GENERAL MANAGEMENT IN THE NHS: THE INITIAL IMPACT 1983–88

The Griffiths report of 1983 resulted in radical changes (to which the label 'general management' has been applied) to the formalities of organization and management in the national health service. We report the findings of a major study (involving more than 300 interviews) of the impact of these changes up to 1988. Although general management has been widely accepted in the service, and seems to have resulted in some improvements to management processes, there has been no substantial change in organizational culture. We conclude that the impact of the Griffiths model of management has been limited in comparison with the continued influence of medical autonomy and financial limitations.     

The Horn of Africa

The following address was given by Mr. Waterfield to a jointmeeting of the Royal African Society.and the Royal Empire Societyon October 3, 1957. Mr. B. F. Macdona, vice-chairman of theCouncil of the Royal African Society, was in the chair.     

China: The Next Big Crash

Buoyed by its creditor's hold on the United States and its ability to withstand the harsh winds of recession blowing from across the Pacific, China has graduated in its own mind from an emerging economy to a world power. From their confrontation with Google to their renewed repression of dissidents to their dissing of President Obama, China's leaders clearly feel that the time has come for the world to accomodate China, not vice‐versa. Is the West ready for this new reality? Is China's new arrogance well‐founded, or is it going to be the next bubble to burst? As it moves beyond “the primary stage of socialism” is it ready to open up politically? In this section, some top China scholars, one of China's most well‐known dissidents and a former US spy chief discuss these issues.     

Mini‐lateralism Will Get Us Nowhere

The further we get from the crisis moment of the global financial meltdown in 2008–2009, the weaker the momentum to establish an effective system of global governance. Gordon Brown, the former prime minister of Great Britain who hosted the most successful G‐20 conclave in London at the apex of the crisis, laments the complacency that has taken over. With the scandalous departure of Dominique Strauss‐Kahn as head of the International Monetary Fund, a global debate has opened up over whether the emerging economies should have a greater voice in that institution. Nobel laureate Michael Spence comments.