Cogwheel: a physician's view of a local version.

A preliminary experiment in the divisional system of medical administration has been started in a large regional hospital in the Metropolitan area. This has involved considerable local interpretation of the original proposals in the Joint Working Party's report. The chief benefits of this version as tried so far have been a more effective use of doctors' time at all levels, a more rapid carrying out of practical suggestions, and closer co-operation between different departments. Those who give first administrative place to streamlined efficiency have seen the absence of an authoritative executive committee as the chief defect to date. The main fault in the eyes of those who emphasize the fundamental importance of participation has been the delay in the involvement of the junior medical staff.