Clinical governance is working and managers are feeling the load

Scandals used to hit the NHS singly. Now two or three surface every week. As HSJ went to press, a single day's newspaper cuttings - 70 pages - were dominated by pathologist Dr James Elwood and gynaecologist Richard Neale: one man accused of misdiagnosing hundreds of cancer tests; the other of botching operations on women on two continents. This on top of Bristol, Harold Shipman, Rodney Ledward and Alder Hey.

On one level, it is good news. Scandals that might once have remained hidden are being unearthed - evidence that clinical governance is starting to take effect. And stories that might once have been buried are getting extensive coverage - evidence that the public is sloughing off its illusions about saintly medics and adding to the impetus for reform.

On another level it is bad news - not just for the victims of incompetence and arrogance, but for the whole NHS. Every emerging horror provides further ammunition for those who would like to sweep it away.

It is also adding to the load on managers . As this week's debate at the King's Fund showed , 'why didn't they act?' is an easy question to ask once problems are laid bare.

Sometimes it is a good question. Sometimes it just ignores the historical difficulty of getting information and then using it against well-defended consultant 'kings'.

The continued spread of clinical governance and initiatives such as Professor Liam Donaldson's 'early-warning system' should impact on the first part of that difficulty. If the storm can be ridden out, the mounting tide of evidence that doctors are not kings should help with the second.