The human brain is probably the most complex organ of the body, and comparing it to the National Health Service may give us conceptual hints as to how we approach reconfigurations.

The brain cannot undergo limitless growth in response to increasing demand, which may or may not increase as a person gets older.

This is shown for example by the fact that it’s contained within a skull. It has an outer covering which encases it. This is known as the ‘blood brain barrier’ regulating traffic between the body and the brain, analogous to the regulators.

Seeing what is happening from output this barrier can be a good marker of the quality of activities within the brain itself.

The brain makes decisions, plans ahead, makes decisions, has a working memory, can learn, has memory for events, and is able to perceive aspects of the world around it.

Also bits of it can suffer from a build-up of toxic metabolites, which may be kept hidden.

It needs a brainstem to survive, which for example contains centres that control our breath. This brainstem also connects the brain to the rest of the body.

We of course need lungs to breathe. In the same way, the the NHS needs the rest of the economy to survive. And we can’t absolutely divorce what is happening in the NHS from the rest of what is happening in the UK, in much the same way the brain cannot be thought to be separate from lungs. There’s an interdependency.

The human brain is incredibly metabolically active. Without being given adequate resources, the whole thing will simply die.

The body needs to work too. For example, if we can’t breath, we don’t get the oxygen to run the brain. If there is insufficient monies to run the NHS, of the order of billions, it will simply fail.

No-one really understands the complexity of the brain, in a similar way to not many people understand how the NHS works as a whole. There are thought to be 100 billion brain cells, in various proportions of the types of brain cells.

With so many brain cells, and connections between them, it’s inevitable that some connections (and even brain cells) will become “redundant” with time.

The number of each category of brain cells doesn’t matter as such as long as the whole brain functions well. However, some people worry that certain types of brain cells, or entities in the NHS, consume too much energy and are not particularly efficient. This is of course of concern if you’re thinking about having enough energy for the brain as a whole.

It’s likely that no one part of the brain fulfils a certain function in the brain, such as decision making. It’s likely that different parts of the brain work in synchrony to fulfil these functions. However, some parts of the brain may be more important than others for producing certain brain functions.

This is possibly helpful to think about what happens when some parts of the brain fail.

Some parts of the NHS may be running a deficit in a moribund way before they enter an outright failure regime.

In the same way, it could be that some parts of the brain don’t have enough oxygen – maybe insufficient money or spending too much money, and so forth. Lack of oxygen can produce a stroke.

The question is what happens when a part of the brain has a stroke. Somebody has to ascertain that that part of the brain has no residual function left.

Who makes that diagnosis, that there’s no function left, and no amount of oxygen will make that brain part work, is bound to be controversial, as to the subsequent management step of allowing that brain part to go peacefully out of action.

A problem obviously arises if it’s decided that that ‘out of action’ brain part goes into managed decline too quickly.

It could be that that part of the brain is actually critical for a function from the brain. This could be the case for a particular entity in the NHS itself too.

If a part of the brain is truly dead, the rest of a network of other parts of the brain could be recruited to fulfil that function. Such plasticity is known to a limited degree in the adult nervous system, but is much easier in the developing nervous system.

Brains which are old depend on activity in parts of the brain to determine where the connections are strongest and best made.

This is fundamentally the ‘issue’ for socialists who think that activity can determine some NHS services going into ‘managed decline’ through a mercenary neo-Darwinian ‘survival of the fitness’ process.

A problem with Lewisham, originally, was that it appeared that bits of the brain, to overegg this analogy, were being shut down because other parts of the brain had failed. This is of course counterintuitive.

It could be through proper planning can we can work out how to reconfigure networks so that the brain is still able to provide all its functions.

A major problem with recent legislation is bits of the brain can now be shut down without proper analysis,

Another major problem is that there is enormous public distrust, so that people are uncertain that the brain will be given enough oxygen to carry out its functions.

But on a happier note, the brain is a bit unpredictable. It is a remarkably sophisticated organ. There’s a lot of affection for it which far transcends it being a ‘sacred cow’.

As it gets older, we need the very best sophisticated minds to work out how best to progress English policy. I am not absolutely certain we have them just yet.