The NHS must reform the way managers are held to account rather than 'pointing the finger' at those who receive pay-offs, union Managers in Partnership has argued.

Severance payments are not perks but 'the price the taxpayer has to pay for the failure of the system to manage senior executives competently, fairly and legally', MiP chief executive Jon Restell is expected to tell delegates today at the managers' union's annual conference.

Mr Restell will say that NHS chief executive David Nicholson 'needs to do more than point the finger at the end result of a dysfunctional and more and more discredited system of accountability'.

His speech will call for a fair and open contractual disciplinary procedure which allows investigation, requires and tests objective evidence and results in fair and independent hearings and appeals. He will describe junior health minister Lord Darzi's review as an opportunity to ensure that managers, not ministers, are accountable to the public.

For more on Managers in Partnership from this week's magazine, click here