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After 30 years in the nhs, the last 15 on Trust Boards, I can honestly say that the gap between rhetoric and reality has never been greater. The bullying culture thrives, a culture driven and encouraged by the very top, so those whose philosophy and style fit the profile get promoted and those that don't get bullied into submission. Let me tell you about one senior manager who confessed to me that he was so terrified every day at work that he vomited his breakfast. Is it any wonder that our nurses are exhorted to remember Compassion, they work in system totally devoid of any such feelings. Sir DN, behave according to your stated values - resign now