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I think what people have a problem with is Parsi's public statements which suggest that he can make unprecedented level of savings without it having any impact on the quality of service delivery.

Not long agos he was stating that they had no plans for cutting staff, implying that he could somehow find making £20m+ of savings a year through the old chestnut of "cutting waste and inefficiency".

Most of us that have worked in the service and are aware of the proportion of the budget that is spent on staff salaries are a bit skeptical of this. We don't believe he's got some magic plan to remove costs, we pretty much know that he'll have to do it the same way as everyone else and that it will be painful.

When he says (to paraphrase) "we've concentrated up to now on turning around the clinical performance and now we need to focus on the financials" we know he's ignoring the fairly obvious fact that maintaining that clinical performance might be quite difficult if you cut 20% (or even 15% or 10%) of the staff.

And let's not go through the tired old "we'll make the cuts in back office and support services" nonsense. Whilst there might be a few hundred thousand readers of the Daily Mail that believe all our hospitals are crammed with hundreds of managers and administrators doing no useful work, those of us that have actually worked in them know that isn't true.

Most administrators are doing stuff that someone else would have to do otherwise. If you want to axe all your ward clerks it will improve your clinical staff to non-clinical staff ratio, but you're just going to be paying more expensive nursing staff to do the things they were doing.