Clinical Governance became a new mantra in Britain in the late 1990’s.

Suddenly Managers were responsible not just for the budgets,the waiting lists and the complaints but for the Patient Care delivered.

Medicine was too important to be left to the doctors and systems were necessary to monitor and evaluate work, to correct problems effectively and to measure the impact of that medical service.

Increasingly clinical care would be judged , the world of league tables was here, a hospital ,a clinic, even a doctor could be given a ***** rating.

The doctors were puzzled, uncertain and suspicious. Plainly there had to be a better partnership with Management and better understanding of the joint task-hence this lecture.