Intended for healthcare professionals


This house believes doctors are neglecting their duty to lead health service changes: Second opposer

BMJ 2009; 338 doi: (Published 21 April 2009) Cite this as: BMJ 2009;338:b1573
  1. Mark Goldman, chief executive, Heart of England NHS Foundation Trust
  1. mark.goldman{at}

    Medicine has been evolving for thousands of years. The National Health Service is 60 years young. It is an instrument of delivery of health services led by politicians and directed by civil servants to promote the health of the nation. At its core the relative priorities of health care and the way they are received by patients and communities in the UK are shaped by policy. Between the policy at the centre and the individual patient in the distant community are structures which are in a constant state of flux. The NHS is but one of many systems in use worldwide and, by most measurements, not …

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