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  In order to fund the NHS - free at the point of delivery as it should be - it needs to be managed. Perhaps to call it a business sends the wrong message, but a business has to attend to the profit and loss side to make sure it does not run at a loss (the debt the NHS is currently wading through). Profit is not a dirty word: charities have to try to run at a profit in order to maintain the services they deliver and plough back enough to do some good. No-one shouts about charities being a bad thing because of that. Culturally we have to try not to shy away from words like profit and loss, or we will not be able to manage our services to the benefit of the community, which, after all is what most of us want.

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