Dawn Griffis is originally from Aynho, but lived in Oxford for seven years and trained at the Horton Hospital in Banbury. She has lived in America since 1965, but lived in Banbury for four years from 2005 to 2009. Mrs Griffis worked as a nurse from 1956 until 2013 when she retired. She has written several memoirs, three of which are related to nursing or medical care.

I believe it is possible to make the NHS independent and cost effective by going back to basics.

When it was put into place in 1948 they used the umbrella concept for the entire National Insurance scheme – it was a great idea.

The money was brought in from citizens and employers paying into one entity, the National Insurance. There were many departments under the umbrella that the NI would distribute the money to, the NHS being one.

What I mean by going back to basics is this: the original concept and operation was well thought out. The same can be used today, with adjustments, by following this very simplified explanation.

The National Heath Service Primary Office would receive its share from the National Insurance as it is now scheduled and the primary office would oversee the whole programme. This would include five primary departments listed below. It would coordinate all of the following: The NHS’s primary departments would receive the monies from the Primary Office that would be then distributed to District Trusts, according to needs submitted by each trust.

The departments would include a central purchasing department.

With the NHS's massive buying power, this department should be the one to save the most money for the NHS.

Central Purchasing would be one of the largest departments, because they would be responsible for all the buying for the entire NHS. It would need separate sections, to allow for the ones with the most expertise in any given area to be assigned to whatever section they are buying for.

The different sections would be Hospital/GP surgeries/ Dental surgeries supplies and equipment, A distribution department would distribute the money received from the primary office to the various District Trusts.

The distribution department would receive each trust's monetary need from the primary office section at main office.

It could not deny a request without good reason, and without giving the requesting facility a chance to appeal the decision and to defend their request. Both will be able to negotiate an acceptably final decision that is agreed by all parties.

An education department would be for the education of all healthcare personnel, including but not limited to doctors, dentists and nurses, countrywide, plus continuing education.

It will save money in the end, and be worth the money spent. It will put an end to staff shortages, and have better trained nurses.

Physicians, dentists and chemists would be fully trained through the NHS, including residences and paid a pre-agreed stipend, until fully trained.

On completion, they would have a commitment to the NHS for a minimum of five years.

They would be paid salaries according to the contracted pre-arranged pay scale.

Nurses would be fully trained by the NHS, but the training would be a joint training scheme coordinated between the hospitals and universities – not just universities as is done now, with students only receiving limited hospital experience. They would receive a minimum of 20 hours per week hospital experience.

All of the hospital experience would be closely monitored and planned to allow for maximum practical nursing experience, by the hospital’s education department, in conjunction with the university.

This earlier change was probably one of the worst changes ever made to the NHS This would solve staff shortages and give more people the opportunity to have more extensive training and qualifications.

The NHS would have better trained people, and eliminate the use of costly of agency personnel.

A department for major constructions, maintenance and replacement countrywide would work. This department would be responsible for all new builds or renovations to convert buildings into NHS facilities.

A payroll department would be responsible for standardising salaries and contracts for all NHS employees, including those in training within the NHS scheme. All contracts would be within very strict guidelines.

Many of the current salaries, especially in the top ranks are obscenely high, as are the number of positions at that level. There has been insufficient funding of the working or lower ranks.

Timely filling of the vacant positions has been inadequate, putting the patients at risk. These positions must be filled, and or more created to give safe and quality patient care.

My suggested cap would in a full time position is a suggested amount of £250,000 annually, no bonuses.

The NHS has become so large and cumbersome it is very difficult to manage.

If it was to be operated using the umbrella concept, it would work again.