In this chapter, life in UK psychiatric hospitals during the long 1960s is described. Based on oral testimony from a witness seminar, the chapter reveals perspectives which are not readily available in written sources. The authors outline how changes in treatments, the Mental Health Act 1959, multidisciplinary teams and ideals of community care provided opportunities to improve the lives of patients but that wide contrasts existed in the pace and extent of these changes and in clinical standards and practices between, and even within, hospitals. The chapter also addresses how some institutions were characterised by individual charismatic – and often ideologically dogmatic – leaders and the risks that this entailed. For many, their experiences had a lasting impact. Individual senior staff – ‘good’ or ‘bad’ – were role models who had profound effects on the course of junior clinicians’ future careers, while the memory of a tragedy, such as the suicide of a patient, could haunt involved staff members lifelong.

Effective administration of healthcare in an emergency setting, especially in field-hospital deployment where order must be established, needs assessed and limited resources allocated effectively, is considerably more complex than the regular patient–doctor interactions characteristic of routine times. Due to the complexity and uncertainty typical of such an environment, leadership is required not only by the field hospital staff but also by the affected public, which seeks leadership in those who are perceived to be the center of clinical service delivery.

This type of leadership demands organized command and control and practice of more than just basic leadership processes, and therefore requires, alongside the mission leader, a structured management and task-orientated chain of command.

For the hospital to operate effectively and independently, it is necessary to also define the organizational structure. The organizational structure discussed in this chapter is a model tested over the past three decades by the IDF Medical Corps hospital in numerous missions. This structure is generally similar to the basic structure of a small- to medium-scale hospital in routine times. At the same time, it allows more focused and simple managing processes required in non-routine scenarios such as emergencies or disasters.