Dave
re your #46
In Shields we too are in danger of losing our A & E plus Maternity services being downgraded. This is a result of South Tyneside NHS Trust combining with Sunderland Hospitals to form a single integrated Trust with specialist services on one site only, so Maternity is being downgraded in Shields and concentrated in Sunderland.
The claim is that by integrating services can avoid duplication and thus make savings. One size fits all springs to mind but with regard to health that's b.s.
At present there is (another expensive) consultation forum going on where jo public can air their views (doubt if any notice will be taken of them though). One thing is for sure though that even after the integration the number of "Managers" will not reduce.
Even in a small Trust like South Tyneside there are around 20 "Managers" on 6 figure salaries.
As you say Dave. The NHS is a monolith that needs a top to bottom shake up, starting with its Whitehall Ministry. It needs all political parties to get together and stop using it as a football. Start with asking the front line staff (nurses, doctors, NOT Managers) how they want the NHS to function, cancel all P.F.I. payments, institute a I.D. card system so that only genuine people who have U.K. Nationality and a N.I. number can get free care, all others should contribute towards any care they receive.
Will it happen, doubt it.
Rgds
JA