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Failed by catastrophic management at PCT

From Dr John Cormack, South Woodham, Essex

With reference to your piece on clamping down on GPs and the GMC in the wake of the Shipman affair (News, 17 December), it's worth pointing out that NHS managers can do a great deal of harm ­ it's just that because they are not in the frontline, the public is slow to catch on.

I don't see why there should be one rule for us and another for them. For example, when a PCT goes off the rails, patients who write to the strategic health authority or Department of Heath are directed, directly or indirectly, back to the PCT itself ­ the very organisation they were complaining about in the first instance. Imagine what would happen if we clinicians tried this on?

To give one further example, I have complained to the department and had to ask it twice for its complaints protocol.

Would a GP get way with such a lackadaisical approach these days?

Here in South Woodham, Essex, we have had a prime example of catastrophic management which has resulted in the waste of hundreds of thousands of pounds of taxpayers money. Yet, far from anyone being held accountable in a supposedly 'open and transparent' NHS, no effort has been spared at covering the tracks.

I therefore sent Sir Nigel a copy of the rules of the game as it is presently played. He hasn't found time to thank me ­ but he's a very busy man and it's early days yet.

My Woodhamgate Rules

1. In the new NHS no manager shall under any circumstances tolerate any imperfections in clinicians. If a clinician is found to be deficient in any way (and, in particular, where the health or well-being of patients is concerned) he/she shall be dealt with immediately in such a way as to minimise or (where possible) eliminate any further risk to patients. This is, of course, as it should be.

2. In the new NHS, every manager should not only tolerate imperfections in fellow managers, he/she shall actively seek to cover up for his/her colleague(s). This rule shall apply to each and every deficiency ­ and, in particular, should be upheld where the health or well-being of patients is concerned. Moreover, the cover-up shall go to the very top.

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