[arpinum]

Drugs are more streamlined, but most of the NHS looks a lot like the US system. There are 8 major private electronic health systems, and many have not signed interoperability pledges. 145 CCGs. Foundation Trusts, remember just 10 years ago GP Practices would become part. Quasi-private GP Practices. Mergers going on every year (195 CCGs to 145 last year). Funding comes out of a myriad of mystery buckets (winter funding).

[quietbritishjim]

The NHS employs about 1.4 million people (and I don't think that includes GP practices). Of course an organisation that big is going to have quite a bit of structure. I never intended to dispute that.

I was disputing that specifically drug purchasing is a "racket" with "more layers" the US system, which is what the parent comment claimed. None of the organisations or organisational units that you mention have anything to do with drug price negotiation, so I don't see what they have to do with the conversation.