What to do, Richard asks, if you don't like associations / institutions. (Not that I think he is of that frame of mind.)
I think the progression to an organisation of some sort may be inevitable as the existing institutions will be lobbying the NHS hard to become the chosen one. It will swell their coffers magnificently.
If we want to stop it, all we can do, I think (and I am not a political animal so may not be the best person to answer), is to give a good service, make our managers aware of the financial consequences of organising, (fees, pay stucture, training etc, etc) and let them know we do not think it is required. After all, a lot of buinesses employ engineers at the moment without any sort of formal qualification structure and are very successful. Why shouldn't the NHS do likewise.
While I accept that our job has a bit extra tacked on to it, in that patient protection is a consideration in our daily lives, I can't see that that requires us to be exceptional people to do the job.