//How would you like to see a monolithic organisation like the NHS managed? Should it be broken up into smaller localised units? Say an NHS for each county?//
It is broken up into smaller localised units - at least as far as treatment goes. From the top of my house I can see a nearby hospital. I can walk there in about fifteen minutes. But I can't be treated there. I happen to live on the edge of an NHS administrative boundary and the hospital is next door. Last summer Mrs NJ had the misfortune to fracture her arm and needed physiotherapy. The accident happened in Greece where she was treated in the local A&E (excellent service: in, examined, X-rayed, diagnosed and strapped up inside 40 mins). Upon returning home she had to attend our local fracture clinic at the one and only hospital we can use (seven miles away, two buses, car parking virtually impossible - even if she was able to drive which, with a broken arm is a bit tricky). Upon discharge she needed physio. The "big" hospital had no physio facilities. A smaller nearer hospital (no A&E) stopped doing physio a couple of years back. No problem, we thought, she'll go to the hospital we can walk to in 15 minutes. No can do. It's not in "your area". She ended up with a sheet of exercises to undertake