Government rhetoric says that if all hospitals were as good as the best the NHS could cope. I'm sure that if city central populations were able to look after themselves with the affluent resources of the patients surrounding, for example, Frimley Park that might just happen.
Let's be honest, blaming management, practices and patients for the woes of the NHS is disingenuous at best.
Attempting to preserve the local hospital, expect world class service delivery and instant access to primary care with a 65-year-old model is stupid.
Our only hope is an open public discourse balancing societal change, radical individualism, innovative healthcare and fiscal policy, effectively rewriting the social contract between population and health service.
This will only be possible at local level, this can only occur when party policy is forgotten, when organisational stability is traded for innovative approaches, when 'my personal choices' are accompanied by an understanding of their impact on others, when 'my job' is no longer sacrosanct and 'our mission' will guarantee all of us health and employment.
In short, only when we, patients, carers and politicians hold each other accountable for our actions and outcomes will we have a health care organisation which is delivering for all stakeholders.
We need accountable care, and we need it now.
- Dr Chris Mimnagh is a GP in Liverpool and head of clinical innovation liaison and deployment at The Innovation Agency, the academic health science network for the north-west coast.