Camilla Cavendish’s excellent article (Opinion, April 25) describes how the pandemic is forcing us to address health system failures.However, when she says “in a pandemic, you need a system with clear lines of responsibility and accountability”, she unwittingly nails it. This is essential not just in a pandemic, but at all times.

Moreover not only do you need this within the health system, you need clear responsibility and accountability for the health system. Responsibility clearly resides with government and accountability with parliament. Both have failed to prevent the problems the author describes. System failure happens slowly over many years. It is ironic that Ms Cavendish was Head of Policy to one of the governments that has presided over the slow failure of our health and many other of our systems. Perhaps her next article will analyse the failure of our system of government which has let this happen.

Ashok Gupta
Chair, Financial Systems Thinking
Innovation Centre, London SW6, UK

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