The recent Darzi report recommends an increase in clinical leadership in the NHS. Whilst Professor Stefan Scholtes believes it is important to have more clinicians on the board, he cautions that this approach needs to be thoughtfully implemented; "haven't we been here before during the first fifty years of the last century when hospitals and organisations were lead by clinicians… we ended up bringing in managers as the clinicians couldn't organise the finances". Professor Scholtes argues that the key is to motivate clinicians to want to become managers, and to then train them up, equipping them with the necessary managerial skills to make economically sensible decisions about the distributions of resources. Their deep-seated professional perspective combined with an over-arching view of the 'system' will lead to innovations in the services and even greater beneficial efficiencies in the future.