Intended for healthcare professionals

Observations Life and Death

The emperor’s new constitution

BMJ 2008; 337 doi: (Published 30 September 2008) Cite this as: BMJ 2008;337:a1857
  1. Iona Heath, general practitioner, London
  1. iona.heath{at}

    A proposed constitution for the NHS is superficial and hypocritical

    A draft constitution for the NHS in England was published on 30 June 2008 and is open for public consultation until 17 October ( A constitution establishes the fundamental principles according to which an organisation is to be governed and is usually composed and published at its inception. The NHS has celebrated its 60th birthday this year, and you have to wonder why a constitution is thought to be needed now.

    The current draft is seven parts platitude, two parts mendacity, and one part hypocrisy. The worst excess of platitude comes in the statement of six values listed at the end of the constitution. The fourth of these concerns compassion: “We find the time to listen and talk when it is needed, make the effort to understand, and get on and do the small things that mean so much—not because we are asked to but because we care.” I find this particularly sickening precisely because it describes what I and so many others working in the NHS try to do every day—but our aspiration is cheapened by this kind of trite and superficial writing. I almost …

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