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IHM chief executive Stuart Marples laid into the rating system but agreed on the need for managers to 'sharpen up' Signs were afoot this year that the Institute of Healthcare Management was at last being brought in from the cold.

The IHM had little input in the NHS plan, and even less thanks. Last year, there was even talk of possible merger with the NHS Confederation. That debate seems to have been silenced.

Both NHS chief executive Nigel Crisp and health minister John Hutton hinted at a closer partnership with the institute, each talking of 'closer dialogue'.

Welcome though that was, the flirtations didn't distract chief executive Stuart Marples, who a few hours later was laying into the Department of Health's beloved star system, describing it as an excessively complicated game.

'Explaining the offside rule to my wife would be easier, ' he said. Jokes apart, his attack went further than any statements coming from the NHS Confederation.

'The rules were not clear up to the announcement. . . Given a proper understanding of the rules of the game, this is a game we would happily be part of. It is not right, and it is probably illegal to threaten people with dismissal if there is no improvement within three months.'

He attacked the concept of franchising as 'an obsession. . . we have got into that there is someone out there that can do it better', which was 'largely unproven and destructive'.

Observers attempting to discover which way the wind is blowing for the institute will focus on its emerging role in management regulation.

It has taken a lead on the issue since it featured among the raft of recommendations of the Kennedy report on the Bristol inquiry.

Mr Marples was known as an enthusiast for regulation before it became fashionable.

He said that whatever level managers were working at they needed to have a minimum set of management knowledge and skills - and in particular that there were 'specific issues at the point of transition for clinical staff whose role becomes more managerial in nature'.

And he suggested that some managers might have to sharpen up on their technical performance: 'I also feel we will have to accept that many current management qualifications have let slip some of the harder skills, if I might use that phrase, like stats, like finance to the point of understanding balance sheets and public finance initiative regulations, and the law as it affects our management performance.'

At the conference, the institute published its management code and made its adoption a condition of membership.

'Honesty, integrity, openness, accountability and respect' are its central buzzwords.

News immediately came from Ann Lloyd, director of the NHS in Wales. She told one of the workshop meetings that she would be speaking to trust chief executives to see if they would want to see the IHM code applied to managers on a compulsory basis.

Although there are rumours that Scotland will be making a similar move, Mr Marples admitted that England may take some time to follow suit.

He told HSJ : 'I welcome what Nigel [Crisp] said during the conference about opening a dialogue, and it does show that they are keen to move closer to us. I would certainly like to think we will be getting involved in the development of management regulation, but we have had no hints from the department that they want to use us yet.'

They were wise words. Mr Hutton, speaking at the end of the conference, played the issue with a straight bat, saying the government's answer would come when it responds formally to the Kennedy report.