As everyone is aware, instead of maintaining the good elements of business, the NHS insists on keeping its bad managers. If they are failing, they are simply paid off and they go off to get a job at another Trust or a quango like the Kings Fund. Have we ever had a manager who was prosecuted for their negligence. This never happened in Stafford either. Instread, hard working staff working against all odds are scapegoated. If you don't believe me, just observe what was done in Stafford. Witch hunting season is over now and I think it's important for the NHS to start some accountability for failing management. Might be good to think about a management regulatory body. Lord Darzi never quite liked this idea. Then Lord Darzi never quite likes much that holds the system to account. I think my idea of cutting management pay is a cost saving one. It should be managed in line with junior doctors salaries. Secondly, they should give their parking spaces to patients and their relatives, that too for free. All these ideas are workable but not by those who believe in fleecing the NHS. Anyway to more interesting matters. I wrote this article about processes used to manage whistleblowers. I think this prevents the kind of victimisation and silliness that is engaged when someone raises a legitimate concern. http://nw-businesssense.com/in-praise-of-whistleblowers.html While I have a very poor view of managers, they are not all bad. I guess my view is based on the fact the Chief Executive at the hospital I raised concerns about ended up with a big salary at Bolton. When the death rate spiked there, he was then shifted to the Kings Fund. I have dealt with many obtuse managers, some who tried to scupper my GMC registration in the early days to those who had no insight into how to handle the concerns I raised. Ofcourse, when we move further up the evolutionary scale, right up to the Department of Health, we find the situation worsens. Something about high pay and low IQ always amused me. The DH and I arent great friends. Possible because I know about their mean remarks in the file they hold on me. I know about how they concealed reports on the vindication of my concerns and I know how they worked with the GMC to discredit me with correspondence moving between these paper pushers. It amazes me that these pen pushers assume they have some God given right to judge legitimate whistleblowers. The fact that they couldn't even change a lightbulb even with a proper business plan escapes them. We wonder why the infrastructure of the NHS is failing. We simply have to look at the impractical conceited personalities hired to run the NHS. It took me a while to understand that thttp://nw-businesssense.com/in-praise-of-whistleblowers.htmlhe concerns I raised related to management and policy failure . I can now understand why managers attempted to shut me down by fruitless criminal investigations that went nowhere, by spurious regulatory body investigations that went nowhere and by social stigmatisation but I guess with some strength of character, everything can be overcome. This is called whistleblower reprisal and its generally not talked about in posh management circles for good reason. After all one wouldn't want to cast aspersions by referring to research detailing the psychopathy in managers. I am describing the above because I know that we always talk about the culture of medicine that needs changing when we should also be talking about the culture of management that requires an overhaul. Without that, we will never have proper management of legitimate concerns. Dr Rita Pal