More news of casualties from the front line: there are 1200 preventable deaths every month in Britain from kidney malfunction where the cause is usually dehydration, with most of the incidences happening in hospitals. I use the expression “front line” because our hospitals increasingly resemble a war zone. 364 hospital deaths last year from MRSA . And 2053 from clostridium difficile. One in sixteen hospital patients picks up an infection in the course of their stay – a statistic which the National Institute for Clinical Health and Excellence (NICE) unsurprisingly describes as “unacceptably high.” The usual cause of the deaths from dehydration is neglect; and for MRSA and CD it is poor hygiene. It is scandalous that neglect and poor hygiene occur in what are supposed to be caring environments, places where people come to be made better not made worse or put to death.

I was with a friend who is a doctor, now retired from a career during which he was a very eminent surgeon and I wondered aloud how much longer it will be before the British people rise up in outrage against the unsatisfactory conditions in the hospitals. He opined that the scandal is so huge that the public’s dissatisfaction is imminent. I am reluctant to disagree with a professional who has a lifetime’s experience of the NHS, but I do disagree on this matter. There are so many vested interests in the NHS on the part of the political class and the health bureaucrats – extending to a whole tier of the bureaucracy engaged exclusively in public pacification, propaganda and the persecution of whistle-blowers such as the cardiologist Dr Raj Mattu who has spoken of “the dystopian culture” of our hospitals.

The general causes of the inevitable failure of the NHS were laid bare decades ago by Dr Max Gammon  in Gammon’s Law which Milton Friedman described as the “Theory of Bureaucratic Displacement.” Gammon’s Law, developed after a long study of the NHS from the inside, states, “In a bureaucratic system, increase in expenditure will be matched by fall in production. Such systems will act rather like black holes in the economic universe, simultaneously sucking in resources, and shrinking in terms of ’emitted’ production.” Gammon’s Law attracted international attention when it was first announced, with such consequences for Dr Gammon’s career as might be expected. Massive unaccountable bureaucracies do not take kindly to criticism and, as numerous cases have demonstrated, those who draw attention to their failings are persecuted and victimised relentlessly.

The fact is that when any institution becomes too large and very heavily bureaucratised, it ceases to exist for those it was appointed to serve and exists instead for the benefit of the mismanaging bureaucracy itself and the army of highly-unionised employees who earn their living in it. What applies to the NHS applies similarly to state education.

These public bureaucracies are species of totalitarianism, too big to fail – or rather too powerfully self-serving to have their failings exposed.