Letters

NHS chief executive Sir Alan Langlands has said: 'No matter what opportunities are created by organisational and policy changes, they will bring little benefit to patients and staff unless there are confident and skilful leaders to take advantage of them.'

This worthy sentiment is hard to reconcile with the consistently downward pressure on senior managers' pay (news and news focus, 11 February). Once again, we are facing a pay award significantly below that offered to the rest of our colleagues in the NHS. It is difficult not to interpret this as an indication of how little we are valued.

Senior managers are perceived as a soft target for efficiency savings, and yet there are high expectations of us from the government, the public and staff. The level of experience, knowledge and skill required to be a senior manager in the NHS is now undoubtedly out of proportion to the rewards. Professionally qualified senior managers are increasingly more likely to be paid less than the staff for whom they are responsible.

Sir Alan and health secretary Frank Dobson need to take stock. Frontline clinical staff are not the only groups who can find better pay and conditions in the private sector. If you pay peanuts you can only expect monkeys, and I for one do not want to see monkeys running the NHS.

Sarah Byrom

Northwich

Cheshire