[tweetiepooh]

The NHS does need reforming but an issue that would face any government of any persuasion is that those who get to implement any change are those who are most in need of reforming and the ones who actually never get reformed.

As a crude example, say it's identified that job cuts are needed. The first task is to employ lots more admin and HR bods to implement those cuts. Nett result is there is little saving but degradation of service.

I used to work in the NHS back some years and I bet it hasn't changed much. Far too much bureaucracy and middle management (who can't manage), huge waste and inefficiency.

We promote the best (nurses, doctors, technicians) to management roles that they may not be suited to and keep the less good in those jobs.

We don't get rid of the dead wood who stay employed by just doing the work they are paid for, no initiative, no desire to do extra but they are "covered" by "The Unions", often they are the union reps.

So we need to get the best people into the jobs they are best at and empower them to make those jobs better. This may mean "promoting" less good (doctors, nurses, technicians) to management roles they may excel at and keeping good ones in the roles they love. (Need to address rewards here.)

Focus treatment where it is best needed, we can't afford everything. To my mind focus on prevention more than cure, maybe business needs to pay a little to this end in short term as they benefit if staff don't go off "sick". This is the hard one, if you are one who is in need of treatment then you need it.