Is the NHS getting better or worse?

doi:10.1136/bmj.328.7431.106-b

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Better to be vaguely right than precisely wrong

David Kernick (su1838@eclipse.co.uk), general practitioner

St Thomas Health Centre, Exeter EX4 1HJ

EDITOR—In his editorial Smith asks whether the NHS is getting better or worse.1 By falling into the reductionist trap of assuming that the healthcare system can be understood by dissecting it into its component parts, he succeeds in being precisely wrong rather than vaguely right.

Underpinning his argument is a belief that the transfer processes that relate inputs to outputs …