Intended for healthcare professionals

Letters NHS reform

Study proposal

BMJ 2011; 342 doi: (Published 21 April 2011) Cite this as: BMJ 2011;342:d2584
  1. Joseph J Lee, academic clinical fellow in paediatric epidemiology1
  1. 1Institute of Child Health, London, UK
  1. josephlee{at}

Because the proposed changes to the NHS have no overwhelming supporting evidence,1 ethically the proposed changes can take place only in the form of a trial. I ask you to consider favourably the following study proposal that I submit without permission on behalf of the UK government.

  • Title: Reorganisation of the NHS in England.

  • Background: The NHS is in its 63rd year. It is suffering the same demographic and technological challenges as all high income countries, specifically ageing of the population and increasingly expensive new technologies. These are major problems that we seek to deal with. We also have concerns about outcomes in the NHS compared with other countries. France spends more on healthcare …

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