Chris Lancelot on...Managers failing to care

I watched the TV programme featuring Sir Gerry Robinson at Rotherham Hospital with a mixture of fascination and horror.

Horror is an understatement, I had to be scraped off the ceiling in a state of gibbering insanity at the crassness of Rotherham's situation, which included a totally inefficient way of running theatres that no manager had spotted, challenged or changed and a chief executive who did not realise that part of his job was to be out and about, learning at first hand about his hospital's problems.

Then there was that consultant's infamous question, why doctors with five or six degrees each should be bossed around by people with only three O-levels between them (I suspect hyperbole, but Sir Gerry thought he was very arrogant).

Yet this goes to the heart of the NHS's problem. It is totally frustrating for bright, articulate, qualified, innovative and responsible people to be controlled by managers with fewer abilities, little foresight and no drive. Few would object to managers with no formal qualifications if they performed brilliantly. Indeed, one of the best PCT managers I know falls in to this category. But huge difficulties arise when ineffectual managers (even with MBAs) order clinicians around without demonstrating a drive to change things for the better.

Rotherham had problems that were clearly amenable to simple managerial intervention. So why had this not happened already? The defects Sir Gerry pointed out, and their cure, seemed to me so obvious that I am amazed that its managers needed his help.

Why does the NHS employ managers who cannot see the wood for the trees? I do not care what their qualifications are, if they are unable to spot problems or introduce more efficient ways of working, then they simply are not worth their salaries - worse, they get in other people's way.

I hate the double standards in the NHS, where doctors constantly have to prove their competence and risk losing their livelihoods for a single mistake - yet managers can be totally ineffectual and make a gargantuan mess of things with virtual impunity. Only when managers are judged by the same high standards, have to exhibit the same consistent high quality and drive and bear the same level of personal responsibility as the staff they are organising, will the NHS become a happy, efficient ship.

- Dr Lancelot is a GP from Lancashire. Email him at

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