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Are we suggesting that people who have shot to the top of the NHS tree without ever having worked in the system and with no reality or connection to the people and services they are meant to be representing could possibly be over confident - and that those same people who sit in ivory towers with a belief that you need never step-out into the real world as everyone will come to you, and besides you might meet some of those awful patients, are being found as failng in their ability to inspire and are in fact demotivating others... well I never... who could have seen that one coming?

Oh, and read 'rolling up their sleeves' as 'think they are always right and so take no direction from their more experienced staff whom they trample underfoot on their way to the top'...