Human Milk and the Preterm Baby /1 Mothers Should Breastfeed

might be to introduce a purchaser-provider model like that introduced into the NHS. The Advisory Council on Science and Technology suggested this to Mr Waldegrave, but he turned it down. With this proposal the MRC (and the other research councils) would become purchasers of research and have no responsibility for managing providers. The units would become providers of research and would compete for contracts from the research councils, the charities, government departments, and other bodies. The remote, heavy handed management style of the councils would become irrelevant, and the units would develop their own management styles and flourish or die. This system would allow what the management guru Tom Peters calls "fast failure,"6 which would be overt, swift, and predictable in contrast to the slow, covert, and questionable procedures currently used to close units. Resources could quickly be released for more rewarding research. Mr Waldegrave seems to recognise the need to shift research management from being top down to bottom up, and he hopes that this will be achieved through his proposed "foresight procedures"2: in these procedures researchers and others are systematically questioned about research prospects and the information derived is combined with information from marketing people to develop a strategy that is scientifically advanced and fits with what the market needs. But Mr Waldegrave seems to have neglected the effector arm of this process. If the management styles of the research councils are not radically reformed-perhaps to the point of a purchaserprovider split being introduced-then nothing will change.