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Since I started working in the Service more than 30 years ago, it has always been the case that those with the biggest boots kicked those further down the line. Strangely in any hierarchical structure this occurs, its part of the way tribalism works. As a manager you get paid to manage, and that means dealing with bullies and managing them back into the box, and sometimes, very uncomfortably sticking your neck out. The skill that you are getting paid for as a manager is knowing which fights to have, with whom and what the fall back plan is. That calls for political nous and common sense, it really isn't helpful when people pretend that the NHS is not staffed by human beings, who exhibit human behaviour. The NHS has not lost its soul, its staffed by people who for the most part really do care, and who each day make a difference by just getting on with the job warts and all. Lets not pretend its a fairy tale - these are real people doing difficult jobs and they deserve our respect.