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Virtual politics in the new NHS

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7165.1091 (Published 17 October 1998) Cite this as: BMJ 1998;317:1091
  1. Brian Salter, professor of health services research (editor@bmj.com)
  1. University of East Anglia
  2. If you would like to submit a personal view please send no more than 900 words to the Editor, BMJ, BMA House, Tavistock Square, London WC1H 9JR

    Neither the white paper for England, The New NHS: modern, dependable,nor its subsequent guidance has done anything to address the real political problem of the health service:the apparently irreconcilable collision between the ever growing demand for health care and the finite resources available. What it has done, and herein lies its considerable political skill, is to transport us into another dimension of virtual politics. It was indeed “a triumph of style over content,” as Rudolf Klein and Alan Maynard have observed, but that, after all, was its ambition and not merely the unfortunate consequence of incompetent drafting.

    The purpose of virtual politics is to create a parallel world where belief in the difficult reality of change in a particular policy arena is suspended and all becomes possible. In virtual politics, it is the immediate symbolism of the policy illusions which is of paramount importance, rather than the practicality of the content. If successful, …

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