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I think we need a Mulkerin for HSSD! Lets face it, HSSD runs on a model probably thought up decades ago, is it really fit for 21 century? There needs to be a shift in the thinking, start with what exactly do you want the service to do? Dave Jones is right in some ways its us, the public, who want a gold standard service but we dont want to pay for it. On the flip side, I think wer are saying, we are giving you the money, you dont seem to be spending it where we want it to go, i.e. on front-line services. If somewas was to go in and talk to the staff they would find lots of examples of where money could be saved. Some of it would be by reducing the top heavy management. I personally think there should be proper audit of services and departments to see if they are fit for purpose now.