Sometimes, it's the little things that offer the greatest insights. I was standing in a store cupboard with two outraged nurses.

It was dark and stuffy, but the nurses had insisted I inspect the soap. It looked normal enough to me, but that was the problem.

'It's a family sized bar,' said one nurse. 'But we are not dealing with families, we are dealing with individual patients who need a fresh bar every time, so we are throwing away a large bar of soap after every bed bath. It's an appalling waste.

The answer seemed simple, I said: smaller bars of soap. The nurses shook their heads. 'The NHS dictates who we can buy from,' said the nurse. 'And while the chosen supplier makes so much profit from the large bars, well, they're not going to change, are they?'

The two nurses were so upset that they spent their lunchtime - and their own money - buying small bars of soap for their patients.

Those nurses know the NHS spending party is over and that something has to be done about the way we finance our healthcare.

Spending has doubled from £51billion in 1999 to £101billion today.

Chief executive David Nicholson has said that the NHS must look to save £20billion by 2014.

But how on earth will it cope with the exploding number of elderly patients and the costly new procedures and treatments coming on to the market?

The answer, says the health think tank the King's Fund, is to increase productivity in the NHS. But over the past decade, it fell by almost 4 per cent.

(Over the same time, it rose by almost 23 per cent in the private sector). So how to push up productivity and get value for the taxpayer?

A possible solution came this week from the Hinchingbrooke Hospital in Cambridgeshire. The hospital has debts of £40million.

So from next year it will be run not by the NHS, but by one of five private sector organisations. This is the closest the NHS has come to the privatisation of a leading hospital.

The full story available from here : The sorry saga of the NHS and my year undercover in hospitals | Mail Online