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Even if Mr Nicholson goes we have to remember that there was a culture throughout the early to mid 2000s, starting at the top with Hewitt and Reid, and through all the SHA CEOS and their turnaround consultants (who made lots of money) that said to people: "Promise to break even, or we'll find someone who will." I know becauase I saw it in action. Ultimately the cause of poor care is the insistence by the people at the top (and in the middle) on usign whatever flimsy evidence they can find to show that there is nothing systemically wrong. The 17 hospitals are the tip of the iceberg. There are lots of hospital wards for the frail elederly where the elderly just get iller and weaker, rather than better. You wouldn't neglect or deskill the Queen in them, so why are they good enough for the rest of us?