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I think Heather's comments are unhelpful.they could just as easily be directed towards anyone clinical and managerial administrative or layperson in an NHS organisation. The reality is that NHS managers are unfairly vilified bullied and left unsupported. The NHS is dominated by professions, including the financial profession. And yet for some reason it is always the general manager who is lambasted when anything goes wrong. I have worked at every level of the NHS from clinical front line to board. We need to start talking openly about the real problem of the NHS: It is managerially and professionally toxic; competitive, divided, and at worst in open conflict. And the new system is appallingly poor in terms of governance.How can we be seven weeks away from handing responsibility over to clinical groups that have no concept of how to run an effective business where patient safety is properly prioritised? The new NHS is already a train wreck; overlay Francis and you have no prospect of addressing the real issue for commissioners: how do you know that your suppliers aren't killing people?