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Welcome to the club. Doctor bashing has also become a national sport, but in ways NHS managers might find difficult to appreciate. Then there is the overbearing and at times surreal tyranny of appraisal/re validation.

DOI: was a clinical director and then a medical director within the NHS. My background is orthopaedic surgery.

It got so bad I left the UK. I now work in a fee for service environment where I am fairly and directly rewarded financially for what I do. Litigation is almost non-existent and there is a high degree of trust between patients and clinicians. I get what I want: within limits of course, but there is no quibbling over my right to ask. Nurses do not 'backchat' at me: they know they would get short shrift. That does not mean they cannot ask questions or clarify what was meant, but there is none of the tedious passive-aggressive baiting that has become so common on wards and in theatres in the UK.

The NHS is doomed and in free fall: cannot understand why any self-respecting doctor stays within it. Regrettably, the UK private sector as an alternative is not that much better: ask me, I tried it!

The same goes for any self respecting manager: do not become a victim of NHS Stockholm syndrome: get out now and do something else with your life.