Will a market deliver quality and efficiency in health care better than central planning ever could? No

doi:10.1136/bmj.c1300

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Neal Lawson, chair

¹Compass, London SE1 7SJ

neal.lawson{at}btinternet.com

James Gubb (doi:10.1136/bmj.c1297) and Stephen Smith (doi:10.1136/bmj.c1299) are convinced that market forces will improve the NHS, but Neal Lawson and Jonathon Tomlinson (doi:10.1136/bmj.c1302) have their doubts

Markets or targets? That’s about as good as the choice gets for people working in the NHS. You—the doctor, nurse, secretary, cleaner, or manager—can’t be trusted to do your job properly without daily interference from the top or competition. There is no such thing as public service ethos, no calling, and no duty to the public to serve. There is certainly no ingenuity or ability to be innovative or make common sense decisions based on the evidence before your eyes, the experience you have gained, or the training you have gone through. Instead, you are either so stupid that you have to be …