comment: Cull of chief executives does the service no favours

Published: 10/04/2003, Volume II3, No. 5850 Page 17

Three years is not a long time in management - but it is the approximate length of stay for the average chief executive before they jump or get pushed (news focus, pages 14-15). In the Thames Valley area six chief executives have left their posts already this year - most notably Oxford Radcliffe's David Highton, whose marked improvement of accident and emergency waiting times was not enough to save him.

Other health economies can tell similar stories - of well respected and experienced managers put to the sword despite clear successes. The last few months - and particularly the last few weeks of March - have seen tremendous work on targets in many trusts (news, pages 6-7). That work will be thwarted if the culls continue.

No-one would defend poor management, and those in senior positions should expect to be judged on the performance of their trust, but surely no-one believes such quickfire hiring and firing works in the long term.

The cadre of bright, ambitious managers underneath the top few jobs do not want for challenges where they are. The considerable leap in pay that comes with promotion will often be far outweighed by increased pressure and uncertainty.

And many will feel that moving into the chief executive's job will mean that they will stop battling for the hospital and start skivvying for the government.

Good leaders grow good leaders. The inevitable result of 'churn' at the top is that too many middle managers are being mentored by those who have too little experience themselves, either of the job or the organisation. This is bound to reap bitter rewards. l