Now it applies to the NHS ... from the BBC:
"Changing hospitals - and in some cases closing parts of them - is the elephant in the room no-one dares talk about.
It is just too controversial. Hospitals are the visible face of the NHS and unsurprisingly people feel great affection for them. So when a particular unit is under threat they start to protest.
This has left many [politicians I guess] worried about putting the case for change - hence the ambiguous phrase the NHS uses to describe the process, reconfiguration."
The King's Fund, a health care think tank, that previously supported the previous government's shake-ups in the Greater Manchester area, is now warning against the current government's plans for the NHS with the intent of giving them more control/power of commissioning and reducing the role of hospitals in NHS decision-making. See the report.
The new NHS chief, Sir David Nicholson, (the new bogey man?) has warned
"Private sector take-overs, mergers and more community-based care may be needed to ensure all hospitals survive the shake-up of the NHS, the head of the health service says.
Sir David Nicholson told the BBC the combination of reforms and squeeze on spending meant some hospitals would find the future "difficult".
He said he did not expect any hospitals in England to close completely.
But said some would needed to adapt and change to remain competitive."
This begs the question of whether he will he be paying GPs more for their new responsibilities?