By driving David Loughton out, the health service will be the biggest loser

Published: 14/03/2002, Volume II2, No. 5796 Page 19

Another chief executive's career has foundered in the storm over star-ratings and clinical governance reviews. David Loughton of University Hospitals Coventry and Warwickshire trust has finally announced his long-anticipated departure - in six months' time, after he has worked his notice to ensure a smooth handover to his successor.

Mr Loughton appears to have been crushed by the shifting tectonic plates of public opinion represented by star-ratings, Commission for Health Improvement reports, a restless consultant body and indignant local MPs, as well as impatient and publicityconscious ministers - all against a background of an unforgiving local press. To have stayed on in the teeth of this would perhaps have taken superhuman determination and skin as thick as elephant hide.

Yet Mr Loughton clearly lacks neither toughness nor determination. He is among the longest-serving trust chief executives in the NHS, one of those who live and breathe the hospital where they have spent most of their career. He evidently has a problem with some of his doctors, or they with him, but that is hardly unique and not an automatic hanging offence. Encouraging consultants to embrace change, and confronting obstructive medical power blocs, is the nub of much of the modernisation process.

Many other chief executives may have to tread these dark halls where Mr Loughton has gone before if the government's aspirations are to become reality.

Doubtless he made mistakes; doubtless the patient experience at his trust is not always perfect. But doubtless, too, he was wrestling with an unconscionable workload as he marshalled efforts to secure a new£330m hospital. And as so often, the departure of a chief executive leaves a nasty taste in the mouth and a lingering sense of injustice.

For initially Coventry and Warwickshire was awarded a comfortable two-star status, until a critical CHI report led to the humiliation of its removal - and threw a spotlight on the contradictions inherent in the system. It had been expected that CHI's followup report would decide Mr Loughton's fate, but it is understood that this time around CHI has bestowed a favourable and positive verdict.

Which leaves the strong impression that the system demands a sacrificial lamb before the trust can be thought to have purged itself of its sins. The NHS, however, can ill afford to lose top managers like David Loughton.