Paying for new drugs and treatments and meeting the demands of an ageing population requires that the NHS finds £20bn of efficiency savings by 2015. Never has the need for effective leadership and management of resources in the health service been more apparent.
It is all the more worrying, therefore, that the government's NHS reforms involve deep cuts in management posts. Even in advance of the controversial health and social care bill becoming law, the number of health authorities and primary care trusts has been reduced, resulting in the exit of many experienced NHS leaders. Thousands more will leave in the coming months, as these organisations prepare for their abolition in a year's time to be replaced by the new NHS Commissioning Board.