NHS regions. They were the weakest link.

The role and autonomy of regional chairs has been eroded since they were established in 1974. Regional chairs became increasingly anomalous after the abolition of regional health authorities in 1996. In recent years they have been caught between the NHS and the civil service. The shift from RHA to an outpost of the civil service was profound. Experience as a regional chair suggests that really imaginative initiatives come from local enthusiasm rather than top-down directives.