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Accountability is two fold, 1. Cost 2. Care.
As with all local Authorities, each NHS trust will be unique in various ways. Catchment area, social ecconomic mix, ethnic mix,available facilities resource ie. One large new PFI hospital or five old small hospitals. Some services contracted out/all services contracted out. All these need to be considered/understood by central government, the trust(consultants, nurses management, contractors, patients and public). Then and only then can you be accountable. I speak as a local government officer who has managed operations both prior to, and post C.C.T. in client and contractor roles in a large London borough.
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