The NHS has never been an easy institution to manage. It is vast, bureaucratic and peopled in its upper echelons by some giant egos. You don't make a good surgeon as a shrinking violet.
Mostly people rub along all right. But the occasional clashes one expects among any organisation of highly paid, self-opinionated individuals working under pressure sometimes erupt into something much, much worse. As Mark Porter, chair of the BMA consultants' committee points out, when things go wrong in the NHS they tend to go spectacularly wrong.
Last month United Lincolnshire Hospitals Trust paid an undisclosed sum to its former chief executive Gary Walker, sacked in 2010 allegedly for ... swearing. He said he was being targeted as a whistleblower after complaining the safety of patients was being put at risk to achieve targets. He had claimed £1m in compensation.
In August the Royal Cornwall NHS Trust lost its appeal against the unfair dismissal of its former chief executive John Watkinson, who was awarded £1.2m. The trust is £25m in debt.
These cases are dwarfed by that of Michalak vs Mid Yorkshire NHS Trust, both in the scale of wrongdoing exposed and the size of the compensation paid out. It is difficult to comprehend how so many senior people in the supposedly caring professions became involved in such an unpleasant and dubious campaign to oust a colleague.
This was a malfunctioning organisation that had lost its moral compass. The tribunal considered making the 12 respondents in the case personally liable but was unable to for legal reasons. The penalty will be paid by Wakefield and North Kirklees patients whose hospitals face an even greater struggle to make ends meet.