The NHS is always in crisis and the biggest risk, outside of total collapse, is that a government looks to shift the burden on the coffers by essentially privatising parts of the organisation. At the same time, it is right that the service is challenged to improve and make efficiencies.
I agree that the NHS should be benchmarked on spend, at the same get the funds it needs to continue operating today, until it can be agreed how to position it for the future. This must include looking at the cause and effect of wider societal issues, such as elderly care, mental health support, binge drinking.
The NHS wastes money and must work harder to improve either as a central or regional entity/s but certainly by improving the estate, reducing overheads, working better with technology and challenging staff to control costs including management spend.
The easiest option might seem like commercialisation, but that will improve internal costs but not external costs as the move would simply shift the emphasis to profit. Instead the NHS can lower costs by improving and thus free up existing spend to invest in patient care and long term development. Cutting budgets is one way to force trusts to examine spend, but must hurt some patients.
Business Consultants are not the answer, more management is not the answer and not is political interference. We need to settle on a structural approach to reforming the NHS that empowers and makes accountable.