Supporters of the management class believe that workers are either too dumb or are incapable of managing their work-place. Managers are necessary, they say, to change and/or reform organizations. For example, if you wish to introduce market forces into a public service like the NHS, you need managers to organize it. The workers themselves could not do it. If you want workers to do their work properly, and diligently, you need managers on their backs, otherwise consultants would spend all their time in their private clinics - presumably this does not apply to the saintly managers who are expected to police themselves. If you want to bring down the price of drugs, call the manager, because doctors cannot choose properly, unless they are given clear options by another group outside of their profession, presumably of more superior intellect. A health service cannot be run by doctors because they have no talent for administration - presumably GPs are not doctors.