Intended for healthcare professionals

Observations Life and Death

The costs of the reverberating bedpan

BMJ 2010; 341 doi: (Published 21 October 2010) Cite this as: BMJ 2010;341:c5541
  1. Iona Heath, general practitioner, London
  1. iona.heath22{at}

Collaboration not competition is the key to the viability of the NHS

The NHS grew out of the communitarian sense of social solidarity that arose from the shared experience of the second world war. It is loved by the British people because it represents what is best about British society and is, and has always been, a collective achievement despite the deep social and economic divisions that mar other aspects of life in this country. Funded through general progressive taxation, the health service is provided for the people by the people; and since its inception many, many people, including myself on more than one occasion, have had cause to be profoundly grateful for its existence and for the comprehensive care it is able to provide.

Throughout the more than 60 year history of this great national institution the clanging of bedpans has continued to reverberate in Whitehall. Each successive government has reiterated its commitment to the NHS’s founding principles, albeit principles that seem to vary according to the prevailing ideology, and almost all have succumbed to the temptation to radically “reform” the service. There …

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