[Obstacles to innovation]

Three publications by K.P. Kisker that appeared in the 'sixties of the present century are milestones along an important path of panoramic changes in the recent history of psychiatry. They are model reflections of the steps or stages towards a new approach to understanding the social system represented by the hospital and the style of working practised therein. A present-day critical assessment is given of the forces that have been acting against this development, as pointed out by Kisker, and especially so of those originating from the dynamics of tension between the nursing and the medical staffs.