...Garling nailed the inadequacies and tragedies of the health system as they had never been nailed before. His 139 recommendations - released a year ago next Friday - provided a rallying point for change that doctors, nurses and the State Government seemed almost universally to agree on.

But just one year on, the feel-good moment may already have passed. Despite notable bright spots, separate reports this week by the Australian Medical Association and an independent audit committee charged with measuring progress point in the same general direction: to well-intended reform plans that are bogging down in the same ponderous bureaucracy they were designed to address...

....Hospitals, Garling told the Herald recently, are ''probably the most complex government enterprise''. Forty per cent of NSW's 100,000-strong workforce are doctors, nurses or other tertiary-qualified clinicians, all with independent professional traditions and strong views on patient care that may not coincide happily with flow charts and memos from central office....[READ MORE]