A question has been bothering me, an ex-nurse, for some time. In these days of managerial cuts and general control on bureaucracy, what is the purpose of chief executives? They cost on average pounds70,000-pounds80,000 and additionally require the support of one, normally two, secretaries. So the cost of a chief executive's office is probably about pounds120,000 per year. What do they really do? What genuine value do they bring to an organisation?

In my experience, not much. The chief executive of the trust where I previously worked had been a civil servant and knew nothing about the practical functioning of the hospital.

When I left last year, my colleagues on the wards were not impressed by him. Why not spend the money on something more useful, they said; all he seemed to do was write patronising articles for the hospital magazine. So please, Mr Dobson, if you read this, remember one chief executive equals five or six nurses. Please ask yourself who provides more care to the patients. No contest.

N Brown,

Elstree,

Herts.

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