- as obstacles to joint working and barriers to change.
Of course the conflicting evidence is not enough on its own to force back the management offensive, which is very much driven by the cash pressures in an NHS which is now constantly claiming that it is in balance or even in surplus, while beneath the service frantic efforts are being made to cut back mental health and hospital services to balance the books.
One Hertfordshire manager responded to the Royal Colleges' report by arguing that it is "just a point of view"
It's very much up to trade vons to masa moe evdence, inform their members and encourage them to fight back for jobs and services -and give a lead to local campaigns which are continuing to challenge local cutbacks and centralization.