Over the last five decades , there have been as many changes in NHS and its administration. In this country, the health care is mainly provided by the taxpayers ; hence health is an intensely political issue. All politicians tend to cash in with a view to receive better public support. Different political parties when in power , therefore, attempt to 'change' things just to live a mark on the service. Perhaps these are done with sincerity and honesty but are they always necessary for the 'betterment' of service !
Whilst changes are always welcome and often necessary , sometimes these are introduced for a different reason or motive. It is like changing the name of a shop without any appropriate reason or any significant change in its activity ; changes should happen when changes are needed - not for any other ulterior reason or motive.
There are many shortfalls and gaps in the NHS - it will NEVER be perfect or adequate for everyone all the time ; the etiology of the 'disease' must , however, be ascertained before any restorative measure is applied.
I have grave concern about the care of older people in he future. Indeed the primary care and community care MUST be improved and effective but the answer there is not to have another new 'management' system without fundamental correction in training , standards and evaluation. Perhaps all these are in place but is it working? Health care can not be delivered by committees or management structure - it is a 'one to one' activity under proper supervision with proper evidence -based standards. Sadly this is still not happening. I doubt there will be any great improvement in the overall care for the frail elderly - most professional are not interested in them any way!!!!
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