McKinsey and the 'Tripartite Monster': The Role of Management Consultants in the 1974 NHS Reorganisation

The first major reorganisation of the National Health Service took place in 1974, twenty-six years after the service had been established. It has long been perceived as a failure. This article draws on archival records and a witness seminar held in November 2016 to provide a more nuanced assessment of the 1974 reorganisation and understand more fully why it took the form that it did. In particular it identifies the reorganisation as an important moment in the ongoing story of management consultants engaging with health policymakers, and explores the role of McKinsey and Co. in detail for the first time. Key explanatory factors for their involvement are identified, including the perceived lack of expertise and manpower inside the civil service and the NHS, and perceptions of their impact and effectiveness are discussed. Many debates about the use of management consultants today were directly foreshadowed during the early 1970s. Alongside this, the role of other groups of policy actors, including civil servants, politicians and medical professionals, are established and the extent to which British health policymakers have had to work within existing cultural, political, legislative and practical constraints when trying to initiate change is demonstrated. The fact that many of the 'mistakes' that were made have been repeated in the course of subsequent reforms, speaks to the poor institutional memory of Whitehall, and the Department of Health and Social Care in particular. In the run up to 1974 management consultants could make only a limited contribution to an imperfect compromise.

Population Control, Family Planning, and Maternal Health Networks in the 1960s/70s: Diary of an International Consultant

Over the past decade historians have explored the rise of the mid-twentieth-century population/family planning movement on both the international and the local levels. This article bridges the gap between these studies by exploring the work diaries of Dr. Adaline Pendleton ("Penny") Satterthwaite, a midlevel technical advisor who traveled to over two dozen countries for the Population Council from 1965 to 1974. Penny's diaries draw our attention to a diverse network of advocates who mediated between international population activists, state actors, and local communities while also acting as conduits for the transnational spread of strategies and resources. Her experiences also provide evidence of the coercive practices, gendered tensions, and political conflicts shaping the movement while illustrating the resistance and engagement of local actors, the existence of health- and women-centered approaches even during the high period of population control, and the many structural and social barriers shaping family planning projects in practice.

James Herrick (1861-1954): Consultant physician and cardiologist

In 1910, James Bryan Herrick published the first clinical and laboratory description of sickle cell anemia. Two years later, he published a case report on coronary thrombosis. Together, these case reports solidified his reputation as one of the premier diagnosticians of his generation. Now regarded as a central figure in the history of American medicine, Herrick played an integral role in the clinical adoption of the electrocardiograph and the professionalization of cardiology in the United States. Although a full decade passed before the medical profession recognized his clinical description of coronary thrombosis and myocardial infarction, it has had profound implications for cardiovascular medicine and prevention over the past hundred years. As a consultant physician, Herrick advocated in favor of incorporating chemistry and laboratory evaluation into clinical practice.

2010-2011 ASCP president Al Barber: a man for all settings

Next month, Albert R. Barber, PharmD, CGP, FASCP, becomes the president of the American Society of Consultant Pharmacists for 2010-2011. What distinguishes his career is his wide-ranging experience in almost every pharmacy setting: retail, long-term care pharmacy, independent consultant pharmacist, clinical administrator for a large health care company. His goals as president are to directly involve more ASCP members and to reach out to pharmacists serving seniors beyond the nursing facility setting.

The life of Dr Jan Ingen Housz (1730-99), private counsellor and personal physician to Emperor Joseph II of Austria

A brief biography is presented of Dr Jan Ingen Housz, as written, originally in Dutch, by M J Godefroi, a mid-nineteenth-century Dutch physician who was a friend of a near descendant of Dr Ingen Housz. From being a general practitioner at Breda, his home town, he moved to England to learn smallpox inoculation, was sent to inoculate members of the Habsburg family at Vienna and dedicated his later life to scientific experimentation, notably revealing the fundamentals of photosynthesis.

Profile of a leader: pioneer government advisor: Laura Holland, RN, RRC, CBE, LLD (1883 - 1956)

Laura Holland, nurse and social worker, became one of Canada's first official "nurse advisors" to government when she was appointed Advisor to the B.C. Ministry of Health and Welfare from 1938 to 1945. Before that appointment, she had served, with distinction, as a Nursing Sister in World War I, brought innovative Red Cross and public health advances to northern Ontario, reformed Children's Aid services in Vancouver and B.C., and started a new department that combined nursing/social work in the field during the Great Depression of the 1930s. She was an extraordinary leader.

Sam Greenhouse: his contributions as a consultant to the Food and Drug Administration

This paper recounts contributions made by Sam Greenhouse to the Food and Drug Administration during his tenure as an advisory committee member and as chair of the committee. The events and topics are taken from available recollections and minutes and selectively describe a range of topic areas and issues about which Sam Greenhouse played a substantial leadership role. Published in 2003 by John Wiley & Sons, Ltd.

The contributions of Sam Greenhouse to research on psychiatric diagnosis and psychopharmacology

Sam Greenhouse began his involvement in mental disorders research in 1954 when appointed chief of the Theoretical Statistics and Mathematics section at the National Institute of Mental Health. He remained with the NIMH until 1966. Despite moving on to several other positions at the NIH and at the university during the ensuing years, he continued as a consultant to NIMH investigators. He also participated actively as an advisor and co-investigator on a number of important collaborative research programmes launched by the Institute in the 1970s and 1980s. His contributions to the design and methodology of the first clinical trials of drugs for the treatment of schizophrenia, to research aimed at revising the national and international classification systems for the mental disorders, and his participation in the planning of the first attempt to use the collaborative research model to test hypotheses about the genesis of a specific mental disorder (depression), are described. Finally, the signal importance of the 'profile analysis of variance' method that he and Seymour Geisser developed, to research on personality and mental disorders, is examined in detail. The authors describe applications of the method in their own research on the classification of the mental disorders, predicting response to drug treatment and the variations in the expression of mental illness across different cultures. Sam worked in mental health during an era of revolutionary changes in the diagnosis and treatment of mental disorders. The field was acutely aware of his many contributions to the progress of research and his colleagues are very grateful to have had the opportunity to work with him.

The past: 'the good old days'

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The history of geriatric medicine in Scotland

The concept that care of elderly people required special facilities and training started early this century but was only implemented with the advent of the NHS in 1948. In Scotland the speciality gradually evolved and grew in stature and prominence. The early pioneers in Scotland are described.