Dr Lansley’s Monster

"Financially sound" ? I cannot agree with you Richard.

Wales took the step of supposedly abolishing the purchaser-provider
split some years ago, and has reversed the management process of decades
by merging lots of trust providers and locally-responsive 'Local Health
Boards' into a handful of great amalgams running everything. Historically
these re-creations were hugely costly, and always overspent.

We in Wales witness a rapid decline in efficiency from a low starting
base, and no clear responsibility as to who to blame for what.

"Real cash and head count savings" ? You might as well argue for the
abolition of money, and everybody can just get on with seeing patients
without regard for cost, being grateful for the odd half-dozen eggs, or a
bottle at Christmas in a pre-capitalist 'gift', or rather, barter economy.

"Clinicians can then move their focus from cost issues to real things
like efficient and effective patient care and quality". Never have I
known a clinician (from the lowly GP on up to tertiary Oncologist), once
released from cost concerns, do anything but spend spend spend on the
"best" (ie- most expensive new drug) available.

There must be a way to optimise acceptably safe effective treatment
somewhere in the UK, but it cannot possibly be achieved by disregarding
cost.

I rest my CASE for a Cheap, Acceptable, Safe and Effective NHS.