I live in a moderate house – nothing too lavish but something that is comfortable.

Each month I pay to keep my services running. The gas powers our heating and cooking and electricity ensures that our ‘gadgets’ keep working as well as providing light. Water suppliers supply my cleaning and hydration.

Hospitals provide a health service to its patients for a defined budget determined by central government. This budget is continually threatened and essential services are also being threatened.

in my house, if I cut back on energy, then things would stop happening – the house would get cold, the ‘gadgets’ would not work when I wanted them to and I would smell.

Faced with options, I choose to look at different energy providers and save a buck here or there. I get to a stage where actually I do not really save that much in changing and that the ‘cost saving’ is now in clever contractual wording.

I know that continuous improvement and cost reduction programs are in force in the NHS.

Perhaps where we are with the NHS is that we cannot cut anymore.

Perhaps where we are is needing a ‘leader’ to take control and enable the NHS to be great again and celebrate the amazing people that coexist with it.

Perhaps what we need is for a realisation that we need something different to balance the books, something that is sustainable and fair to the wider population.

Where is this going? We need to stop before we fall off the end.

Where is this going? We need to stop before we fall off the end.