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Can the NHS cut costs without substantially damaging the quality of health care? No

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c1966 (Published 14 April 2010) Cite this as: BMJ 2010;340:c1966
  1. James Owen Drife, professor of obstetrics and gynaecology
  1. 1Leeds General Infirmary, Leeds LS1 3EX
  1. j.o.drife{at}leeds.ac.uk

    Rebecca Rosen (doi: 10.1136/bmj.c1967) and Paul Corrigan (doi: 10.1136/bmj.c1999) think that the NHS cost cutting that will occur over the next few years does not inevitably mean that the quality of care it provides will suffer. John Appleby (doi: 10.1136/bmj.c1959) and James Owen Drife are not so sure

    For NHS clinical staff, cutting costs is a way of life. When I was a final-year student in 1970, extra beds were squeezed into the middle of the wards. When I was a consultant in the 1980s, the financial formula was simple: your department’s budget is the same as last year’s, minus 2%. Through good times and bad this mantra has never changed, except that “department” is now “team.”

    So my first reaction was that the coming lean years will make little difference. Writing this article, however, made me face facts. Eighteen per cent of government spending goes on health—second …

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