At present there is a somewhat damaging ‘splitting’ occurring within the NHS ‘reforms’ – assisted by the media. Consultant psychiatrists, who are regarded as intrusive and paternalistic, administer treatments (mostly medication and ECT) to patients who are not consulted, and are generally thought to know what is best for themselves. General management, which overtly sets out to ‘change the culture’, appears to sustain this irrational harmful and pseudo confrontation.