The Executive Years of the NHS: the England account 1985-2003 takes a look at the rise and fall of the NHS executive boards in their various guises. The story is told against the backcloth of a turbulent phase in the history of the NHS starting with the industrial unrest in the late seventies and the radical reforms of the Blair government.
The authors argue that the attempt to place a powerful independent executive within the Department of Health failed because Ministers held onto operational power. Even today, each Minister has a long list of operational policy areas for which they are responsible…from information technology, maternity services, to food. Few have any competencies in these fields and most have little experience of managing large and complex service organisations.