Dr Stephen Black, a health-management expert at PA Consulting, blames the lack of straight-talking from the government. He thinks, ''Your analysis of the timidity of the government's response to the NHS listening exercise missed the underlying reason for the messy results. The health secretary, Andrew Lansley, failed to provide any clear diagnosis about what is wrong with the service, so in the absence of that context, it is hardly surprising that listening to feedback from across the NHS did not generate coherent conclusions.
It is clear that the sort of innovations the NHS needs will not happen unless we recognise that it has tended to invest too much in traditional hospitals in response to the influence of big providers. The absence of a clear diagnosis of this problem meant that the listening exercise just gave those providers the opportunity to re-establish their influence. Governments will eventually have to admit that a better NHS might have fewer hospitals. The sooner they do so, the easier it will be to mprove the system''.
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