Thank you, Chris, for your blog. I have >25yrs experience working within the NHS in District General Hospitals and, latterly, also experience as a user of services by proxy, given both my mother and father's health problems. It seems to me that the strength of the NHS lies in its emergency medicine provision. The weakness of the NHS lies in its management of chronic disease. Given the exponential rise in demand of the latter, surely the key challenge for the NHS lies in its ability to survive at all. Let's be clear, the system is in crisis as never before. Repeated top down structural change has not resulted in cost saving - it has only forced cost up, whilst also wearing down those that have had to implement these changes. Experienced clinical staff have left in droves in recent years, leaving a huge vacuum. Perverse incentives inherent in the purchaser/provider system and the focus on targets perpetuate waste and, often, poor care. Mid staffs weren't an exception. They were just the ones that got caught and provided a welcome target for politicians and the media. I had a great belief in the NHS when I started out all those years ago. I believed it was the best health care service in the developed world. I now think it's one of the worst. Surely it's time for an open and honest discussion about its future.