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Au contraire this is a prime example of the results of competitive tendering for health services with the contracts going in large part either to commercial organisations or NHS Direct. They have performed as well as G4S did at the Olympics. However since this is only the NHS and problems can be easily covered up the Army has not been called in ahead of time and the woeful embarrassment of NHS111 is being allowed to continue in many areas.

Several areas had their soft launches this week and almost immediately had a plug pulled - rightly- on patient safety grounds when they could not remotely approach local OOH provider performance.

In other areas the DH and upper echelons of NHS management have put pressure on regional and local commissioners to deliver at all costs and pretend it is all nice and dandyl. A&Es, ambulance services, OOHs and above all patients are picking up the pieces. So much for Francis!