'Divorced from reality of life' The group were then advised that they had been given the "green light to present what boards feel reform may look like" and that "areas which were previously not viable options are now possibilities".The minutes note "concern" about an alleged lack of clinical input into political decision-making which, they say, leaves some Scottish government suggestions feeling "divorced from reality of life and purpose of service."An ageing population, coupled with ever-more expensive drugs raises some very difficult, uncomfortable questions for decision-makers about where the boundaries of a health service should lie.Arguably the single biggest inefficiency in the NHS is patients being kept in hospital when they are medically-fit to leave.Chancellor Jeremy Hunt said in his Autumn Statement on Thursday that the country must ask "challenging questions" on how to reform all public services for the better, including the NHS."