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  Keith
  
  I agree. Outside catering and cleaning contracts have been a disaster. Lets take politics out of the equation. For far too long politicians have 'used' the NHS as a political vote catcher.
  
  So where do we go from here? I suppose cutting back on waste is a beginning. The amount of stuff that is wasted is unbelievable.Employing managers that can manage ,motivate staff. Getting shot of deadwood that can't manage without giving them golden handshakes.
  
  Re-examing funding looking at various methods,tax,insurance and patient met but ensuring that at the point of contact that care takes precendent. Visitors paying for treatment either through insurance or out of their own pocket. Why should UK tax payers pick up the tab for a Nigerian visitor to have her child over here or have their broken arm fixed. It sounds harsh but having lived overseas I have either had health insurance or picked up the bill privately. The first thing the Doctor says on admittance is how will you pay? before they stop the blood streaming from your wound..
  
  Local hospitals for local people meeting their daily needs with central specialised hospitals dealing with more complicated delicate illnesses. Why do we need mega hospitals miles away selling everything from a sprained ankle to lung cancer.
  
  Meals for instance ,why not let patients who can afford it purchase an a la carte meal and those that can't or are not bothered have the 'menu de la casa'. So much food is wasted because the patients don't want or don't eat those type of meals when at home.
  
  Reduce Red tape etc I could go on...

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