Letter: NHS winter woe

Sir: A contributory factor to the current crisis in the NHS (leading article, 6 January) is the poor performance of its management.

There is no shortage of this burgeoning group in health authorities and trusts, a significant proportion of whom are unable or unwilling to make essential decisions involving vast sums of money which affect patients' services. The Government's penchant for reorganisations means that, in many health authorities and trusts, man-agement's sole preocc-upation is with survival.

The service is littered with failing trusts, compulsorily merged, causing, on average, two years of operational blight, making derisory savings (in the case of my own trust, less than pounds 500,000), but the same managers are again slotted into post.

The NHS apparently cannot afford redundancy payments, but it simply cannot afford to keep recycling its tired management.

In any sensible organisation, mergers are followed by a robust reorganisation and a new management body.

Dr GRAINNE EVANS

Consultant Paediatrician Community Child Health

Farningham, Kent