The starting point for this case is the rationalization process which happened in the Eastern Cape Department of Health in 2002. This process was a top down approach with no consultation with stakeholders. This resulted in a structure which was bureaucratic, with strategic units that negated the functional reporting structures. This new age movement from structure to process was not preceded by training of managers, who were still stuck in the old industrial age focusing on control and hierarchy. Two significant events, the first being the 2006 ICU baby deaths at Cecilia Makiwane hospital and the 2007 Daily Dispatch expose into Frere baby deaths highlighted the cracks in the system.When the researcher analysed the history of the problem, it immerged that the rationalistion process undertaken was a significant root cause. The aim of this project was to Perform an organisational diagnosis, describe the impact of change (rationalisation) and to analyze why there was such a high staff turnover. This project is targeted at Clinical and Non-Clinical Managers in a Healthcare setting, but also open to any manager in any organisation.