Intended for healthcare professionals


A “common sense revolution” for UK health care?

BMJ 2000; 321 doi: (Published 08 July 2000) Cite this as: BMJ 2000;321:63

The Conservatives unveil their latest plans

  1. Jennifer Dixon, senior health policy analyst (
  1. King's Fund, London W1M OAN

    For the NHS, just like English football, it's been a salutary month. At home some of us might just convince ourselves that the NHS is the envy of the world. But playing away, where we are compared directly with other nations, our performance is found wanting. Ranked 18th overall in the World Health Organization's worldwide league of healthcare systems, we can argue with the referee about the rules.1 But the sneaking suspicion must be that the result is about right; indeed it could have been much worse. Other countries may spend more, be less fair and less efficient, have more trouble containing costs, and have messier organisations than the NHS, but somehow they provide a better overall standard of health care. How do they do it?

    At a macro level, the difference between the United Kingdom and other European countries is obvious: the United Kingdom spends less on health care and there is far less private financing and private provision. The benefits of more expenditure are comparatively clear: more and better paid staff, more and newer equipment, and …

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