Education And Debate

The New NHS: commentaries on the white paper: From command economy to demand management

BMJ 1998; 316 doi: (Published 17 January 1998) Cite this as: BMJ 1998;316:212

Financing the NHS

  1. Chris Ham, directora
  1. a Health Services Management Centre, University of Birmingham, Birmingham B15 2RT

    The white paper sets out a bold and imaginative vision for the organisation and provision of health care. The unanswered question is whether the money will be available to turn this vision into reality.

    Taking the optimistic view-the view set out in the white paper-there is no reason to believe those who argue that the NHS will be unable to cope with the demands of increasing public expectations, medical advances, and an aging population. On this reading, the proposals for improving clinical effectiveness and reducing unnecessary bureaucracy will enable the NHS to accommodate future pressures without sacrificing its commitment to universality and comprehensiveness. Moreover, by aligning clinical and financial responsibility, the government's plans will empower doctors and other health care professionals to improve services from the patient's perspective, particularly by reducing variations in performance.

    Taking the pessimistic view, there …

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