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Under David Nicholson the NHS has received unprecedented levels of funding and it is as inefficient as ever, it has failed to improve outcomes in most areas that are assessed, it has allowed failing organisations to fail without recourse to the taxpayer and it its staff have been blatantly let down by those charged with improving the system. He has allowed short termism and protectionism to become ingrained in the culture, and has failed to take a "big picture" approach to the system to reform and improve it. How can anyone justify his continuing in the role. Apart from Mid- Staffs, look at the rest of the diabolical mess he has made of things!