Shooting down the NHS reform track

doi:10.1136/bmj.39056.426528.BE

BMJ 2006;333:1280-1281 (23 December), doi:10.1136/bmj.39056.426528.BE

Editorials

Shooting down the NHS reform track

Why ministers cannot pull the brake even if they want to

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

Anyone who wants to understand the process ofchange in England's National Health Service could do worse thanto summon up memories of watching the bobsleigh events in thewinter Olympics. The bobsleigh riders hurtle down the icy trackat great speed. There is nothing they can do to change direction.Their course and goal is determined for them, and there is littlethey can do apart from keeping their balance and their nerveas they round the terrifying bends. If they were to brake suddenly,regretting that they had ever got themselves involved in sucha high risk sport, disaster would strike.

The policy makers engaged in transforming theNHS are in a similar position to those bobsleigh riders. Oncethe government had decided on the new three part model for theNHS, the course was set. In turn, the logic of the model—competingproviders, active purchasers, and money . . . [Full text of this article]

Rudolf Klein, visiting professor

¹ London School of Economics, London WC2A 2AE

rudolfklein30@aol.com