Management guru Sir Gerry Robinson's televised stint at Rotherham foundation trust to reduce waiting lists might have worked better in a trust that has not already achieved so much to place it on a more business-like footing.

Management guru Sir Gerry Robinson's televised stint at Rotherham foundation trust to reduce waiting lists might have worked better in a trust that has not already achieved so much to place it on a more business-like footing.

Perhaps some of his ideas would have been more motivational and have had a better direct impact had the organisation been in a situation, as many are, where there are business deficiencies already inherent within the systems employed.

I think the idea to begin with was commendable and I would share the view of the chief executivethat it might have been more useful if the reasons for the problems had been better defined. This would aid public understanding of the complexities of healthcare versus the comparative simplicity of industry.

Elizabeth Wood, service manager/specialist nurse practitioner, occupational health services, Mid Yorkshire Hospitals trust


Quality not speed
Two things stand out to me about Brian James's responseto the Sir Gerry Robinson TV programme. The first is the lack of charisma and ideas in someone who has achieved the rank of chief executive of an NHS trust. This is apparent in the programme and in his defensive response.

While the clinical consultants might have sounded appallingly arrogant in their dismissal of NHS managers' lack of qualifications, Brian James does little to reassure us about the calibre and intellectual credibility of people running operations at a senior level.

The second is the total lack of attention to the matter of the quality of clinical care. The programme and his response are all about volume, capacity, numbers. If you gave all patients a choice about where they are put on a spectrum between clinical quality versus speed of processing, I wonder how many would choose speed. Surely clinical effectiveness ought to always be running alongside the productivity agenda.

Andrea Jones, project manager, community nursing, South Downs Health trust