The NHS through American eyes

doi:10.1136/bmj.321.7276.1545

BMJ 2000;321:1545-1546 ( 23 December )

Editorials

The NHS through American eyes

It has an enviable goal and constancy of purpose: build on it

The first 150 words of the full text of this article appear below.

Criticism from without, demoralisation within, and ubiquitous scepticism besiege the National Health Service. The NHS Plan,released in the summer,¹ is the latest in a series of blueprintsintended to redefine the resources, programmes, and operatingprinciples of the NHS, but it too has met its share of cynics.We are two Americans, privileged to have an inside view of theNHS and its proposed reforms, and we share an optimism about theNHS that is hard to find in the UKnowadays.

Not that we don't see the trouble. The performance problems of the NHS are no secret. Some reflect random episodes of malfeasance,such as the murderous Harold Shipman, but more chronic problemsafflict the NHS as a whole and, in aggregate, cause far more sufferingand waste. They include long waiting lists, postal code variationin practice, and poor outcomes in cancer care, and they causedthe . . . [Full text of this article]

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