White paper puts GPs in the driving seat of the new NHS

BMJ 1997; 315 doi: (Published 13 December 1997) Cite this as: BMJ 1997;315:1559
  1. John Warden

    The British government views its new 10 year plan, outlined this week, as a turning point for the NHS. The white paper The New NHS gives control of most of the NHS budget to GPs and community nurses, writes John Warden

    The new NHS, foreshadowed in the white paper, will build on what has worked and discard what has failed. It is the basis of a 10 year programme of “evolutionary change rather than organisational upheaval.” There will be no return to Labour's old command and control system. But there will be an end to the competitive internal market, introduced by the Conservatives; in its place will be a system of “integrated care” based on partnership driven by performance. The government believes that “what counts is what works.”

    Many features of the internal market will survive. For example, the separation between the purchase and provision of hospital care will be retained; cooperation, however, will replace competition. Local doctors, nurses, and health authorities will have new powers to commission services and ensure that the local NHS is built around the needs of patients. Health authorities will have a powerful supervisory role with greater input …

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