Management or leadership?

Abstract

This article considers the roots of the division between management and leadership, and suggests that the division encourages individuals and organizations to displace responsibility for problems in health services onto others. Given the significant limits to the power of leaders, the difficulty of establishing a science of leadership, and the increasing complexity facing health service management, the problems might appear insurmountable. However, drawing on lessons from the different approaches of the combatants in the infinitely greater complexity of the Second World War, it is suggested that trying to 'manage' the chaos by controlling it, or relying on 'leaders' to solve our problems, or buying in yet more consultants, are deeply problematic strategies; only mass leadership and collective responsibility are likely to solve the problems.