Letters: The Lucy Letby killings shouldn’t mean we lose trust in all NHS managers

Murder mystery

Sir: I once made a diagnosis of a very rare condition too late to cure the patient. She was nevertheless grateful and thanked me, though my conceit evaporated when she asked: ‘What took you so long?’

I suspect the managers at the Countess of Chester Hospital must feel as I did (‘Hospital pass’, 26 August). Murder was not on the top of their differential diagnoses. Many senior clinicians who have had leadership roles in NHS hospitals bear the scars of conflicts with management, though perhaps not as deep as those of the Chester paediatricians. 

We would nevertheless acknowledge that most managers are dedicated, conscientious professionals committed to the success of their hospitals. They do not get the recognition and adulation received by the clinical staff. They have an unenviable job reconciling the demands of senior executives with pressure from the clinicians whom they manage. The executives are no less uncomfortable as they live with a succession of often mutually exclusive priorities from government, Royal Colleges, trades unions and universities.