Intended for healthcare professionals

Observations Body Politic

That sinking feeling

BMJ 2009; 339 doi: (Published 12 August 2009) Cite this as: BMJ 2009;339:b3251
  1. Nigel Hawkes, freelance journalist
  1. nigel.hawkes1{at}

    The health service faces a financial storm so severe that it may struggle to keep its head above water

    Andy Burnham, England’s health secretary, has called for children up and down the country to invent a new swimming stroke. The breast stroke, the crawl, the butterfly, and the backstroke are evidently passé, and we now need to be inventive, he says. His call forms part of the Change4Life initiative, designed to make children more active.

    Suppressing an unworthy snigger I reflected that the NHS could do with something similar. As the recession sweeps in, and analysts forecast a gloomy financial future, a new stroke is desperately needed. How is the NHS going to stay afloat on flat or declining budgets, when it has already spent a fortune doggy paddling not very far? People are queuing up to tell us, but are they waving or drowning?

    There is an end of term feeling about health policy. Partly it is a result of a string of high level resignations: the health minister Ara Darzi, Mark Britnell (head of “world class commissioning” at the Department of Health), and William Moyes, chief …

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