Rapid responses are electronic letters to the editor. They enable our users to debate issues raised in articles published on thebmj.com. Although a selection of rapid responses will be included online and in print as readers' letters, their first appearance online means that they are published articles. If you need the url (web address) of an individual response, perhaps for citation purposes, simply click on the response headline and copy the url from the browser window. Letters are indexed in PubMed.
The NHS is a poor and inefficient use of tax-payer funds. Years of over-funding has created significant productivity issues. Bureaucracy, poor value for money with respect to many drugs and interventions and over-prescribing are all issues that should be tackled. If citizens were less complacent and more responsive to their own health, such as maintaining good health and taking responsibility for health issues, we would all be far happier. That in itself would be cost-effective.
I believe there should be individual savings accounts with the NHS and any surplus should be added to the individual's pension. Such an incentive would be cheaper, than continually throwing monies after problems without resolving the underlying issue.