Internationally, problems of remote and rural healthcare include centralisation, lack of chronic condition care, health worker shortage, failure to adequately address prevention and lack of infrastructure for co-ordinated, integrated care [ 18].
Political instability, frequent staff changes, over-centralisation, lack of long-term planning by bureaucrats, aggressive unions and the occasional war all get in the way.
It has even been portrayed by some as a recipe for dystopia, in which over-centralisation, lack of choice and falling standards are the norm.
The Germans want a different sort of centralisation, built on rules to punish the profligate.
He said Labour would end the "centralisation" and "lack of accountability" in Tory education policy.
He pointed to the lack of commitment from athletes to the centralisation plan for the British Performance Institute at Dartford.
The period spanning from the colonial period through Tanzanian independence to 1982 was characterised by a strong centralisation and parallel lack of a local government system in its real sense.
Reversing generations of centralisation.
But the political burden of centralisation is onerous too.
This is the unavoidable side-effect of centralisation.
