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Ultimately someone (the public?) needs to decide what form of leadership is required for what kind of healthcare system we can afford. The hugely ambiguous current NHS contains (at the least) two principal types of organisation within it - the foreground organisation, that essentially is based on chaotic principles, and the equally large background organisation that seems to be based on transaction principles. The background organisation is massive, of equal size, we are told, to the foreground organisation. Its personnel may never meet a patient. Leading it may require a different set of personal values and beliefs to the leadership required to lead the foreground organisation. In the foreground is the classic ideological conflict between the professions and the bureaucracy, requiring sensitive and acute skills to bridge the gap and keep everyone going in the same direction. Leaders in the foreground organisation really require the skills knowledge and experience at all three levels A, B and C, with a lot of experience at levels A and C to be truly good at the job. The lack of these skills is fairly clear at the moment, and provides some explanation as to why certain imports from other organisations find it hard to succeed in the NHS. Equally, of course, exports from the NHS also can find it hard to deal with organisations that are not multi-professional and complex. Ultimately, it seems to me at least, the attributes of individuals are key, and become the foundations on which to build the skills knowledge and experience at levels A, B and C. Whether they are successful will depend on the cultural foundations of the organisation they are leaders within, and that's a whole new ball game.
Derek Mowbray, from Linkedin