple but effective organisational structures, to be able to delegate and manage.

The last thing the NHS needs is bad managers, even if they are all clinicians, and we all know of excellent doctors who unfortunately are not that good as managers. So, while I applaud the idea of the double qualification of 'doctor-manager', and greatly appreciate those clinicians who also become good managers, we need to recognise that this is indeed a dual qualification which few are gifted enough to possess.

Dr Lancelot is a GP from Lancashire. Email him at

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