I first met Norman Gill many years ago when he was an administrator in the NHS and I had just been appointed a laundry manager.

The standards within the hospitals where we worked were high. Managers managed and took responsibility for decisions. The admin /management structure was short. Everyone knew what was happening and talked to each other. Problems were solved within the family.

Now the chain of command is much longer, rules are sent down from on high and no dissent is countenanced.

There used to be a “Value for Money”, system where managers could test items before buying and assess their worth against similar goods.

Today, the only criterion is money: how much does it cost to buy? not, how much does it cost to use which means that someone has to look at and take responsibility for assessing the total cost, – purchase price, length of life, and costs of maintenance and disposal.

During my time as a contracts assessor, I was disgusted to be told that the cost of employing someone to monitor contracts was too high, so ward sisters had to report to monthly or even quarterly meetings.

The technical assessments were often left to the contractor. In one case, the current service supplier sent in a tender submission that was virtually a copy of their previous document and did not reflect the huge changes in equipment.

But, because the price quoted was significantly lower than other potential suppliers’, it was accepted, even though there were worries about the quality of the service. That is the culture that exists in today’s NHS. Tenders are meaningless as the cheapest always wins.

Finally, my wife was admitted to a ward for heart bypass surgery. A card sent to a previous patient and left in the skirting board by her bed was still there three days later.

She once asked the cleaner to wipe the top of her locker and he used the same cloth that he had used for the ward sink.

In three weeks she never saw a supervisor or anyone who checked the quality.

As Norman said to me, they would not want either of us back in the NHS; we would rock too many boats and could not accept being PC. Too true!