It's not about blame - it is about responsibility.

The National Health Service has just announced a deficit of £512 million for the last financial year.

Doctors are blaming Managers; Managers are blaming Government; Government is blaming Managers. The Audit Commission is blaming Managers.

Everyone is blaming someone else. Sounds a bit like life.

Speaking as a former NHS manager for 35 years I say it is not as simple as blaming one group of people.

I remember nine years ago and very early in the term of the Tony Blair Government there were loud calls from within the NHS from doctors, nurses and managers for more money to be ploughed into the service. A huge ‘listening exercise’ was carried out by NHS managers and politicians about what the problems were and the solutions needed.

The outcome was an acknowledgement by the Government that much more money needed to be ploughed into the NHS. This was done. I remember Mr Blair saying – and I paraphrase;

‘We have listened to what the professionals inside the NHS have had to say and we have acknowledged more money is needed. We are now giving that money to you in the NHS and we expect managers to make the best use of this money to carry out the improvement you have told us are needed.’

Without making a political point there is no doubt whatsoever more money has been invested into the NHS by this Government than any previous Government in history since the NHS was established in 1948.

The debate about who is to blame of this overspend is pointless. It is not about blame; it is about responsibility in my opinion.

I feel the government did all they should. They listened to professionals in the NHS and they provided the answer that the professionals wanted to hear.

The responsibility is within the NHS – the Government cannot just keep simply throwing millions of pounds every year into a hole while NHS managers sharpen their spades to dig that hole deeper.

I smile when I remember that every single one of the 35 years I worked in the NHS I remember Finance Managers telling me;

‘This is going to be the most difficult ever year.’

Managers like me always knew that finance folks kept reserves so it was a game of ‘bluff’ and managers as a result spent to the limit knowing the finance folks would always ‘bail them out.’

There is nothing complicated about that and it is human nature that if you know you have a ‘back stop’ you can afford to be ‘adventurous.’

There is a something of ‘the boy cried wolf’ and maybe now the chickens have come home to roost.