How to restructure-proof your health service

doi:10.1136/bmj.39272.443137.59

BMJ 2007;335:99 (14 July), doi:10.1136/bmj.39272.443137.59

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How to restructure-proof your health service

Jeffrey Braithwaite, professor and director, Centre for Clinical Governance Research, Faculty of Medicine, University of New South Wales, Sydney, Australia

j.braithwaite@unsw.edu.au

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

Politicians are often criticised for saying one thing and doinganother. Is the announcement last week by prime minister GordonBrown and new health secretary Alan Johnson a further example?They are sponsoring a major review of the NHS while pledgingto stop giving top-down instructions and ceasing centrally dictatedrestructuring.

What do major reviews produce, other than more instructionsand new rounds of restructuring? This is especially contradictorygiven that Mr Brown and Mr Johnson, in making their announcement,argued that the NHS "cannot stand still," and the review's termsof reference stipulated that the way forward for the NHS isto be "clinically driven, patient centred, and responsive tolocal communities."

This review will surely try to reorganise from the top the waypredecessor reviews did—principally, through above-downmeasures. It is unlikely politicians will leave implementationto an independent NHS.¹ In politicians, the strong desire tobe seen . . . [Full text of this article]

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This article has been cited by other articles:

Braithwaite, J, Runciman, W B, Merry, A F (2009). Towards safer, better healthcare: harnessing the natural properties of complex sociotechnical systems. Qual Saf Health Care 18: 37-41 [Abstract] [Full text]
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