Why doctors need efficient hospital managers

sir – As a retired consultant, I must take issue with those who want to go back to the days when doctors ran the hospitals (Letters, November 17).

What I remember about then is all the patients being brought in at the start of a clinic and being made to wait for up to three hours; waiting lists of three years for operations such as cataract surgery and hip replacements; patients being discharged on a consultant ward round, which often took place only twice a week, and long stays for patients with conditions that are now treated on an outpatient basis.

Consultants know their job and the support they need to do it, but by and large they are not good managers. They do not have time to do it properly in addition to their core job of treating patients. The solution is to cut a lot of the bureaucracy that takes up so much time, and build a management structure that works closely with clinical staff to ensure efficiency. Dr Jenny Jessop

Doncaster, South Yorkshire

sir – As a retired hospital manager, I found consultants welcomed the introduction of financial discipline. Contrary to the experience of Dr William T Easson (Letters, November 16), it led to better patient care.

As an accountant, I was naturally viewed with suspicion at first, but was eventually accepted as a positive addition. I agree, though, that there are now too many managers in hospitals.

Incidentally, the medical executive committee that Dr Easson remembers fondly still existed in my time, though I recall the agenda being dominated by talk of retirements and car parking. Lovat Timbrell