The perils of giantism

I find myself arguing rather often these days that you can't have localism with over-large institutions, whether they are monopolistic supermarket chains or giant factory hospitals.

And there I was talking to a neighbour who has just given birth this week, and find some personal anecdote about merging hospitals means. She went along to Mayday Hospital, as she is supposed to, for the baby's hearing checks (Mayday is near West Croydon station). She was told that because of staff shortages, they couldn't see her - and had made her an appointment in teddington.

For thos not familiar with London, the journey between Croydon and Teddington in the far west of London, is well over an hour - even by car. She has a baby and two other children and no help.

I might add also that recent research in the USA says that hospital mergers inevitably raises costs for the hospitals as well.