There's no row like a family row and the NHS family is not an exception. It has long been recognised that the NHS's own staff can often be the worst ambassadors for what is happening in the service, nationally and locally.
As MORI research has shown, NHS employees are more cynical and more critical of reform than in other areas of the public sector. And because the NHS is such a large local employer, the circle of friends and family that surrounds each staff member can add up to a significant circle of negativity.
As we report in our cover story this week, this state of affairs has been accepted for too long. It is important that managers take responsibility for looking clearly at why staff think the way they do - after all, these are staff who often remain deeply committed to making their own contribution to the NHS, whatever they may think of 'the bosses'.
This is about more than just better communication to staff. Talk to hospital doctors, for example, and they will tell you that what annoys them most is being wheeled out to 'support' plans they have had no hand in creating. By bringing in staff too late and too narrowly, organisations are almost guaranteed to lose potential support.
It would also be a mistake to restrict this engagement to clever chaps in bow ties. The MORI research shows that one of the biggest indicators of what people think about the NHS is what they are told by people who work for it, and that applies whether your daughter-in-law is a consultant or a healthcare assistant.