Sir Roy Griffiths, a senior manager in the food marketing industry, was asked by the government to lead an inquiry into the effective use and management of manpower and resources. The report was delivered in October 1983.
The review found that there was no clear definition of management functions in the NHS and recommended that the government should establish a Health Services Supervisory Board (HSSB) chaired by the secretary of state for health to decide on objectives, budgets and strategies for the NHS. To strengthen management capability, Griffiths recommended that all regional and district health authorities should appoint general managers to take charge of services at regional and district management levels from April 1984 and that the same principles should be applied to the Department of Health. Until then, the dogma had been ‘consensus management’. General management would manage conflict and set objectives. Opposition came from those groups that would lose power, such as public health doctors and nursing managers.
Griffiths stated that: ‘At no level is the general management role clearly being performed by an identifiable individual. In short, if Florence Nightingale were carrying her lamp through the corridors of the NHS today she would almost certainly be searching for the people in charge.’
The inquiry team also felt that clinicians could be more closely involved in making decisions about priorities in the use of resources.