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Having recently returned to the NHS after a number of years in HR with other public sector and not-for-profit employers, I am amazed at the number of administrators, clerical, staff PA's etc. employed. I am also dismayed at the number of staff employed in analysing, reporting, monitoring, quality, intelligence, performance, risk, governance, etc. etc. compared with other organisations elsewhere, who are also spending public money, and who are also heavily scrutinised and regulated. 137,000 job losses may seem daunting and it would certainly concern me greatly to look to cut clinical and allied posts, however, surely there are some 'sacred cows' that need to be challenged. For example, does every Director/Associate Director/Assistant Director/Head of Service require a PA - in this day and age of PC's, laptops, Blackberries, etc.? Also, does everything have to be reported so many times over, with highly paid professionals being required to spend a large proportion of their time providing data to other staff, instead of actually utilising their professional expertise in to do their job and attempt to improve their service, in order to benefit the customer?