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Mr Mahoney clealry needs to be reminded of some factual information regarding NHS funding:
1. Wanless estimated that the NHS was underfunded to the tune of £267 billion over 25 years (1998 prices) and UK spending was well below the European average
2. The projected £12 billion deficit has resulted from predicted and necessary public spending cuts due to massive public debt. This has mainly resulted from bailing out the banks. However, the PFI was already about to take Mr Brown well above the 40% GDP Golden rule because the international financial reporting standards (IFRS) have now put PFI on the public borrowing books. Interestingly the banking crisis has masked this and let off the PFI yet again!
3. Yes, there were and still are inefficiencies in the system, but the healthcare market and private sector will add to this, not reduce it. There is no evidence that choice and competition improve healthcare systems. Most of the published, peer reviewed data suggest the opposite. Would Mr Mahoney like to cite evidence to the contrary?

A few other points for Mr Mahoney to consider:
1. Mr Britnell was voted 4th most prominent figure in the NHS because he was a very senior member of the DH with a major remit to deliver WCC. These rankings are about levels of power and influence, not success.
2. Britnell was keen to expand the market, so it is not surprising that entrepreneurs from the private sector liked him. As a taxpayer and not a shareholder of a multinational healthcare company or managemnt consultantcy, I was less keen on him!
3. WCC and PBC is a key area where policy is currently failing. lots of criticism in the literature at present
4. Where is the hard evidence that money is being saved by commissioning? What about the costs involved in delivering it?
5. I agree with him that we should all search the HSJ site for examples of policy that is working. I'm afraid that this Journal is an evidence free zone. It is full of opinion formers that are given a significant platform to promote their ideological fads with no referencing to any academic policy literature. It nicely sums up what is wrong with the NHS.
6. As for losing "creative talents", we have more than enough of them delivering their "creative destruction" on the NHS.
7. Finally, he suggests that the systems Mr Britnell has put in place will be beneficial for patients and the taxpayer. Where is the indepedent peer reviewed evidence for this?

As a clinician, I am used to critically appraising the academic literature in order to deliver the highest quality and most cost effective care to patients. Current health policy is based on political ideology, not evidence. Unfortunately, NHS managers will continue to deliver on it, because their jobs depend on it. I don't blame them, especially in the current economic climate, but it would be nice to see some honest evidence based analysis of current policy in this journal.

The number of anonymous comments speaks volumes to me.