The NHS is a common theme in these blogs - well I did work there for 25 years so I know a little bit about it. Common themes run along the lines that members of the public want a good local service, there is pressure to close smaller hospitals and there should be local accountability.
However there is no local accountability and the NHS has been centralised. There seems to be a certain inevitability about centralisation as technology advances and becomes more expensive, but the whole of the NHS, regardless of its sophistication, has been swept into the tide of centralisation. Minor injuries are often dealt with at centres of excellence. Consultations often take place in hospitals which are miles from the patient's home when all that is needed is a private room. Local hospitals have closed.
Times may have changed in regard to the provision of local NHS services. The BBC reports that the new chief executive, Simon Stevens said that there needed to be new models of care built around smaller local hospitals.There appears to be a welcome shift towards prevention rather than treatment. When there is a need for acute care then centres of excellence may be the place to be, but there are so many health care interactions that take place that do not need these centres.
The appointment of Simon Stevens could provide a much-needed opportunity for change for the better. He has a lot of relevant experience and a good reputation and crosses the political divide, being an adviser to the former Labour government that the current government is very happy to have acquired. Hopes and expectations are running high. Are those hopes and expectations justified? Well you can see from the links above that he's now saying some of the things that I've been saying in the past, so that's definitely a good sign :-). Maybe it is beyond Simon's scope but let's also hope that local accountability also gets on the NHS agenda.
Change the world.