Julian wants to know…so just who is navigating this ship?

In regard to the great healthcare reform I confess I am not well informed, as I have only been catching snippets of news.

And I filter the stuff I do hear, because I can see merit in reform – although every "change management” rule I have ever been taught has been ignored as far as I can see on this one.

However, it seems that in the "rehab” sector, it is increasingly difficult to find anyone in charge at a national guidance level.

Is it just me – or have most of the Department of Health folk who used to be so intimately knowledgeable about homecare equipment, daily living, wheelchairs, adaptations and the like gone?

If they have, whilst I understand it's planned to be all about localisation as far as provision and implementation is concerned; but surely there needs to be some structure to provide local commissioners with an a la carte menu of ideas, choices and best practice models? To say nothing of leverage of buying power etc.

You can see I'm confused on this issue. Maybe it's an age thing. Any (useful and printable) ideas or comments welcome.