CHARLOTTE SAUSMAN is the lead researcher on the Nuffield Trust's Policy Futures Project, which looks at the future of health and possible policy responses to it. Dr Sausman has published on the role of senior managers and officials in the public sector. SANDRA DAWSON is Director of the Judge Institute of Management, Cambridge University's Business School, where she also holds the KPMG Professorship of Management Studies. She writes and consults on organizational behaviour, health management, occupational safety, innovation and technology transfer and is author of numerous articles and four books. From 1992-1995 she was Chairman of Riverside Mental Health NHS Trust.