Interesting link, but outdated, as there is already a 'Lean' initiative gaining momentum within the NHS. Also, I empathise that those working within the NHS are angry, and they have a right to be. But partisan attitudes to politics and the politicians will only lead to further deflection away from what really matters, and further towards modeling the US; an even uglier proposition than the ones currently available to us. Demanding a merit based approach from our local elected representatives, and applying constant pressure to them on those points that promote change, will quickly eliminate the weaker representatives and diffuse the autocracy from Downing Street. The same degree of autocracy that seems to be present in today's unions, despite what the union leaders say they stand for. The union leader should be non less accountable for results than the politician, as there is seldom a degree of difference between the two.