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The implicit agreement between the government, the medical profession,
and the public (on which the NHS was established) has been undermined
over the years and needs to be updated, say Ham and Alberti (p 838).
They recommend that a new, explicit agreement is needed, based on
patients' rights, public responsibilities, greater accountability of
the medical profession, resources, partnerships, support for effective
care, and stewardship. Such an agreement can only be reached if
representatives of the medical profession, the public, and the
government trust each other and believe they are working towards common
goals. This will not be easy, they say, but it is essential to enable
the different partners to make an effective contribution to the reform
of the NHS.

(Credit: BARRY BATCHELOR/PA)