We have been fortunate in our group that the executive committee has elected the medical superintendent as chairman of the executive committee. He has in the past spent a large amount of time on administration, so this position did not require him to radically alter his timetable. Nevertheless, in groups where the chairman does not already spend a large part of his time on administrative duties he must get considerable support from his colleagues within his specialty. But any clinician must be able to act as chairman either of his division or of the medical executive committee. The fact that one of our four consultant general surgeons is at the present time mayor of the city illustrates that many consultants can find time for this amount of administration if the will is there.Any group contemplating setting up this type of administration must insist on adequate clerical help to assist both the executive committee and the divisions with clerical work and also to produce and collate the necessary statistics.We agree with the Cogwheel report that it is difficult for hospitals with fewer than 20 to 30 consultants to have a divisional system of administration but consider that all but the smallest groups could elect a small executive committee from their medical advisory committee, who could then meet more regularly than the main committee and come to decisions more quickly and effectively than previously. ConclusionsWe agree with the Cogwheel report that each individual group must tailor the suggestions to their own requirements. If the hospital medical staff do not streamline their own administration before the reunification of the health service and the setting up of area health boards we will probably be administered increasingly by non-medicai administrators and have little say in the running of our hospitals.
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