Good deconstruction points. You're completely right that touching upon a plethora of services is not a direct argument for reform, but perhaps in Gumbel's world it is. There's no insight in financial numbers.

Finally: since I know you're in favour of quality food production sold as locally as possible, how would you supply a huge hospital group? my answer would be : sounds difficult, but all the same, the hospitals buyer must do her/is best to get quality food and not to concentrate too much on one supplier...

Exactly the question. You know, when I walked the dog today, I may suggest that the hunger for scale enlargement may again be at the heart of it. The distribution from chickens (or pigs) is really not hard: you transport the chikens to the butcher and from there they can be distributed directly to the hospital. It's just that if you do this locally, costs per chicken increases. That's it. Now, if only we could increase transporation costs to make local, small scale distribution/butcher complexes more attractive again... Let's get 29 distribution centres with the best chicken meat from local farmers to ill people. I'm all for it. Perhaps we should contact Jamie Oliver...

(Is there a diary on how much miles a dead chicken currently makes before it ends up in a pot?)