Intended for healthcare professionals

Views & Reviews Review of the Week

Time to turn the world upside down

BMJ 2010; 340 doi: (Published 16 February 2010) Cite this as: BMJ 2010;340:c918
  1. Richard Smith, director, UnitedHealth Chronic Disease Initiative
  1. richardswsmith{at}

    Are rich countries’ aid programmes part of the problem, not the solution for improving health in the developing world? Richard Smith reviews a sceptical book by a former NHS chief executive

    In 2006 the NHS in England was left with many of its parts in deficit after the biggest ever increases in funding, and Nigel Crisp, then the service’s chief executive, was kicked upstairs to the House of Lords and offered what many saw as a face saving job to see how the United Kingdom could help with health care in developing countries. A year later he produced a report, Global Health Partnerships, much of which has been ignored; but in January he published a book on global health that is refreshingly radical.

    Crisp, as he compares and contrasts his experience running the world’s largest healthcare system with working in poor countries, argues convincingly that our present systems are bust in rich and in poor countries alike and that it’s time for something new to arise. His case for “turning the world upside down” …

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