Andrew Boff is referring to cutting the 'fat' within the NHS, i.e. the waste that exists in NHS' middle management - aka the 'Administration.' The NHS has never before experienced such colossal cost allocations to non-operational, largely unnecessary areas, causing those operations to be less effective. I don't want to get into party politics, but I think it is safe to say where the blame lies for poor policies and a dereliction of duty with regard to continuous improvement. Some of the comments here seem to want it to remain status quo. I would question where it is they believe their voting power will continue to lead the NHS, should they vote for the incumbents. In my opinion, the answer lies in the lack of accountability mandated to the individual in the UK. Social medicine is something to be proud of, but the original vision failed to foresee the lily-livered 'leaders' that we would eventually vote in, and the imbecilic nature of today's Briton; without goals, without purpose, and without a sense of social and patriotic reciprocity. The resulting costs are immense, and furthermore the costs are being paid by the wrong citizens, including those on the front line. The answer then is fairly clear - every case of intoxication answered and attended to by the emergency services should be billed back at full cost to the recipient of the service. The same should be mandated for those morons who cause injury to one another by fighting. Perhaps the large bills, and County Court Judgments for those who fail to pay, would leave such offenders in no doubt as to the consequences of their actions. It is somewhat astounding that those charged with policy making in this country, continue to use the lowest common denominator as a benchmark for good. I wonder how such 'leaders' would respond when, having sought urgent, life-saving treatment from the NHS for one of their loved ones, were advised that there was simply no money left for the treatment, as it had all been spent on social disorder.