Intended for healthcare professionals


The pattern of London's health services is still shadowy

BMJ 1994; 308 doi: (Published 19 February 1994) Cite this as: BMJ 1994;308:496
  1. J Smith

    Ninety per cent of all health care takes place outside hospital, but 90% of people's image of health care is of hospitals: large, imposing institutions, often reflecting a past era of civic pride.

    So last week's announcement of the end of Guy's as one of London's acute hospitals (see p 496) was much more dramatic than the simultaneous announcement of extra funds for London's primary care. Guy's is visible - not only physically but also in the mythology of the new NHS. Clinical directorates were born there, and it was one of the first and most prominent of hospital trusts. Compared with high profile, specialist services, its new function as a site for academic work and locally based services and “for exploring the boundaries of medicine” doesn't sound so important. To a public weary of the tendency to rename any public service that doesn't work well “exploring …

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