Expert questions whether NHS can be transformed without further upheaval

BMJ 2015; 350 doi: (Published 05 February 2015) Cite this as: BMJ 2015;350:h695
  1. Nigel Hawkes
  1. 1London

Two ideas have taken hold in English health policy, a conference at the health policy think tank the King’s Fund in London was told on 4 February. Unfortunately, they contradict each other.

While there is agreement that the health and social care system needs major reform, there is equally strong agreement that another major reorganisation must at all costs be avoided.

After the trauma of the 2012 Health and Social Care Act no party at the forthcoming general election will be arguing for big legislative changes to the structure of the services. Yet all three main parties agree that substantial change is needed and do not disagree strongly about the direction of change. This paradox was outlined by Chris Ham, chief executive of the King’s Fund. “The last thing we need is another programme of organisational change, but that goes alongside the simultaneous thought that the …

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