Editorials

Social capital

BMJ 2001; 323 doi: http://dx.doi.org/10.1136/bmj.323.7306.177 (Published 28 July 2001) Cite this as: BMJ 2001;323:177

Trusts need to recreate trust

  1. Tom Welsh, management consultant (jane@welsh.demon.co.uk),
  2. Mike Pringle, professor of general practice (mike.pringle@nottingham.ac.uk)
  1. 38 Station Road, Swinderby, Lincoln LN6 9LY
  2. University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH

    In today's British health service the experiences of patients and the insights of doctors and nurses1 highlight demoralisation and fragmentation. The solution lies in correcting years of underinvestment, but the nature of that investment must be appropriate: new buildings and staff are not enough.

    Public policy experts such as Robert Putnam (who recently ran a seminar at 10 Downing Street2) argue that any complex organisation uses three forms of “capital”—physical, human, and social.35 All three have been run down in the NHS since 1948 and are addressed in the NHS Plan for England.6 The planned increase in spending on health and the proposed expansion in staffing, with increased emphasis on good employment practices, may …

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