The clamour for the resignation of the chief executive of the NHS, Sir David Nicholson, will no doubt be making him wonder who his true friends are and who he can trust.

‘this desire to have the head of someone high up is part of an unhealthy blame culuture’

For it will not be the relatives of patients who died through neglect and mismanagement at Mid Staffordshire Foundation Trust who bring him down. It will not be an investigative journalist, a television documentary or a press campaign that forces him to resign either.

In Shakespearian fashion, his potential assassins are likely to be conspirators from within. For sure, they will be reassuring him of their support right up until the moment they stab him in the back; the fatal blow being delivered for the good of the service. No doubt the conspirators already have a name for his successor.

Must Caesar die? This desire to have the head of someone high up is part of a very unhealthy blame culture.

The same culture which put targets before care and the same finance-driven culture which led to the complaints of patients relatives to be ignored, unsafe practices and bullied doctors and nurses into silence.