The invisible hospital--or, what patients experience but managers often don't see

This paper is an extract from The Invisible Hospital and the Secret Garden--an Insider's Commentary on NHS Reforms and is based on a paper presented at The Royal Society of Medicine in London on 11 April 1994. The author discusses the need to identify the invisible hospital--what patients experience but managers often don't see--through Non-Executive Directors, for it is perhaps only they, he maintains, who, if more active and influential, can fulfill the potential of the reforms to change it. In addition to justifying the author's (now widely-discussed) visit to a hospital as a wheelchair patient, the paper is drawn primarily from Mr. Spier's own experience of Chairman of Brighton Health Care NHS Trust and the implementation--or not--of his own initiatives.