I think that the problem with the wards having their own kit is that some "sexy" areas of medicine have money pouring out of their ears whether they need all that kit or not, and other areas have to struggle with clapped-out rubbish, which is either obsolete, or only a few people have the training to use it confidently and safely. This second instance makes using bank nursing staff, or cover nurses from other wards, highly risky.

So a cardiac ward can end up with volumetric pumps on charge but unused for months on end while the endocrinology clinic has to cancel umpty-odd patients because one of their pumps is being serviced.

The major benefits I see are that everyone should be able to access certain key items regardless of the public "sexiness" of their medicine, and by standardising on devices hospital wide, the equipment and the operators can be confidently moved/used where they are needed. This improves safety because it should minimise problems with miss-use.

This does have a side-effect of meaning that essentially less equipment is needed overall, as long as EBME keeps everything serviced and repaired in a timely fashion.

Geoff - our Trust seems to have a demand to save something like 7% on its budget when prices are going up by 5%. The budgets are supposed to be set to cover the work that needs to be done. That looks like a 12% gap to me. Would you expect us to just blindly keep up the same amount of equipment when we need not do so in the face of that?

I can't argue with the bulk of your post there, Clare. Bad management is bad management, regardless of scale or setting.

But with regards to the last bit ... I have many proposals in mind for sorting out the NHS (and, indeed, further afield)... but I very much doubt they would be welcomed on this forum.