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The NHS will never reform itself - I have watched numerous reorganisations and in many cases the wheel has simply spun to its original position - In essence the system has been manipulated by government to try and replicate the behaviour within private medicine (without the money passing between the patient and the hospital) - the government taking the place of the patient. Various efforts have been made to give the patient influence etc but they are not really effective. There is only one way for the patient to be in control and that is for him/her to pay for the treatment (Insurance/cash etc). And that is a step too far for either of our major parties! But it is the answer. It works elsewhere (Germany, France, Oz)