THE COALITION government is making a start in dismantling the bureaucracy, form-filling and target culture which eat up so much of the NHS budget. Layers of management are being taken out to save money.

Instead, the Government wants GPs, family doctors, to decide where their patients should go for treatment.

They will have much more control over money in the NHS to use on their patients' behalf. This could be good new for our area since the Twickenham, Teddington and Hampton GPs work closely together and want to make more use of Teddington Hospital.

There will, however, be a squeeze on NHS funding even though the NHS is being protected relative to other public spending.

The big hospitals may struggle. There are reports that the West Middlesex may lose its independence and become part of one of the big London hospitals, carrying out more surgery and leaving lesser health problems to local centres like Teddington.

The NHS has had money poured into it for many years and the money has often been badly used. It now has to cope with a rising population of elderly people without being given more money. This can only work if people are cared for better in the local community.

We face some very difficult choices which have so far been avoided. Do we spend more money on the younger generation – schools, colleges, universities – and invest in the future through science and new technology or do we channel money to the elderly and deprived?

Britain is a poorer country than before the financial crash and such choices are being forced on us. What we are learning fast is that it isn’t possible to please everyone.