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  There are some doctors, nurses and teachers who shouldn't be there! If there needs to be a review of resources, all staff should be included in that: if they are not performing, or not necessary, or not delivering, why keep them? Part of the NHS challenge is to manage an unwieldy monolith in bite-size chunks in order to reduce waste and inefficiency. That's one good reason why smaller cottage hospitals are a good plan: easier to manage, easier to monitor, and the increased costs in maintenance are balanced by a saving in personnel and wastage, and in a better more targetted service delivery.

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