Evaluate, integrate, or bust‖

General practice p 1054

The gradual introduction of NHS Direct, the 24 hour health telephone helpline due to be a national service by the year 2000, is a small but important symbol of the modern NHS.1 It has been designed to respond to the fastest growing influences on service industries: consumerism and technology.2 NHS Direct aims initially to do for the health service what cash machines have done for banking: to offer a more accessible, convenient, and interactive gateway. Its longer term aim should be to help the NHS change its predominant ethos from paternalism to partnership.3

This method of delivering services is not particular to health care. Telephone services in other sectors have been one of the fastest growth areas in employment in the United Kingdom. However, the speed of planned growth of NHS Direct (pilots launched March 1998, more bids invited May 1998 and announced in July 1998, 19 million people (40% of England's population) to be covered by April 1999) might suggest that fulfilling political promises precedes rigorous evaluation. A more likely interpretation is that the research is aimed at clarifying not if …