Education And Debate

The new NHS: commentaries on the white paper: From specialist services to special groups

BMJ 1998; 316 doi: (Published 31 January 1998) Cite this as: BMJ 1998;316:378

Challenging times for specialist services

  1. Christopher Bunch, medical directora
  1. a Oxford Radcliffe Hospital NHS Trust, The John Radcliffe, Oxford OX3 9DU

    The white paper focuses to a large extent on dismantling the internal market and the development of primary care. The provision of specialist services—which investigate and treat the bulk of serious ill health—get scant mention, despite their accounting for about £1.4 billion of NHS expenditure annually.1

    In an almost throw away line, the white paper insists that “everyone with suspected cancer will be able to see a specialist within two weeks of their GP deciding they need to be seen urgently and requesting an appointment.” It is not difficult to understand why cancer has been singled out for this treatment. It is a common and greatly feared disease. Much work has been done around the country following the Calman-Hine report2 to set standards for cancer care, define protocols and guidelines, develop multidisciplinary teams, and identify …

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