I am minded to start a new thread...I have come to the conclusion that the only way to improve it may be to create a parallel system. NHS experts can be consulted but should not be given any responsibility. No point dropping them in to a new environment and bringing their baggage with them. By all means consult experts in France, Germany and South Africa and find out how they get their admin, IT and processes to work. Protect it from political interference, not just gov't but militant lefty unions.