[tweetiepooh]

But you always need someone to run the efficiency team and to handle transition and they need a team and oversight and so on it goes.

The NHS does need good managers as well as good clinical, technical, service and other staff. Problem has often been promoting good staff to management roles. (I know I've said this before.) So you end up with poor managers working over poor or overworked staff.

And too many old boy (or girl) networks, bad contracts with suppliers, too many people in the chain preserving the chain to preserve their interests.

More money in would result in more people to ensure it's spent properly costing more money.

And while it's hopefully not as bad as it was more common sense won't go amiss either. If you notice a water spill, get some paper towels and wipe it up, doesn't matter if you are a manger, don't fill in a form to get some janitor to come along with the official mop and sign.