Received wisdom has it that introduction of general management in the NHS in the 1980s was a good thing. But Aidan Halligan, the former NHS director of clinical governance who quit the Department of Health last year, has come to the view that putting doctors and nurses in charge is the only way to save the service.

Halligan, an obstetrician by background who now runs his own healthcare consultancy, was commenting on the recent BBC2 programme in which management guru Sir Gerry Robinson was filmed advising on problems at Rotherham hospitals foundation trust. Among the many excruciating aspects, said Halligan, was the amount of time the trust's hapless chief executive seemed to spend locking his office door against stereotypically blinkered and self-interested clinicians.

The next 10 years would determine whether there was any long-term future for the NHS as we know it, Halligan told the AGM of the College of Chiropractors. But that would depend on the most charismatic doctors and nurses stepping forward and being appointed chief executives to lead their fellow professionals as only they could.

"The only way the NHS will get to where it wants to go is by professionals looking to take responsibility for offering patients the sort of care you would want for yourself and, looking neither right nor left, going for leadership positions and going for results. That will happen - I have no doubt - and when it does, people will say it was obvious."