Has anyone else noticed the rise in beaurocracy? The type I identify as a problem is the type that results form people not being trusted to make decisions. This is a major problem in the health service, and it seems fairly universal, from school to farm to police to house building. The rate of increase has been fast over the last ten years. At some point life as we know it must come to a halt - because there will be a gridlock.

Some of the problem has come from Government where appearance is more important than content. 'Frantic management' is a term used by Frank Burke, hand surgeon in Derby, to describe it. This has contributed a lot of the problem. It is time for in-depth management. Call in Toyota style management?