There is a bitter symmetry between the incidence and the prevalence of the punishment beating in NHS culture.

The first reason why the culture of punishment beating exists?

Existential teleology.

There is a cadre of the managerial community whose purpose is to administer punishment beatings.

Therefore, punishment beating must have value: part of the management infrastructure exists to perpetuate punishment beatings. (Without such value, there would be no punishment beatings.)

This is a self-fulfilling prophecy.

The ontology of The Tough Manager
One which leads us to the ontology of The Tough Manager.

Just as punishment beatings exist because there are those who will be in the better of punishment beatings, there must also exist Tough Managers: people who are not unafraid (and perhaps ever-so-slightly thriled) to administer such beatings to NHS sinners.

"Beat me", begged the masochist. "No", replied the sadist.
Simon Stevens won't be unaware of the bitter irony of punishment beatings coming his way.

After all, he himself used to deliver them to errant NHS chief executives and directors in Richmond House, under his first SOS Frank Dobson.

Phew: for a minute there, I lost myself
Karma.
So, yes, Simon's punishment beating. There was close-quarters irony. Weapons-grade sarcasm. Possibly even vague, unspecified and wholly unspecific career threats.

It was probably very much the same when he received it as when he doled it out, no?

Camp inefficiency
The actual trajectory of an NHS punishment beating is as deeply camp as it is inefficient at making meaningful change.

If you've watched former Comrade-In-Chief Sir David Nicholson deal with the Commons health select committee and PAC, then you've seen a system lifer enduring and survinving punishment beatings.

Without taking so much as a scratch.

Because nothing is worse than an itch you can never scratch.

Punishment beatings don't really work, of course.

However, effectiveness is not their point.

Their point is only to help the beater to accomplish The Politician's Sylliogism (copyright 'Yes, Minister'):
1. Something must be done?
2. A punishhment beating is something.
3. Therefore a punishment beating must be done..

Dramatis personae
Have the recent subjects of the punishment beating become more interesting?

The subjects are certainly more eclectic - and more senior.

NHS chief executives have always known, in an existentially-unstated deal, that their turn in ther punishment beating salon will come, if they are unlucky.

Not unskilled. Not uncaring. Not incompetent.

Just unlucky.

Few CEs want to go through the baptism of fire to become bullet-proof.

Most CEs are going through punishment beatings about the money.

Fairness? Is that a small town on the Isle of Sheppey?

A hello to arms
The subjects of punishment beatings are more senior now.

So, who's up for one?

Who's on first?
Simon Stevens is up. Although the punches are being pulled slightly, becaus he worked for The Sainted Tony Blair (and are arguably no worse than any Treasury spending review would inflict when fictionally-important deficits are about the place, as currently).

The Treasury are being epic dicks at present; according to hugely well-informed sources, they believe that not only has the NHS gone too far on using agency staff, but also over-recruiting substantive clinicians.

Oh yes: it is that fucked. Honest.

Elvis has left the building.

Political Stevens
Simon is political to a significant degree: he has seen how you best deal with the punishment beating: remain calm; show no pain; keep going.

Show no fear or pain.

No surprises.

The second-most interesting Jeremy in politics
Jeremy Hunt is up: the Cabinet does not protect its own.

Gideon George Osborne may have the empathy and compassion of a sack of cement (indeed, it's practically his unique selling point).

All the same, in GGO's more paranoid moments, he still sees Mr Hunt as a potential leadership rival.

This is why, knowing the NHS funding would blow up, GGO allowed Mr Hunt's reappointment in health: to wear the pain until next May/June's reshuffle.

After that? Get Boris in: health can ruin two rivals' careers, for the price of one financial crisis.

Hunting ambiguity
GGO has also been very keen for Mr Hunt to use the inevitable ambiguity over what was actually agreed for the Five-Year Forward View £8 billion cash to best effect.

A written deal, you say?

Don't make Gideon chuckle. His pancake foundation layer might crack.

No. The Government has agreed to fund 'The Stevens Plan'.

Others have lost. In GGO's words, "It's all a game".

Until someone loses their social care, of course.

But then, you'd have to feel that someone might be someone you'd know. And if that someone were one of you; well, that could make a fellow feel ashamed of their conduct.

Thank goodness, eh?

Don't mention the Government's tendency to reward older voters, which has been highly generous with benefits for older people - who tend to vote.

If you look at the user profile of the NHS, you'd notice that it too is another such benefit for older people.

So let's hope journalists don't do that.

Evidence? Schmevidence.

All shall be well. And all shall be well. And all manner of things shall be well.

The punishment beatings will continue until morale improves.