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It may be helpful to consider why other European countries have achieved better outcomes/ mortality rates and higher levels of patient satisfaction, and without to my knowledge similar scandals.

The behaviour of hospital executives in these countries is different. They are driven to attract good patients and doctors in competitive markets (choice is much more embedded) and public hospitals are often accountable to local government and hence locally elected politicians.

NHS managers are forced to look upwards and keep their political masters happy by achieving arbitrary targets (Can anyone name another system that uses targets in the way the NHS does?) rather than looking outwards to patients and local communities. Governors and NEDs are little more than a fig leaf to cover naked centralism.

Clinicians, who should have the most intrinsically rewarding job in the world, often have lower job satisfaction rates than staff working on the floor in John Lewis.

Until we create a system which shifts accountability in this way, any investment in Don Berwick and leadership training will be largely wasted