> This project was implemented by the same agencies - MCI together with Caracal. I suspect that this is the root cause of this and for many other systems failing. When a project is created by the lowest bidder, as a one time effort with fluffy requirements why would they invest in proper architecture, planning or testing? Why would they invest in securing resources when they are paid anyway?
This is where quite a lot of people would insert a rant about "state capacity": the ability of the state to actually do things it wants and intends to do. Which requires people to do those things, trained with appropriate skills. The peak of "state capacity" was undoubtedly WW2, when governments bypassed market mechanisms and became command economies. Out of necessity - war is the one venture in which failed state ca…
The only way to see a doctor is to go to A&E, or convince NHS 111 to give you an "emergency appointment" of some kind. All of this drains emergency resources and are not an option due to the time investment for average people with precarious employment.
Unfortunately many people won't believe these facts, because depending on which area you live in there's always plentiful appointments, in advance or on the day! Where I last lived, getting an appointment was easy, the difference in outcomes based on how wealthy or urban your area is leaves a bad taste in my mouth.
Briefly, we had a new surgery open that offered more appointments, at more convenient times of day, and we could actually see the doctor. All the other GP's started losing their patients to them. Then within a few months they were shut down by the local NHS trust, under multiple investigations (one of these investigations was regarding an offensive Facebook post by the surgery's chief, I kid you not). They then later reopened with normal appointment times and no free spaces, like all the other surgeries.
I agree with what you say re the command economy of WW2 allowing the creation of the NHS. But it was not this country that founded the NHS: it is some ancient, lost nation that seems utterly alien to me today. I don't believe we could achieve even a small version of what WW2 Britain did anymore, if our survival depended on it. I cite the UK's response to COVID19 as evidence.