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Letters When managers rule

Making the patient the principal focus of management in the NHS

BMJ 2013; 346 doi: (Published 15 January 2013) Cite this as: BMJ 2013;346:f244
  1. Philip Pearson, consultant respiratory physician1
  1. 1Plymouth Hospitals, Derriford Hospital, Plymouth PL6 8DH, UK
  1. ppearson{at}

Jarman’s most disturbing comment is the reliance on “shame and blame” and fear of job loss to drive quality improvement in the NHS.1

Quality improvement guru W Edwards Deming would have deemed these “deadly diseases” that are bad for organisations and the people they serve.2 Lack of constancy of purpose, emphasis on short …

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