Be careful what you wish for

But the most shocking thing was not the lying. Nor even the incompetence. It was our total lack of surprise at the turn of events, since after 15 years suffering from the failings of the National Health Service we are prepared for almost any ineptitude.

There is no doubt that nearly tripling the health budget in a decade has led to visible advances, especially in the infrastructure. Some of the new hospitals are vast improvements on the crumbling Victorian buildings they replaced, and seemingly small things such as spruced-up waiting rooms and toys for children make a big difference. Unfortunately, it is equally clear that billions have been wasted, poured into a centralised monopoly that focuses on the manipulation of a target culture rather than delivery and innovation. It was little surprise to learn that more managers than doctors were hired last year. And all too often these managers seem to reinforce rather than challenge the patronising attitudes that often predominate, while failing to tackle glaring waste.

Clearly there is systemic failure. And it is a question of management, not money. Some of the worst problems encountered have been at the hallowed Great Ormond Street Hospital for Sick Children, which uses the strength of its brand to suck up money and increase its reach. Many in the medical world are infuriated by its endless growth, but scared to take on the behemoth. But behind the soft-focus fund-raising and cuddly image lurks inefficiency and, all too often, needless insensitivity.

Indeed, should you feel moved to give money to help sick children, I would advise you to give to the children’s hospice movement instead. As I write, my daughter is at Shooting Star in Hampton, Middlesex, a particularly deserving recipient. It is interesting to note that this sector, which derives a paltry five per cent of its income from statutory sources, does not seem bedevilled with the woes that afflicts so much of the public sector.