What does the future hold for the NHS at 60?

doi:10.1136/bmj.a549

Editorials

What does the future hold for the NHS at 60?

Flux and conflict constrained by consensus as in the past

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

When the NHS celebrated its 50th anniversary with much pomp,commemorative stamps, and a service in Westminster Abbey, anew Labour government was busy reversing many of the policiesof its Conservative predecessor. The internal market was abolished,as was general practitioner fundholding. The NHS would indeedbe modernised, but it would be on the basis of cooperation notcompetition.

Who then—in the euphoria of the celebrations when FrankDobson, the secretary of state for health, could claim that"the NHS remains the envy of the world"¹—would have anticipatedthat within a couple of years policy would go into reverse gear?Who then would have predicted the emergence of a new model forthe NHS based on choice, competition, payment by results, anda plurality of providers, let alone the emergence of institutionslike foundation trusts? To ask these questions is to underlinethe perils of prediction. It is . . . [Full text of this article]