Over the  last  five  decades , there have been as many changes in NHS  and its  administration.  In this country, the health care  is mainly  provided   by  the  taxpayers ; hence health is an intensely political issue. All  politicians tend to cash in with  a view to receive better public support.   Different political  parties  when in power , therefore, attempt to 'change' things just to live a mark  on the service.  Perhaps these are done with sincerity and honesty  but are they always necessary for the 'betterment' of service !  


Whilst changes are always welcome and often necessary , sometimes these are  introduced for a different reason or motive.  It is like changing the name of a shop without any appropriate reason or any significant change in its activity ;  changes should happen when changes are needed - not for any other ulterior reason or motive.


There are many shortfalls and gaps in the NHS - it will NEVER be perfect or adequate  for everyone all the time ; the  etiology of the 'disease' must , however, be ascertained  before  any restorative measure is applied.


I have grave concern about the care of older people in he future. Indeed the primary care and community care MUST be improved and  effective but the answer there is not to have another new 'management' system without fundamental  correction in training , standards and evaluation.  Perhaps all these  are in place but  is it working?   Health care can not be delivered by committees or  management structure - it is a 'one to one' activity  under proper supervision with proper evidence -based standards.  Sadly  this is still not happening.  I doubt there will be any great improvement in the overall care for the frail elderly  - most professional are not interested in them any way!!!!