I think that there needs to be a... ...I can't believe I'm going to say this... "Third Way". Instead of relying on market forces, when the NHS _isn't_ a market (we want less 'customers', rather than more, and to achieve this would be the greatest success) - we might better be served by roving troubleshooters, who understand the unique pressures and can better allocate resources to ease pressure. Otherwise, in a few years time I can see the NHS dividing into two - the elite establishments, and the rest. Look at the difference between the Chelsea and Westminster hospital, compared to (for example) Newham General. It doesn't help that the targets that we are supposed to meet have apparently been plucked out of thin air and have little if anything to do with clinical excellence. Or that the allocation of funds often has more to do with politics than with how well a trust performs (I seen it happen to other trusts, where the inspectors have wandered in, said in effect ' you can't improve that much wothout cheating' and left leaving no increase of funding). The simple answer is that we need more resources, at least until we can start teaching people the correct use of the NHS, and start correcting some of the assumptions and attitudes that they have about the NHS. I think we need experts to allocate this, rather than deciding that whoever gets the most Cat A's under 8 minutes 'wins'.