Intended for healthcare professionals

Analysis And Comment

A third way

BMJ 2006; 333 doi: (Published 27 July 2006) Cite this as: BMJ 2006;333:252
  1. Gwyn Bevan (, professor of management science1
  1. 1 Department of Operational Research, London School of Economic and Political Science, London WC2A 2AE

    The question of NHS independence is being raised because of the belief that it has been damaged by a series of reorganisations and dramatic shifts in policies. The Department of Health has been reorganised three times; the regional structure and purchasing tier in the NHS have each been reorganised four times; there have been mergers of providers of acute services and reorganisation of mental health services; and inspectorates have been created, expanded, abolished, and merged (with one lasting 17 days).15 The policy of a market driven by provider competition in which money followed the patient was introduced in 1991,6 abolished in 1997,1 and reintroduced from 2006, …

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