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Focus: Westminster: Ministers begin a drive on effectiveness

BMJ 1994; 308 doi: https://doi.org/10.1136/bmj.308.6928.558a (Published 26 February 1994) Cite this as: BMJ 1994;308:558
  1. J Warden

    Whether state medicine in the style of the NHS is compatible with clinical freedom is a question more suited to academic discussion than practical politics - though in Britain it is never far from the surface and is about to rise to the top again. Twice at critical junctures in the history of the NHS doctors' leaders have had to press for government assurances on the issue. In 1990 a formal agreement was reached with the medical royal colleges that clinical standards would not be compromised by the current NHS reforms. This in turn had echoes of Lord Moran's crucial mediation in 1948 to avert Bevan's threat of a full time salaried service.

    These initiatives were assumed to satisfy the profession on matters of clinical freedom. For their part governments have by and large respected the principle of clinical freedom. Ministers who do not …

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