Here they are again, expressing surprise about its performance comparing badly with other countries. They pause for a second to sound shocked, promise to do better in future and then return to platitudes about 'our NHS' and how it is admired (no it bloody isn't) 'all over the world'. Within a minute they are using whatever horrors have been exposed to justify extorting more money from taxpayers to improve their own working conditions, pay and pensions.

Any service funded by force does not need to satisfy its customers to survive. Many of its employees will rapidly cease to care about them, because they don't need to. It's not a bug, it's a feature. Whatever pieties the politicians and bureaucrats may recite such an organisation - in practice - is not there to serve the patients, but the staff.

As witness the career of Sir David Nicholson, poly history and politics grad (odd qualification to run a health service) and 'tankie' member of the British Communist Party until the shamefully late date of 1983 (ah, there's the qualification). He presided over mass deaths (compared to the performance of other countries' systems) and yet will retire next year a rich man. If he had faced the downside as well as the upside of a soviet aparatchik's life - the sort of management a 'tankie' might be expected to approve of - he would have been shot or spent serious time in the gulag. Under Britain's softer socialist state, it was reported in 2011 that he enjoyed benefits of £37,000 and claimed expenses of almost £60,000 on top of his salary of £200,000+.

Interestingly, the monster expenses were for a London flat. He was required to work in the capital, though his main office is in Leeds. However his home is in Broome, Worcestershire. By Google Maps calculations his 124 mile commute to London was therefore an improvement on that to Leeds! And let's not dwell on the happy coincidence that the NHS found a high-paid and no doubt better-pensioned job as head of Birmingham Childrens' Hospital for the woman for whom he left his wife.

It's a tough life being a British aparatchik, isn't it?

As for why the American system these mandarins despise so much kills so many fewer patients, the answer is simple enough. The medics there answer to patients, not bureaucrats. And the truth about any failures of care is available for them to learn from, not suppressed by aparatchiks to flatter the politicians and bamboozle the proles.