In depth and range of complexity, the hospital as a social institution has few rivals today. In a recent study of the hospital, Dr Edward Churchill, writing from the famous Massachusetts General Hospital, said: ‘The hospital is one of the most complex and dynamic instruments of contemporary society’. In Britain, we need to view the hospital in a similar sense operating within the additional complexities of a nationwide Government-financed, centrally regulated system of administration. No community could hope to succeed with such an enterprise without a large fund of intelligence, and what I like to call cultivated commonsense. This country has been conspicuously successful in producing administrators with these talents, but such gifts by themselves are not now sufficient when it comes to controlling and administering a hospital service. Today we must add a wide knowledge of the Health Service as a whole, a thorough grasp of the work and functions of all departments of the hospital, and at least a nodding acquaintance with a variety of technical, medical and professional terms. I do not wish to join with those who would make a mystique of administration, but I must say that in my experience most lay members, newly-appointed, of a hospital board or management committee are pretty useless during their first year of office. Often, their sense of inadequacy and the efforts they feel they must make to justify themselves in their new role encourage behaviour round the committee table which is either sentimental or grandiose, or both. Too much attention is devoted to elaborate development plans for the hospital, irrespective of the needs of the general practitioner and local authority services, and too uncritical a view is taken of welfare and amenity for hospital staffs. If there is no ‘ordinary’ money available, there is apparently always ‘free’ money. The existence of this fund is one of the few aspects of hospital management which the new member grasps during his first year of office. In all seriousness, however, I do suggest that it is not until perhaps half the three years have gone by that a new member can play a really useful part in hospital government.