The four health services are very different. In essence, we have four laboratories. NHS England is by far the largest, but they all face different as well as similar challenges. I am sure that if there were more discussion of how things have been done, there could be more lesson-learning in different directions.
In 2010, we were promised that there would be no more reorganisation. The same promise was made in 2015, but NHS England is now facing another reorganisation, in the STP system and in accountable care. It is crucial that the focus should be not on bottom-line, budget-centred care but on patient-centred care. It is wrong that any such changes should be introduced through secondary legislation. They must be introduced in this place—either through debate, in Committee, through convention or in a royal commission—to enable us to come up with a structure that will function. Since 2013, the deficits have gone up, the waiting time failures have gone up and the stress on staff has gone up, making it even harder to keep hold of people. Let us put the patient in the middle, but let us also support the staff who look after the patient.