this week

Proposals that could see NHS managers being 'struck off ' a central register if they are deemed unfit to work have received a cautious welcome from within the service.

The Bristol inquiry report says managers should be subject to the same obligations as other healthcare professionals - including being subject to a regulatory body and professional code of practice.

A recommendation to create a new Council for the Regulation of Healthcare Professionals to oversee separate regulation bodies for groups, including managers, has already been accepted by the government. Professor Ian Kennedy's report also says the NHS Leadership Centre should create guidelines on those leadership styles and practices that are acceptable and those that are not.

The report criticises the management style of Dr John Roylance, former chief executive of United Bristol Healthcare trust, but suggests that the only mechanism available to censure him - disciplinary action by the General Medical Council - was not appropriate.

The Institute of Healthcare Management presented four papers to the inquiry - two of which called for a system of revalidation to be introduced. It has already produced its own code of conduct for members, likely to become mandatory in October.

Director Stuart Marples said that he did not want regulation to be seen as 'a punitive framework - it has to be about education, and about catching problems early'.

But he said that in his personal view the government needed to go further than a code of practice and introduce a disciplinary framework.He said all managers needed to have some kind of qualification or competence 'before they are put in charge of people's lives and livelihoods'.

Dr Kieran Walshe, senior research fellow at Birmingham University's health services management centre, who gave evidence to the Bristol inquiry, said he believed Professor Kennedy was determined to 'professionalise' management.

'You do not want people with no clinical qualifications doing your operation so why should people with no financial training try to balance a budget?'

Although all senior managers contacted by HSJ supported some form of regulation, views were mixed about whether the government should go further than a code of conduct and about how best to 'police' a disciplinary system in an area as general as management.

Alastair Henderson, policy manager of the NHS Confederation, said: 'One of the key difficulties is control of entry into the profession. It is difficult to see exactly how it would work. . . a code of conduct might be easier to operate.'

Chief executive of UBHT Hugh Ross said he would be 'very supportive' of moves to regulate managers' behaviour: 'A code of conduct that all managers are invited to sign up to is right.'

Dorset health authority chief executive Ian Carruthers said that managers 'could only expect other groups to go through accreditation and re-accreditation if we are prepared to undertake it ourselves'.

Reading primary care trust chief executive Janet Fitzgerald said more robust systems would be welcome, but that they should be integrated with processes of appraisal and continuous professional development already in use.

And David Roberts, chief executive of City Hospital trust, Birmingham, said: 'If we can reassess the thousands of consultants we have got, why can't we do it with fewer managers? I wouldn't feel threatened by it - quite the contrary. Let's do it - let's all be on a level playing field.'