Intended for healthcare professionals


The secret life of the NHS

BMJ 2000; 321 doi: (Published 07 October 2000) Cite this as: BMJ 2000;321:894

Trust seems not to have understood function of walk-in centre

  1. Toby Lipman (, general practitioner
  1. Westerhope Medical Group, Westerhope, Newcastle upon Tyne NE5 2LH
  2. Woodbridge, Suffolk IP12 1LW

    EDITOR—Jones writes about “what the government of the day would rather you didn't know” and says that “NHS staff have been pressured by management and government representatives not to give interviews or make press statements critical of NHS services.”1 This works both ways. Often NHS management and staff, knowing that they have a problem, don't want their immediate superiors, colleagues, the public, or the government to know—they themselves may not wish to acknowledge its exact nature.

    The problem may be discussed off the record within “in-groups,” which implicitly see public criticism as unacceptable and certainly won't go public with their views. This aspect of NHS culture has taken decades to evolve, and …

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