SIR - I read with disbelief the letter from David Barlow (June 6) stating that the NHS is chronically under-managed. Does he live in the real world or is he and his colleagues (pen pushers) on a giant ego trip? Of course everyone realises that giant organisations like the NHS need good managers, but this many - I don't think so! It defies logic that while nurses are being made redundant, some people are being employed on ridiculous salaries. Let's get rid of the majority of these chiefs and being in more Indians.

JON CIRIC,

Worcester