Published 28 October 2009, doi:10.1136/bmj.b4372
Cite this as: BMJ 2009;339:b4372

Analysis

Lessons from the past decade for future health reforms

Chris Ham, professor of health policy and management

1 Health Services Management Centre, University of Birmingham, Birmingham B15 2RT

c.j.ham@bham.ac.uk

The continual change imposed on the English NHS has caused many staff to feel disillusioned. Chris Ham looks at what the experience can teach those planning further reform

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

The National Health Service in England has been on a rollercoaster ride of reform for over a decade. The journey started in 1997 with the white paper, The New NHS, and continued through the introduction of performance targets and standards. New systems for inspection and regulation were then introduced, followed by reforms to increase patient choice and competition. The most recent changes focus on quality and safety with improvement being led locally by clinicians (box).1 2 3 4 5 6 With a general election expected in 2010, and the opinion polls indicating the likelihood of a change of government, further reform seems inevitable. I have identified 10 lessons for policy makers from the experience of the past decade.


1997: The New NHS—Announced a third way of reform based on partnership and driven by performance
2000: The NHS plan—Introduced large numbers of performance targets and standards with annual assessment of NHS organisations and . . . [Full text of this article]



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