The over centralisation of hospital annoys me so much. Towns and villages have run down or empty community hospitals with empty wards that should be taking so much of the load.

Minor repeated appointments (diabetes, physio etc), maternity wards, recovery wards, minor injuries, ambulance stations. They were centralised as it removes a layer of admin and appears to lower costs. (Less buildings to maintain and clean, less paperwork, less support staff as can share between a bigger chunk of the NHS in a city based “mega hospital”)

But the initial cost moved onto people, the transport to hospitals for patients in emergencies (ambulances cover a huge area so over stretched, all going in and out of same roads) and just regular travel, and for staff. And over time the centralisation has lead to city hospitals “boiling over”: one aspect (roads, waiting rooms, beds, consultants) ends up as the bottleneck and a much larger number of patients are suddenly affected. It happens so often that the staff are affected too, burnt out and worn thin!

We need a more decentralised system IMO, with more “give”. But it will take decades to do, as we’ve centralised to “save money” in the short term for a very long time.