Evidence not ideology: The BMJ should take a position on the evidence about privatisation

doi:10.1136/bmj.331.7522.964

BMJ 2005;331:964 (22 October), doi:10.1136/bmj.331.7522.964

Letter

Evidence not ideology

The BMJ should take a position on the evidence about privatisation

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

EDITOR—The argument is that the BMJ shouldn't have a positionon the privatisation of health care and the NHS, but it shouldsimply be a forum to allow the issues to be debated.¹

But neutrality on this issue is wrong. It means abdicating theresponsibility of a scientific publication to weigh evidenceand argument based on evidence. A very large accumulated bodyof evidence underpins the establishment and development of apublicly owned and operated health system in the UK, evidencethat advocates of its abandonment have yet to supplant withvalid evidence of their own.

The fairest way of funding health services is through a progressivetax based system. The alternatives—social insurance (employer,employee contributions, local authority taxation), private andvoluntary insurance, and user charges—are all, in thatorder, increasingly regressive and inefficient. Above all theyintroduce the potential for disaggregating and fragmenting therisk pool, allowing . . . [Full text of this article]

Allyson M Pollock, professor, health policy and health service research

School of Public Policy, University College London, London WC1H 9QU allyson.pollock@ucl.ac.uk