Personally I feel that consultants earn their money (generally), especially when compared with others earning way more in other sectors. How many lives can a bond trader, merchant banker, college principal, supermarket manager claim to have improved/saved.
Things I would be considering (if not done already) are:
More use of generics rather than branded drugs.
Tougher negotiations with suppliers, perhaps on a national level.
Also maybe:
Immunity from civil damages court claims.
A restriction on marketing spending by trusts.
Replace that 111 line (bag of S@@@) with something more effective in keeping people away from A+E like NHS direct used to be.
I don’t think another complete reorganisation of the NHS makes much sense in that it will cost a fortune in the short medium term and the advantages are only possibilities rather than probabilities. Most internal markets seem to save less in operational spending than they cost in administration.
Of course the main problem is that we are living longer so we could have a “logans run” type scenario where everyone over say 50 is put down before they start costing the NHS loads of money. Alternatively, a series of “Battle Royales” for any group regarded by STW as a drain on the service; fatties, smokers, elderly, childless couples etc.