In this paper I ask what is wrong with 21st century leadership and management. For example, why, when there exists the benefits of decades of research into management theory and practice, are so many organizations so poorly managed and led? I suggest that modern work practices are not a departure from those of the 19th and 20th century scientific management but rather an extension of their principles beyond manual work to include the professions. This is related to the corporate takeover of more social domains, including health and education, and the associated problematic human resource practices which predominate. They include various forms of favouritism which ensure the appointment of ‘uneducated’ rather than ‘expert’ managers/leaders. It is time to start measuring the cost to both organizations and society, of ‘uneducated’ managers/leaders.