Research Article

Other cities, same problems.

BMJ 1993; 306 doi: (Published 16 January 1993) Cite this as: BMJ 1993;306:199
  1. R Maxwell
  1. King's Fund, London.


    London's health care problems, particularly underfunding, are mirrored in other major cities in the United Kingdom and abroad. None has found the perfect solution, but the debates on the Tomlinson report provide an opportunity to review how to manage the three major areas of service provision, medical education, and research in London. Mr Robert Maxwell suggests that some aspects of the successful ambulatory care initiative in New York could be adapted by the capital's primary care providers while the secondary services might learn from the rationalisation of specialist services in Paris.