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Good piece for stimulating discussion. I too have called for more evaluation of leadership along with a stronger emphasis on management, which with administration has been somewhat sidelined by an over-emphasis on leadership.

But perhaps the most important variable to take into account is the relationship between developing a stronger NHS ethos of caring and compassion, and how these qualities are viewed in society as a whole.

I would argue that whilst I share Clare's aims, unless we are seen to be a more caring and compassionate society - as is the case in many other countries - we may have limited success in changing NHS (and social care) culture.

Finally, and this is another way of looking at Clare's points, there is an increasing gulf between the multi-disciplinary, team-based approach of clinical care and treatment with the hierarchical nature of leadership and management in the NHS. NHS management needs to be reinvented so that it mirrors clinical care - perhaps then we would stand a better chance of developing the improved behaviours that we talk about.