The NHS faces a widening gap between demands and resources. 1 2 The UK government has promised substantial additional funding over the next three years. In return, it expects doctors to help reshape the delivery of health care. Meanwhile, as a result of the Bristol case 3 4 (in which two surgeons from Bristol were found guilty by the General Medical Council of continuing to operate on children when they knew their death rates were unacceptably high) the public is asking whether doctors can be trusted,5 and government ministers are murmuring that the medical profession is a law unto itself. Certainly, the public and politicians suspect that doctors cover up their failings, although neither perhaps would go as far as George Bernard Shaw in asserting that “every doctor will allow a colleague to decimate the whole countryside sooner than vitiate the bond of professional etiquette by giving him away.”6