Intended for healthcare professionals


What's next for the NHS?

BMJ 2007; 335 doi: (Published 05 July 2007) Cite this as: BMJ 2007;335:18
  1. Nick Timmins, public policy editor
  1. Financial Times, London
  1. Nick.Timmins{at}

    As Gordon Brown takes over from Tony Blair as prime minister, Nick Timmins speculates on what he might have in store for the NHS

    Day to day most doctors, nurses, managers, and other NHS staff carry on with what they do best: treating patients and trying to make sure the service works. But among policy makers, politicians, NHS trade associations, trade unions, and those with financial and managerial responsibility for the service, the focus right now is elsewhere, and on only one question. What will Gordon Brown's arrival as prime minister mean for the NHS?

    The short answer is that no one knows. Perhaps, at this point, not even Gordon Brown himself. Despite the fact that the NHS now consumes almost a fifth of all public spending, the service is not something to which he has devoted a lot of time over his decade as chancellor.

    To be sure, he has been deeply involved in the really big issue: how much money the NHS should receive. It might have been Tony Blair who announced on television that the government would get health spending in the UK up to the European average—a promise the government delivered. But it was Gordon Brown who—after exploding at the prime minister for stealing his budget—commissioned Derek Wanless to provide the justification for the huge increases in spending that the NHS has seen.

    It is also true that the chancellor was deeply involved in the debate over the freedoms that foundation trusts should enjoy. There are two views of those events. One is that the chancellor hated the idea and was firmly on the side of those who see their creation as just one part of the “creeping privatisation” of the NHS. The other is that all Gordon Brown did was ask a question that Ken …

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