Much has been said and written about Margaret Thatcher in the last few weeks, what she stood for and her political legacy. Whatever one’s views there is no doubt her premiership reframed politics and the policy context of health services. I was teaching social policy at King’s College to undergraduate nursing students during her political heyday. Inevitably my course adopted a contemporary critique of health policy and my students honed their analytical skills in discussing the impact for nursing. So what did she do for nursing? Margaret Thatcher started the trend of inviting business leaders into the heart of policy development. Roy Griffiths a retired Director of Sainsbury’s was drafted in to review NHS management. In a remarkably short report he criticised consensus management as lacking accountability and noting famously that: