Cogwheel Report

During the 1960s, there were controversies over pay for National Health Service doctors and perceived lack of trust between doctors and hospitals. == Committee ==

The Joint Consultants' Committee and the Minister of Health created the joint working party "to consider what developments in the hospital service are desirable in order to promote improved efficiency in the organisation of medical work." John Howie Flint Brotherston was appointed to head a similar committee for the NHS in Scotland. Members included Dr John Owen Fisher Davies, Howard Granville Hanley, J.A. Hauff (Assistant Secretary, Ministry of Health), Dr Thomas Roland Hill, H.H. Langston (orthopaedic surgeon), Tom L.T. Lewis, Dr Richard Mayon Mayon White, Gordon McLachlan (Secretary of the Nuffield Provincial Hospitals Trust), Geoffrey Anderson Phalp (Secretary and Principal Administrative Officer, United Birmingham Hospitals), Sir Arthur Porritt, Sir John Richardson, Dr Kenneth Robson (registrar of the Royal College of Physicians), T.B. Williamson (who retired in February 1967 due to ill health), Dr H. Yellowlees, Dr I.T. Field and Dr G.R. Ford. == Report ==

The committee published its report in 1967, soon after the Salmon Report. The report became known as the "Cogwheel Report" because of its cover design. The Report recommended that doctors be more involved in management, with specialisms having responsibility for their own resources. A medical executive should then be formed from representatives of each specialism. == Impact and critiques ==

Following the report, the Ministry of Health encouraged hospital authorities to implement the report's recommendations. "Cogwheel divisions" were organised and consultants in a substantial number of hospitals had adjusted organisational structures. Another was that it was unclear where medical social workers fit. In 1972, a second report was published. The impact of Cogwheel was limited by the reorganisation of the NHS in 1974, under which consensus management and multi-disciplinary teams were introduced. == See also ==