THE departure at short notice of the chief executive of Britain's National Health Service sends out warning signals that the NHS is in serious trouble despite the huge sums of money that have been poured into it by the government in recent years. It is true that the reforms introduced by Labour have brought improvements for patients in many areas. But financial management has not been one of them; unless severe economies are enforced immediately there will a deficit approaching 800 million pounds by the end of this year. The risk that this might have escalated to one billion is probably what jolted Health Secretary Patricia Hewitt into action by indicating to Sir Nigel Crisp, the NHS's chief executive, that his resignation would be welcome. Ms Hewitt must have seen the danger signals some months ago when she called in the management consultants McKinseys to advise on the structure of her department. McKinseys, who are quite quick on the uptake, immediately realised that, by trying to run both the NHS and the Department of Health, Sir Nigel was taking on too much and advised that he should be replaced by two senior civil servants. One wonders why Ms Hewitt could not see the necessity for this change herself without spending money on outside experts. She cannot escape all responsibility for the financial crisis that now faces the NHS and she is probably yet another minister in Mr Blair's cabinet with a question mark hanging over her future. It will be interesting to see how the Conservatives react to this situation. By expressing his categorical support for the NHS as a publicly-funded institution Mr Cameron has made if difficult for himself to criticise the service in principle. He is left only with the option of saying that the Conservatives would manage it better but Labour's experience is beginning to show that only root-and-branch reorganisation will produce any significant change, and then only if it is controlled rigorously from the centre in a style that runs against Conservative thinking. The NHS is both Britain's pride, that it exists, and shame, that it is nowhere near as good as it should be.