Foundation hospitals: we've been here before

BMJ 2003; 326 doi: (Published 22 May 2003) Cite this as: BMJ 2003;326:1153
  1. Neville W Goodman, consultant anaesthetist (
  1. Southmead Hospital, Bristol

    Here are some headlines. “Health reforms ‘no cure for cash crises’.” “A private hospital by any other name…” “Unsafe hands when the heart's not in it.” Here's an editorial entitled “Doctor, they're in trouble” and which starts, “Imagine the fuss if an untested and untried drug appeared on the market.” Here's another: “When the NHS market crashes”—it begins, “Doctors must be uncertain whether to laugh or cry.”

    These headlines are the main reason that foundation hospitals are doomed. The headlines are from news-papers in 1989-90, at the time of the Conservatives' reforms. They could be recycled. Politicians show no signs of learning the most important lesson: stop fiddling about. The difference now, 13 years on, is that those working in the NHS have already seen the failure of numerous other attempts to reform its structure—18 since 1980, according to Kieran Walshe, reader in public management and director of research at Manchester Centre for Healthcare …

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