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I agree with Anon 4 Dec 9.07pm. The issue that I see on a day to day basis is that managers don't come to work to do a bad job, however they are largely often promoted operational, nursing and clinical staff, who may have been competent in that role, but are not competent at managing. To be fair to managers, the NHS has not bucked the trend in the UK of not investing in this tier, and we therefore suffer (and I mean patients and staff alike) everyday having to operation in self created chaos, which actually is very expensive and diverts resource from where it needs to be spent.