Published: 06/05/2004, Volume II4, No. 5904 Page 21

Having lost its chief executive after just a year, where does IHM go from here, asks Andrew Wall

Institute of Healthcare Management chief executive Maurice Cheng is leaving after less than a year in post. This is an organisation with a mere 9,000 members and its views are seldom heard in public.

What is it doing and what should it do in the future?

In the 1990s, a statement of the IHM's objectives established that members wanted to promote their own professional standing and have an independent voice to influence health policy. In the last 10 years, most activity has aimed to enhance professional status. There is some confusion here between being a professional and acting in a professional manner. Fundamentally, to be a member of a profession is to satisfy entry requirements, usually educational, and to sign up to standards of conduct.Health service managers currently meet neither of these requirements. Indeed since the demise of the IHM's own diploma, there is no agreed educational requirement.

Nevertheless the question of standards is important.How can these be assured? The most obvious way would be to set a code of conduct.

After a considerable gestation period, a code was published by the IHM in 2000. This code was commandeered (with the support of key IHM members) by NHS chief executive Nigel Crisp and republished with significant changes. Significantly, health service managers are now required to be loyal to their employer's interests.

For a brief period in the late 1980s and early 1990s, the IHM would appear regularly in the media offering opinions on government health policy. No longer. It could be argued that it is inappropriate for the IHM to challenge the policies of an elected government. But many people spend their whole working life with the NHS, and that experience should be valued. The IHM could be at the centre of debate rather than leaving that role to the NHS Confederation, whose agenda and membership overlap but are significantly different. It may be no coincidence that part of the IHM's income derives from programmes sponsored by the Department of Health.

There is a way out.Members obviously enjoy opportunities to meet counterparts (regional activities still flourish). There has to be greater respect for their experience and views. Representing those views is what the IHM could concentrate on. Strengthening links with other groups of public servants could re-activate the ideals of public service and clarify its unique contribution to our society.With this wider perspective of public service, the IHM might be revived.

Andrew Wall, a career-long member of the IHM, is visiting senior fellow, Birmingham University health services management centre.