The NHS has its problems - a lot of which can be blamed on the 'managerialism' that was brought in the 1990's by both sides of politics, although Labour probably accelerated it, largely because they did - to give them credit - pump lots of money in that the Tories did not.
However, under Labour (and I am on the left) especially in the 2000's spending totally spiralled out of control, the fraud within the system and mis-management was unbelievable, I know this because my close relative got to see all the case details.
In one case at a major hospital the canteen management 'team' siphoned off THREE YEARS of revenue from the canteen BEFORE ANYONE NOTICED!!!!
By the time they did notice three of them had left the country for Nigeria, au naturellement, and they had two UK people left when they finally alerted Plod.
As the NHS did not want a court case because of the embarrassment they - wait for it - paid the remaining two management people off with massive redundancy payments which as they were long serving staff meant big payouts for both.
One of the people who got the payout - which enabled them to retire at 53 - has sat in my lounge room and told me this themselves, she denied ever knowing the cash was siphoned off and blames the Nigerians - which even if true might not make her a criminal but it does make her criminally incompetent - and she still got the massive payout.
Having said that, anyone arguing for the US 'system' - if you can call it that - is out of their fucking mind.
Every President since Nixon has been trying to change the current US healthcare model - they spend twice as much on healthcare as a % of GDP than anyone else on the planet - and until Obama arrived they had all failed.
Indeed, the only way Obama succeeded was by striking a deal with health insurance companies - who are fucking minted like you would not believe - that he would mandate everyone to have private health insurance, thereby giving the insurance companies tens of millions of new customers, and in return they would stop denying coverage for pre-existing conditions and allow kids to stay on their parents insurance till the age of 26.
My friend used to manage a big hotel in DC, he said that after the defence contractors and the banking industry that the medical industry were the biggest spenders on corporate largesse - ie, bribing politicians with 'study trips' and 'research trips' to 5-Star hotels that he had ever seen.
"A friend of mine has a theory". Don't suppose he's a member of the loony left is he! Hope we do get rid of the NHS as it's been totally abused, leaving the poor doctors & nurses overworked & underpaid.
Surely that is more or less what my mate said? Only difference is you appear to want it to close ( would be interested in your opinion on the alternative ), he wants to bring it back to what it used to be.
In Portugal we have a similar system to the UK, but you pay a small amount to see the doctor (€5 at the moment), and for any tests etc. Seems to work quite well, keeps the hypochondriacs away.
Don't forget that being Britain, your national insurance payments would remain the same, they would not drop to compensate for paying out for your health insurance.
This can be debated till the cows come home but to answer your question, I favour the for-profit and Medicare alternatives. I.e the American system. The NHS is like a wounded animal. You still love it but it needs to be put down. It has been abused by both governments and we need an alternative.
Fair enough. Just hope that should it come to fruition none of your family are the ones who cannot afford cover should an expensive to treat condition inflict them.
I am currently on the waiting list for a knee replacement operation with Maidstone & Tunbridge Wells NHS Trust. Last week I attended a pre-assessment clinic to determine my fitness for surgery and was told I'm okay. I was told the blood tests, MRSA swabs etc. are valid for 8 weeks and if I don't have my op within that time, I will have to have them again.
As I hadn't heard anything about a date for my operation, I just telephoned Maidstone hospital and was advised that my op will probably be in April or May. That means I will have to undergo the tests again. What a waste of my time and the staff at the hospital and more importantly tax payer's money. No wonder the NHS is in such a mess financially.
Your operation is almost certainly classed as non emergency and you'll be pushed back in the queue as and when more urgent operations are necessary. As for the tests etc that you mention, your metabolism will change during a wait for treatment & medical staff like to have the most up to date data on your condition before they operate. All in all your time spent taking more tests etc is not wasted, more tests are a necessary precaution to prevent the possibility of your kicking the bucket on the operating table. Yes the NHS is wasteful in many cases, it is a huge and unwieldy organisation run by human beings and human beings are very wasteful animals. For my part, any waste although reprehensible, is waste in a good cause.
But why not call me in for the tests as soon as they know when I'm going to have my op. They sent the letter to me in January asking me to go for my pre-op assessment. They must have known then that I wouldn't actually have the operation until April or May.
They probably had a waiting time target.
By sending the letter they could tick the appropiate box. Your clinical needs are almost totally irrelevant unless they match the particular target that needs to be met.
I have family members, as I've posted before, who have died through euthanasia without consent (starved and dehydrated to death. The staff, when questioned, lied that the person was being prepared for an operation. For 4 days prior to death?) and neglect (left for hours on the floor with a fractured hip having fallen out of bed in a ward) courtesy of the NHS so I am not quoting the Daily Mail before some arsehole posts that or similar.
Another family member used to work as an administrator and admitted that they used to post letters giving appointments, followed immediately by cancellation letters, as such action (somehow!) fulfilled the target criteria!
As for waste what about the billions spent on a computer system that is unfit for purpose!
Agree 100% and sympathise with you Len. I've had similar horror experiences involving my sister and Mum that are far too involved to discuss here. My sister was only 42 but they couldn't even be bothered with her in her final weeks and left her in a side room on her own without water in reach for a whole day. I will never forget her calling me from her mobile crying her eyes out. The problem boils down to too much bureaucracy and too many levels of management all trying to justify their positions by creating unnecessary paperwork for others. Basic nursing care, changing drips, turning patients to prevent bed sores, washing patients, feeding patients, even just talking to patients has become a thing of the past, with nurses now concentrating instead on writing up their "care plans" and studying for their next degree so that they too can join the managerial gravy train in the future. Many nurses now do not want to get their hands dirty and why should they when they are so highly educated with their nursing degrees and years of study behind them. I can fully understand your fear of being hospitalised in the Uk, I would too if I lived there. For any non urgent treatment I would not hesitate in flying to India, Malaysia or Thailand and pay for treatment rather than risking the NHS (where my wife and I spent 12 years of our working lives) my wife is working at the Chelsea & Westminster atm.
I think we have done this before but the people that treated if that's what it can be called your family is such appalling fashion are nothing less than negligent health care profesionals at best and at worst criminals. They should be called to account and punished accordingly. What I can assure you of is that there is 100% definitely not any kind of conspiracy or strategy to euthanase anyone. Do you really believe that ? I have a very strict code of conduct for my profession as a radiographer of which I can say that I and all my colleagues to a man/woman adhere and are very proud to do so. Certainly where I work any form of ill treatment, negligence or neglect of patients would generate an outcry from the staff and the management. It simply wouldn't be tolerated. To condemn all parts of the NHS because of the actions of a few appalling ward staff is simply wrong.
SHG, I have no doubt that your radiology department works in a highly efficient and ethical manner, as did the theatre where I worked. Unfortunately in my mind it doesn't matter how well those particular departments work, if patients go to the ward and are not then nursed properly. The ward is the most important link in the chain. There is absolutely no point in spending hours working on a patient in theatre, only for them to die a few days later on the ward from infection, choking on food, falling out of bed etc due to nursing negligence, which I personally have witnessed on numerous occasions.
Ignoring the issue of this particular persons sickness, which can be just as much a problem in the private sector tbh, what is the alternative to having someone employed to fulfill an administative roll in the health service?
My mother had an admin job in a hospital and worked her socks off at it doing many hours of unpaid overtime every week, much to the detriment of her health in the end and she wasn't alone.
The alternative to your point of view is what? Would you prefer consultants do their own filing, appointments, record keeping? Would you prefer it if the doctor didn't have time for you becuase he was dealing with a building contractor about a project or the surgeon couldn't do your operation because they were too busy filling in the latest return to central government about waiting time or the endless other requests they are obliged to fulfill.
I'm not syaing there's not waste work done in the NHS, it's a large massive organisation after all, but I do think it's a bit lazy and simplistic to to blame it on the administrators that work there
Not saying that all who work for the NHS are feckless and lazy, your mother being a good example of the other end of the spectrum, but if only a tiny minority are like the woman we know then the cost is one that should be dealt with and no I don't want doctors etc to do their own admin but would like those who are paid to do it to be there so that it can be done. The real point is that the doctors practice functions perfectly well without this person when she has her "away days" so that begs the question as to whether there is a real job there at all.
Not sure what your experience of the private sector is but as said it would not be allowed to happen in my company.
Had the op last weekend and am now on the long road to recovery!
I was at Pembury Hospital and must say that if you need to be in hospital, it is a great place to be. Staff all excellent and the facilities are superb. Having your own room is so much better than being in a communal ward. The only problem is that it is 25 miles from where I live,so was a long way for my husband to travel each time he visited me. Glad that I am at home this weekend and he hasn't had to travel in the poor weather!
Had the op last weekend and am now on the long road to recovery!
I was at Pembury Hospital and must say that if you need to be in hospital, it is a great place to be. Staff all excellent and the facilities are superb. Having your own room is so much better than being in a communal ward. The only problem is that it is 25 miles from where I live,so was a long way for my husband to travel each time he visited me. Glad that I am at home this weekend and he hasn't had to travel in the poor weather!
Glad all went well ME14addick. The Tunbridge Wells Hospital is part of the Trust for which I work. I work at The Maidstone Hospital. The Pembury site is a flagship NHS hospital and blueprint for all that follow. Built with no wards but single rooms it is the future of state hospitals in this country. It is sadly already crippled with the debt burden of PFI which hangs around its neck like an albatross.
I'm not sure how to change to title of this post as it reflects my initial moans which didn't come to fruition, but I have certainly had excellent care from both Maidstone and Tunbridge Wells Hospital so far. The Tun Wells hospital at Pembury is certainly a very impressive place. The single rooms certainly make it much more pleasant to stay in hospital.
It is a shame that so much debt was created, perhaps future PFI contracts will be better negotiated in favour of the NHS.
Not saying that all who work for the NHS are feckless and lazy, your mother being a good example of the other end of the spectrum, but if only a tiny minority are like the woman we know then the cost is one that should be dealt with and no I don't want doctors etc to do their own admin but would like those who are paid to do it to be there so that it can be done. The real point is that the doctors practice functions perfectly well without this person when she has her "away days" so that begs the question as to whether there is a real job there at all.
Not sure what your experience of the private sector is but as said it would not be allowed to happen in my company.
Nearly all doctors' practices are private companies/partnerships that contract to the NHS. This woman you know may well be working for a private company anyway.
I'm 99% sure I've got a hernia, doctors suggestion was a appointment in 4 weeks, ring up tomorrow at 8am for one of 6 appointments on the day or go to A&E. How the hell has it ended up like this, there really does seem to be zero Improvement on medical times and if nothing it's still getting worse
I'm 99% sure I've got a hernia, doctors suggestion was a appointment in 4 weeks, ring up tomorrow at 8am for one of 6 appointments on the day or go to A&E. How the hell has it ended up like this, there really does seem to be zero Improvement on medical times and if nothing it's still getting worse
You have my sympathies. After a recent cardio procedure I had a week's worth of monitoring done. I got copied in, eventually, on a letter from the consultant to my GP. It's a load of goobledigook to a layman, but from what I can deduce, from a reference to Dr Google, I've swapped one cardiac condition for another. And I still have symptoms I need to raise/discuss.
I went to my GP to make a routine appointment during the first week of September to be told there were no routine appointments left, with any GP, for the rest of the month. Naively I assumed I'd still be able to make one for October then. Nope. The October appointment list wasn't open and they had no date for when it would be. Nor could I leave my details for them to contact me when it was.
So I'm left with rocking up at the surgery every week in the hope I get in the sweet spot when the list for October appointments is open...but not yet full up. If I miss it, and I'm on holiday next week, it'll be November if I'm lucky.
The staff are lovely, it's not their fault, and are basically advising me to lie and say I require an emergency appointmen, but that doesn't sit well with me tbh.
I get the point you are making M14, and yes it does seem to be a waste.
A friend of mine has a theory that the government is deliberately allowing the NHS to become as inefficient as possible so that they can claim it isn't working, and cannot be turned around, paving the way for a new, private insurance based scheme similar to the USA. This would be preceded by ministers buying up stock in insurance companies and followed by former ministers taking up places on the boards of insurance companies.
ShootersHillGuru said:
Attendance at A&E for anything other than a real and significant problem should also be stamped out. More than half of all A&E attendees could easily wait to be seen by their GP or Practice Nurse. Few people take advantage of ringing NHS Direct to obtain advice as to the best course of action and consequently the NHS is bogged down and drained of resources quite unnecessarily. People call for an ambulance for all sorts of inappropriate reasons.
Of course a lot of this is true SHG but there is always two sides to everything. Our doctors practice has so many patients and that is because it increases their funding allowance, hence when you want to see a doctor you can't. Mrs dave suffers with Sinus problems it's not a serious complaint I admit but when she gets a bad cold it inevitably turns to an infection in the Sinus. Last time she was getting severe nose bleeds and was generally very unwell but despite numerous attempts we struggled to get an appointment to see the doctor. So they ask you to phone up, which we did and despite a history of the same problem the doctor refused to prescribe any medication and told us that my wife had to come to the surgery so we are back on the same treadmill crazy! So what are the alternatives? Certainly not A&E so eventaully we went to a walk in clinic in Crayford and after 2 hours got seen, antibiotics prescribed and after 2 days she was getting better.
My point is that after a while people who feel unwell get desperate, sure there are the numpties who call an ambulance because they have a cold, but some of the so called time wasting is created by the system. If you can't see your own doctor then what else do you do? I know we probably disagree on this mate but there is a problem with the way the NHS allocates it resources.
To my knowledge all GP surgeries are affiliated to an out of hours service that you can attend. You can ring NHS Direct and speak to a nurse to ask advice as to whether you need urgent attention or you can wait. The options are available but few even consider it as an alternative to pitching up at A &E with a bad headache or a case of the trots.
Mrs TT recently retired from a GP surgery. She hated the waste and has always said that the NHS doesn't need more money. It is very badly run. Neither of us would want it scrapped BTW, just major reforms.
When out of hours was forced on the practice ( which all are effectively private businesses BTW), the practice took a huge amount of money to provide the appointments. I think that I'm right in saying that they never saw any patients during these extra appointment periods, because they never advertised them, would only take advance bookings and because several practices joined together, it was hard to discover which practice's turn it was to do the out of ours stuff.
As for 'Bank staff' system, it's absolutely madness and hospitals will collapse if the current government stop all zero hour contracts as they say they will.
The NHS is a long way from the envy of the world. My experience of health care in New Zealand, Portugal and Italy were all superior to the NHS.
I am posting a link to this article because It affects everyone in the country. It is written by Doctor Julia Grace a former NHS Doctor who has devoted her life to defending the NHS. It talks about NHS in-sourcing which I'm sure few have heard about, but to me sounds extremely alarming.
The NHS has its problems - a lot of which can be blamed on the 'managerialism' that was brought in the 1990's by both sides of politics, although Labour probably accelerated it, largely because they did - to give them credit - pump lots of money in that the Tories did not.
However, under Labour (and I am on the left) especially in the 2000's spending totally spiralled out of control, the fraud within the system and mis-management was unbelievable, I know this because my close relative got to see all the case details.
In one case at a major hospital the canteen management 'team' siphoned off THREE YEARS of revenue from the canteen BEFORE ANYONE NOTICED!!!!
By the time they did notice three of them had left the country for Nigeria, au naturellement, and they had two UK people left when they finally alerted Plod.
As the NHS did not want a court case because of the embarrassment they - wait for it - paid the remaining two management people off with massive redundancy payments which as they were long serving staff meant big payouts for both.
One of the people who got the payout - which enabled them to retire at 53 - has sat in my lounge room and told me this themselves, she denied ever knowing the cash was siphoned off and blames the Nigerians - which even if true might not make her a criminal but it does make her criminally incompetent - and she still got the massive payout.
Having said that, anyone arguing for the US 'system' - if you can call it that - is out of their fucking mind.
Every President since Nixon has been trying to change the current US healthcare model - they spend twice as much on healthcare as a % of GDP than anyone else on the planet - and until Obama arrived they had all failed.
Indeed, the only way Obama succeeded was by striking a deal with health insurance companies - who are fucking minted like you would not believe - that he would mandate everyone to have private health insurance, thereby giving the insurance companies tens of millions of new customers, and in return they would stop denying coverage for pre-existing conditions and allow kids to stay on their parents insurance till the age of 26.
My friend used to manage a big hotel in DC, he said that after the defence contractors and the banking industry that the medical industry were the biggest spenders on corporate largesse - ie, bribing politicians with 'study trips' and 'research trips' to 5-Star hotels that he had ever seen.
Do we know why Ormiston doesn't post on here anymore? When an old thread gets bumped you realise you haven't seen some people post for a long time.
Little update, lady on the phone earlier told me they were queuing out the door for appointments. 4.15 I go to collect my boy from school (rogjt next to the quack) and the doctors surgery is completely dead... not a soul in there.
There is definitely something more going on with this than 'doctors are busy'.
Little update, lady on the phone earlier told me they were queuing out the door for appointments. 4.15 I go to collect my boy from school (rogjt next to the quack) and the doctors surgery is completely dead... not a soul in there.
There is definitely something more going on with this than 'doctors are busy'.
@shine166 best bet is a walk in centre at a hospital mate. At least you know you'll be seen... eventually
I'm 99% sure I've got a hernia, doctors suggestion was a appointment in 4 weeks, ring up tomorrow at 8am for one of 6 appointments on the day or go to A&E. How the hell has it ended up like this, there really does seem to be zero Improvement on medical times and if nothing it's still getting worse
Does your surgery not have an e consultation service? Here in Whitstable you can fill in an online form . I did this at 7 am last week and exaggerated the symptoms. I had a phone call at 10.15 and a face to face at 11.30
Perhaps the new government could outsource GP appointment booking to Ticketmaster.
You can wait in an online queue for 7 hours thinking you can get an appointment for your sore elbow only to find, when you get to the front the queue, due to dynamic triaging, you can actually only get an appointment if you have Ebola.
I'm 99% sure I've got a hernia, doctors suggestion was a appointment in 4 weeks, ring up tomorrow at 8am for one of 6 appointments on the day or go to A&E. How the hell has it ended up like this, there really does seem to be zero Improvement on medical times and if nothing it's still getting worse
Does your surgery not have an e consultation service? Here in Whitstable you can fill in an online form . I did this at 7 am last week and exaggerated the symptoms. I had a phone call at 10.15 and a face to face at 11.30
Yeah it opens up at 12.30 each day, it's a new version of said system. By the time I'd worked out how to get into it at 12.40 it had reached max allocation for the day !. Anyone that works or has commitments that makes it tricky to be available bang on that time has no chance.
Agree with lots of whats been said but lets remember GP practices are private businesses and the contract that they operate under is outdated and in place long before most modern technology was in existence. As a result GP practices have far to much independence in how they operate a large number of things and the NHS cannot tell them how to operate even if it is better for the patient experience. GP practices also own their own data and can choose what and how much they share with the NHS which prevents analysis into how the system can be improved and how we can better target treatment and most importantly prevention.
Changing the GP model and phasing out the private GP practice model would be top of my list if I was in charge of reforming the NHS. Its the most important factor in the Moving from hospital to community care - one of the 3 pillars of their 10 year plan for the NHS. It will be a difficult legal battle but we have a top lawyer for PM so if there is a time to tackle this its now. In my view this is the biggest blocker to the NHS performing well.
Comments
However, under Labour (and I am on the left) especially in the 2000's spending totally spiralled out of control, the fraud within the system and mis-management was unbelievable, I know this because my close relative got to see all the case details.
In one case at a major hospital the canteen management 'team' siphoned off THREE YEARS of revenue from the canteen BEFORE ANYONE NOTICED!!!!
By the time they did notice three of them had left the country for Nigeria, au naturellement, and they had two UK people left when they finally alerted Plod.
As the NHS did not want a court case because of the embarrassment they - wait for it - paid the remaining two management people off with massive redundancy payments which as they were long serving staff meant big payouts for both.
One of the people who got the payout - which enabled them to retire at 53 - has sat in my lounge room and told me this themselves, she denied ever knowing the cash was siphoned off and blames the Nigerians - which even if true might not make her a criminal but it does make her criminally incompetent - and she still got the massive payout.
Having said that, anyone arguing for the US 'system' - if you can call it that - is out of their fucking mind.
Every President since Nixon has been trying to change the current US healthcare model - they spend twice as much on healthcare as a % of GDP than anyone else on the planet - and until Obama arrived they had all failed.
Indeed, the only way Obama succeeded was by striking a deal with health insurance companies - who are fucking minted like you would not believe - that he would mandate everyone to have private health insurance, thereby giving the insurance companies tens of millions of new customers, and in return they would stop denying coverage for pre-existing conditions and allow kids to stay on their parents insurance till the age of 26.
My friend used to manage a big hotel in DC, he said that after the defence contractors and the banking industry that the medical industry were the biggest spenders on corporate largesse - ie, bribing politicians with 'study trips' and 'research trips' to 5-Star hotels that he had ever seen.
The problem boils down to too much bureaucracy and too many levels of management all trying to justify their positions by creating unnecessary paperwork for others. Basic nursing care, changing drips, turning patients to prevent bed sores, washing patients, feeding patients, even just talking to patients has become a thing of the past, with nurses now concentrating instead on writing up their "care plans" and studying for their next degree so that they too can join the managerial gravy train in the future. Many nurses now do not want to get their hands dirty and why should they when they are so highly educated with their nursing degrees and years of study behind them.
I can fully understand your fear of being hospitalised in the Uk, I would too if I lived there. For any non urgent treatment I would not hesitate in flying to India, Malaysia or Thailand and pay for treatment rather than risking the NHS (where my wife and I spent 12 years of our working lives) my wife is working at the Chelsea & Westminster atm.
Ignoring the issue of this particular persons sickness, which can be just as much a problem in the private sector tbh, what is the alternative to having someone employed to fulfill an administative roll in the health service?
My mother had an admin job in a hospital and worked her socks off at it doing many hours of unpaid overtime every week, much to the detriment of her health in the end and she wasn't alone.
The alternative to your point of view is what? Would you prefer consultants do their own filing, appointments, record keeping? Would you prefer it if the doctor didn't have time for you becuase he was dealing with a building contractor about a project or the surgeon couldn't do your operation because they were too busy filling in the latest return to central government about waiting time or the endless other requests they are obliged to fulfill.
I'm not syaing there's not waste work done in the NHS, it's a large massive organisation after all, but I do think it's a bit lazy and simplistic to to blame it on the administrators that work there
Not saying that all who work for the NHS are feckless and lazy, your mother being a good example of the other end of the spectrum, but if only a tiny minority are like the woman we know then the cost is one that should be dealt with and no I don't want doctors etc to do their own admin but would like those who are paid to do it to be there so that it can be done. The real point is that the doctors practice functions perfectly well without this person when she has her "away days" so that begs the question as to whether there is a real job there at all.
Not sure what your experience of the private sector is but as said it would not be allowed to happen in my company.
I was at Pembury Hospital and must say that if you need to be in hospital, it is a great place to be. Staff all excellent and the facilities are superb. Having your own room is so much better than being in a communal ward. The only problem is that it is 25 miles from where I live,so was a long way for my husband to travel each time he visited me. Glad that I am at home this weekend and he hasn't had to travel in the poor weather!
Best wishes for a smooth recovery.
It is a shame that so much debt was created, perhaps future PFI contracts will be better negotiated in favour of the NHS.
I went to my GP to make a routine appointment during the first week of September to be told there were no routine appointments left, with any GP, for the rest of the month. Naively I assumed I'd still be able to make one for October then. Nope. The October appointment list wasn't open and they had no date for when it would be. Nor could I leave my details for them to contact me when it was.
So I'm left with rocking up at the surgery every week in the hope I get in the sweet spot when the list for October appointments is open...but not yet full up. If I miss it, and I'm on holiday next week, it'll be November if I'm lucky.
The staff are lovely, it's not their fault, and are basically advising me to lie and say I require an emergency appointmen, but that doesn't sit well with me tbh.
When out of hours was forced on the practice ( which all are effectively private businesses BTW), the practice took a huge amount of money to provide the appointments. I think that I'm right in saying that they never saw any patients during these extra appointment periods, because they never advertised them, would only take advance bookings and because several practices joined together, it was hard to discover which practice's turn it was to do the out of ours stuff.
As for 'Bank staff' system, it's absolutely madness and hospitals will collapse if the current government stop all zero hour contracts as they say they will.
The NHS is a long way from the envy of the world. My experience of health care in New Zealand, Portugal and Italy were all superior to the NHS.
https://jujuliagrace.substack.com/p/reflections-65-we-need-to-raise-the
There is definitely something more going on with this than 'doctors are busy'.
You can wait in an online queue for 7 hours thinking you can get an appointment for your sore elbow only to find, when you get to the front the queue, due to dynamic triaging, you can actually only get an appointment if you have Ebola.
Changing the GP model and phasing out the private GP practice model would be top of my list if I was in charge of reforming the NHS. Its the most important factor in the Moving from hospital to community care - one of the 3 pillars of their 10 year plan for the NHS. It will be a difficult legal battle but we have a top lawyer for PM so if there is a time to tackle this its now. In my view this is the biggest blocker to the NHS performing well.