Intended for healthcare professionals


Commentary: Fixing the policy may not sort out the politics

BMJ 2011; 342 doi: (Published 04 April 2011) Cite this as: BMJ 2011;342:d2093
  1. Nigel Edwards, acting chief executive
  1. 1NHS Confederation, London SW1E 5DD, UK
  1. nigel.edwards{at}

There has been growing disquiet about the NHS Health and Social Care Bill and how the reforms will work in practice. Walshe and Ham’s long list of proposals covers many of these.1 Others remain, including changes to the public health system and the Health Protection Agency, concerns about workforce planning and education, and unanswered questions about organisations that will not be able to become foundation trusts. All these points will need to be addressed, but fixing the technical issues is only part of the problem. Fixing the politics, telling the story, and containing the anxiety that has been created may be much harder.

Major reforms require a strong narrative about why the inevitable upheaval they …

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