It is long ago but there was a time when I was involved in running the NHS, if only in a very small way on the committee of a local Area Health Authority.
My chief experience of medicine had been the number of people taken to the Casualty Ward during the course of rugby matches, notably medic's from hospital teams who became patients rather than doctors.
A great deal has changed. During the 1980's, Ken Clarke, still around and still ever fond of telling people they are totally wrong and he and only he is right, threw it all up in the air and was amazed that when it came down it was not what he intended.
In the last quarter century it has become a rite of passage for Health ministers on appointment to do a reorg' on the basis of old and unreliable data and with the advice of 'org' and man' consultants hoping to retire on the proceeds rather than medical consultants whose needs are more complicated.
Most of these have seemed fixated on the methods of mass production as applied to hospital throughputs together with management structures borrowed from retailing sectors that have either gone bust, been taken over by financial corporations or operate on pre-computer age structures.
The diagram above, Corporate Capture Of The NHS came from Spinwatch making the point that the NHS is now in the hands not of local and regional interests trying to achieve a balance of provision that matches needs but of the money providers.
They are being given deals that Croesus would envy while the election promises are for more and more government money to be thrown at them rather than the actual service providers.
Sadly, this money will be needed largely to try to contain rising deficits by increasing debt which loads more costs to add to future deficits.
If the expectation of life figures start to fall how will the spinners deal with that?