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| The first 150 words of the full text of this article appear below. |
Secondary care consumes a large proportion of the
healthcare budget and the need to spend wisely is ever pressing. The
prevailing political philosophy of the past few decades in Britain has
meant that efficiency and effectiveness have become part of NHS
vocabulary. Doctors have probably been better at adopting new practices
than they have been at dropping outdated methods, but in both areas there is room for improvement. Moreover, government funding is unlikely
to improve unless the profession can show not only its commitment to
best practice but also its ability constantly to examine its procedures
and implement improvements or abandonment when necessary. Clinical
governance should nourish this process, but if success is to be
achieved it will come from leadership, drive, and initiative from
within the profession. The move to keep patients out of hospital is
clearly part of the search for efficiency and effectiveness, but it is
important
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