Diplomats argue that the country's civil service has inherited the competence of British colonial administrators.

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In my experience, most managers in the health service have no credentials and have passed no tests of competence, although medicine and health-service management are very complex affairs.

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For all these sweeping intentions, the competence of the civil service is more routinely judged on how well it avoids expensive disasters.

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You could argue that Medicare administrators have fallen down on the job in terms of putting downward pressure on the price charged by service providers, but private insurance have not shown any competence in this matter either.

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In assessing the value of a senior health-service manager or council chief, for example, the line between core competence and bonus-worthy brilliance might be hard to define.

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The new powers are a reflection of the increasing role of the ombudsman in the health service complaints system since 1996, when that body was allowed to investigate matters of clinical competence for the first time.

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Besides, a strong presidency presumes a competence in Mr Karzai, or another candidate, not to mention the Afghan civil service, that is far from proven.

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