I agree with Dr Alf that this Japanese system with improvement would force a more open culture if adopted in the UK. However, the problem in the UK is compounded here by litigation, gagging orders on whistle-blowing NHS staff, and the actions of insurers. Also there are cultural challenges in modern UK society as well as within the NHS.

The public need to address their own propensity to sue at the drop-of-a-hat and to fail consistently to take greater responsibility for their own health.

A cursory look at dating websites of even the very young reveals burgeoning waistlines and phrases like “A little overweight”, “cuddlly” and other euphemisms for people who quite frankly would do no worse than participate in one of Sir David Attenborough’s wildlife programs about Killer Whales engaged in feeding frenzies.

A recent television program called “Pensioners Behaving Badly ” featured enormous people, men on their last legs taking Viagra prior to attending debauched gatherings in a house in Radlett, Hertfordshire. One of them died a week later, as was reported in one of Rupert Murdoch’s newspapers, and others die from drug and drink fueled excess after “larging it up ” in sleazy nightclubs.

All this shows the need for better education and the inculcation of better values into the minds of the more nihilistic and weaker members of the public who create disproportionate demands on the NHS which seems unable to deal with them effectively.

The NHS is being eaten into financial oblivion by overweight people and by older people whose lifestyles and food/exercise preferences put them on a fast track to dementia and madness. Until this changes, the NHS is looking at the wrong end of the telescope, namely supply rather than at demand.

Put simply, fewer people needing to go to hospital reduces NHS costs, the number of operations, procedures and medical interventions and ultimately reduces the number of mistakes and deaths caused by the NHS.