Medicine And Books

Care in Chaos

BMJ 1996; 313 doi: (Published 12 October 1996) Cite this as: BMJ 1996;313:951
  1. Julian Leff

    Roger Hadley, Roger Clough Cassell, £15.99, pp 226 ISBN 0 304 33525 8

    The 1990 NHS and Community Health Act was a watershed for all of us working in healthcare. The act established the internal market, the central tenet of which is that health is a commodity that can be bought and sold and hence needs to be measured quantitatively. This is a testable proposition, but the reform was not introduced in an experimental vein. It was imposed without consultation with the NHS workforce, in the belief that it would work. In this respect it can be seen as an example of what Popper termed “utopian engineering.”

    Six years after the act, is …

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