Well Geoff I'm sure the guy servicing the x-ray unit, anaesthetic machine or ventilator to name a few has far greater potential to do harm than the neb king! Obviously there's going to be a big difference between training required for the tasks.
Another thing I've noticed in the NHS is the response to call for yet more management as a answer to any problem. It reminds me of the old story of the Japanese/American boat
race. In risk management particularly using the swiss cheese model supervision is only a factor, you can't supervise your way out of a problem. Also you'll find in the private sector that many of these management roles are actually incorporated into engineering and technician roles, therefore a register of managers is a very bad idea.
