Routine reporting

doi:10.1136/bmj.39091.552940.47

BMJ 2007;334 (13 January), doi:10.1136/bmj.39091.552940.47

Editor's Choice

Editor's choice

Routine reporting

Fiona Godlee, editor

fgodlee@bmj.com

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

UK health care is suffering from what Will Huttoncalls the "delivery paradox" (doi: 10.1136/bmj.39080.574699.47).Although standards of care are improving, public satisfactionis falling. This is important, says Hutton, because public dissatisfactionthreatens could support for the universal public delivery ofhealth care, which is fundamental to the NHS.

What's to be done? Hutton's solution won't suiteveryone. It's called distributive democracy and goes completelycounter to the current tide in the UK towards ever greater centralisation(despite the government's rhetoric of decentralisation). Huttonargues that general elections and party democracy can't respondto users' needs at a local level or on a day to day basis. Insteadhe advocates making our public institutions as responsive tocitizens as the best private companies are to their customers.Health care should, he says, follow the BBC's lead in applyinga "public value" test for everything it does. Clinical judgments. . . [Full text of this article]