This may be the age of the £125,000-a-year trust chief executive responsible for 15,000 staff and a budget of more than £400m, but can any manager in today's NHS claim the untrammelled power and influence - let alone the unquestioned personal authority - of the group secretary and house governor in the 1950s and 1960s?
(See News Focus, pages 10-11. ) Their management style was honed while running large tracts of India or commanding Spitfire squadrons. The NHS today may still have a sprinkling of macho managers, but who - even among their ranks - would make staff stand to attention when they entered the room, or inspect their fingernails?
Managing the health service then was a curious combination of adhering to the rules to a stultifying degree and taking outrageous liberties with NHS resources. So while management committee minutes had to be written up in such detail it took two days, no one batted an eyelid if staff were sent to place bets or check the weather forecast for the group secretary's sailing weekend. In another 50 years, what aspects of today's NHS will appear equally absurd to those contemplating the service's centenary?