Healthcare changes are profound

The Health and Social care bill is out there now; the implications for those trying to work with the NHS are concerning. Whilst within the NHS there seems to be a rush to get some things done before PCTs go, in others areas it's simply leading to freezing in the headlights of change.
Good PCT staff are finding places to go to; the others are trying to keep going but information and decisions become harder to come by for the rest of us.
Whilst I deal with 5 PCTs on behalf of the service I manage, it will tune into about twice that number of GP consortia - making meetings, communications and achieving consistency ever more difficult, and costly. So, I will have to factor that cost in to our calculations. It will make us more expensive in an area of the economy that is trying to do more on less resources all the time. We run a specialist service - not one that attracts lots of activity but essential - End of life care.
How well will the UK stack up against other parts of the world in 2-3 years time, in terms of the quality of end of life care? How far do we want economic pressures to shape healthcare? Inequalities of provision and allocation of resources seem inevitable across England. Have the other home nations got a better system? Plenty to think about and prepare for...