In building up an effective health-care service in England the ratio of managers to front-line staff will have to be cut - the pay bill for the NHS must drop and through wage controls for management salaries the pay bill would drop.
Modernising the NHS is not axing services and jobs at the front line.
It is actually dismantling the pyramids of excessive pay among managerial personnel.
And in the unfairness of the postcode lottery people are not receiving equal status when it comes to treatment.
Through shelving the constant carousel of NHS reorganisation the money would soon become available.
In changing the NHS we need to stop paying redundancy pay to managers earning £50,000.
The end product of this is that the health service has become a gravy train in which patients have suffered and nurses and doctors demoralised.
The NHS's target culture has devastated confidence.
The failure of these targets to improve performance and the money spent on meeting them has created large budget shortfalls in our hospitals.
Oliver Healey Telford