First, there is the classic bully: the weak person throwing their weight around in order to counter their own insecurities.

Then come the clueless: those whose plans are so suspect that they won't allow them to be discussed.

Others are poorly trained: having seen only a bullying management style, they don't know how to manage in any other way.

Finally there are those who were bullied in early NHS employment and, like any victim of any form of abuse, risk later becoming a perpetrator.

Judging by the response to GP's survey of PCTs, managerial bullying is active in the NHS: PCTs who won't consult their GPs, hospital managers who put gagging orders on clinical staff and PCTs that rule by diktat.

Not only is managerial bullying all-pervasive, it minimises the output of other NHS workers.

Strangely, the British Army may provide both the means to diagnosis and the solution. Clearly, discipline in the army is of the first importance: so won't effective officers be bullies? Not at all. Remember the army mantra: 'In the field, officers eat last.' Their job is always to put the welfare of their troops first and never order a soldier into a situation they aren't prepared to face themselves. Commanders like this are respected and even revered by their troops. By contrast, despots don't care about the welfare of those under their rule.

The secret of good leadership is to care more about your staff than yourself, respect them and never give them a job you wouldn't do. Good leaders understand their staff, are sensitive to their needs, and open to fair criticism: bullies throw their weight around.

Managerial bullying is endemic within the NHS, and we clinicians should have none of it. Whenever we come across bullying, it is our duty to stand up to it.

Complain - firstly to the perpetrator, because they may not realise what they are doing. If the problem persists, don't give up: go to their boss, their boss's boss, the LMC, the GMC, the Care Quality Commission or the health secretary.

And if all else fails, go to the media.

Cartoon by Fran Orford: www.francartoons.com