- Since 1948, doctors have had a powerful influence on national and local health policies. They have not, however, always had a happy relationship with the administration that had to implement the policies. Recently the argument for cost effective management, rather than just efficient administrators, in the NHS has been greatly strengthened. The changes, culminating in the Griffiths reforms, are affecting the medical profession's influence in the NHS. This book, based on a series in the British Medical Journal, is aimed at helping doctors to adjust to the management revolution and to guide them to a constructive and participative partnership with the new managers.