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Will a market deliver quality and efficiency in health care better than central planning ever could? No

BMJ 2010; 340 doi: (Published 10 March 2010) Cite this as: BMJ 2010;340:c1302
  1. Jonathon Tomlinson, general practitioner
  1. 1Lawson Practice, London
  1. echothx{at}

    James Gubb (doi:10.1136/bmj.c1297) and Stephen Smith (doi:10.1136/bmj.c1299) are convinced that market forces will improve the NHS, but Neal Lawson (doi:10.1136/bmj.c1300) and Jonathon Tomlinson have their doubts

    Last week the Turkish advocate at my practice turned to me and said, “Dr Jonathon, these doctors are drinking the blood of their patients.” It was the second time an advocate had used that phrase. The first time was in 2004 when I was working in Afghanistan. For as long as anyone could remember, local doctors had visited villages by motorbike with a backpack full of colourful injections. Whatever symptoms were presented, the treatment was an intramuscular injection—at best, sterile water; at worst, coloured water rich with pathogens. Patients often ended up with abscesses and occasionally died from septicaemia. A common treatment offered by …

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