What makes a good leader? There are several schools of thought. Should a leader be reserved like Gordon Brown, or gregarious
like Tony Blair; quietly dignified like Bobby Moore, or in your face like John Terry; boisterous like Alan Sugar, or overfamiliar like David Brent?

In October 2003, there were 14,319 books on leadership listed on Amazon. In November this year, there were 52,628 - more than three times as many. Assuming you could read these books at a rate of one a day, it would take you more than 100 years to get through them all.

The most efficient leaders are those who prevent fires starting in the first place

The most relevant titles at present are surely those that deal with leading in a financial downturn. There are several leaders who have never experienced a downturn before, and so do not know how to deal with the necessary changes. And there are changes to be made.

According to the NHS Confederation report Dealing with the Downturn the NHS will face a severe contraction in its finance with cuts worth billions of pounds likely in the three years from 2011. The need for strong leadership is greater than ever, because the NHS will not survive the spending squeeze unchanged. Courageous decisions are needed.

So, how to prepare for 2011?

Edgar H Schein, a professor at the MIT Sloan School of Management in the US, says in his book Organisational Culture and Leadership that a leader should be someone who stands apart: “Leadership is the ability to step outside the culture… to start evolutionary change processes.”

Many organisations reward stand-apart, heroic leaders - those who “put out fires” and turn things around when faced with a looming crisis. The most efficient leaders, however, are often those who prevent fires starting in the first place by ensuring their organisations are prepared for change and run smoothly.

In his book Leading Quietly, professor of business ethics at Harvard Business School Joseph Badaracco says: “The most effective leaders are rarely public heroes; they move patiently, carefully and incrementally. They do what is right for their organisations… inconspicuously and without casualties.”

Ashbridge Business School chief executive Kai Peters says the “global leaders of tomorrow” should understand and be able to respond to changes, have the skills to survive and thrive in situations of low certainty where there is little agreement and have the ability to understand and engage with external partners.

But, as one NHS manager said, it all boils down to human nature - if individuals get what they want from a leader, they will consider that person effective. If they don’t get what they want, they will think the leader is in the wrong job.

All managers and leaders can do is perform the best job they know how for the good of their teams and their organisations, and try to get the balance right in what will be a challenging period ahead. There is no single right answer, a point demonstrated by the thousands of books on Amazon.