Published: 30/05/2002, Volume II2, No. 5807 Page 22 23

In the context of primary care trust shortfalls (news and comment, 16 May), the recent Royal College of Nursing congress and Agenda for Change, here is a short bedtime story.

Daddy Milburn spoke to his children while they were on a few days out in Harrogate. He explained to them that they can't just expect more sweeties without doing more at home - and importantly, doing it differently/better/quicker - they must understand that he had a limited amount of sweetie money to share round.

The children felt guilty for asking but knew they shouldn't take sweeties from others, so decided to have another look at things back at home to see if they could, indeed, produce massive change and much higher productivity for a few more sweeties. They were, on reflection, very na´ve.

Back at home, mummy Milburn's primary care trust was in deep trouble. Daddy had set her targets as well - but he'd also transferred all sorts of outstanding bills from past trust family members to her and the family.

Mummy was very angry and stressed. 'I haven't got enough money to manage day-to-day family needs as now, ' she snapped. 'How can I give you time to re-organise and change anything?

'Just get on with it, for goodness sake. We have all got pressures - and the main ones are achieving daddy's performance targets before he comes home to check on us.'

Mummy was upset. She could see how some of daddy's ideas were very good for the family, but they just didn't have time and space to change. She was angry that daddy had earmarked money, but couldn't see that they needed it at home now to solve the current mess and free them to develop better ways of doing things.

The children were also annoyed.

No-one understood or had time to appreciate their reality; many left the family home.

But daddy didn't listen to mummy. It is sad really, because the family became more and more disillusioned and, a few years later, they voted daddy Milburn out of the family completely. Daddy, on reflection, was also very na´ve.

Bernice Baker Freelance consultant nurse Horsham