Intended for healthcare professionals


Hospital of the future

BMJ 2000; 320 doi: (Published 11 March 2000) Cite this as: BMJ 2000;320:715

Health economics may be misleading

  1. L C Luke, consultant in accident and emergency medicine (
  1. Royal Liverpool University Hospitals, Liverpool L7 8XP
  2. University of Birmingham, Birmingham B15 2TT

    EDITOR—Posnett in his article asserts that “a close observer of the NHS… might be forgiven for thinking that the debate about the concentration of acute hospital services has been driven more by the needs of NHS managers and the medical professions than by the needs of the local populations that they are supposed to serve.”1 As director of the York Health Economics Consortium, he explains that the apparent logic of rationalisation and mergers is not supported by the evidence. He argues that service planners would do well to give more prominence to the importance of ensuring that hospital services are local and easily accessible.

    Fine words, but what about the rationalisation in Liverpool that followed the consortium's recommendations in 1992? In their review of accident and emergency and related acute services for …

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