Intended for healthcare professionals

Views & Reviews From the Frontline

Greed isn’t good

BMJ 2011; 342 doi: (Published 26 January 2011) Cite this as: BMJ 2011;342:d524
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

I have realised that I am not middle class enough to call myself a socialist and that capitalism does work to drive production. Indeed there is plenty of scope for efficiency savings in the NHS’s £100bn (€120bn; $160bn) annual budget without a loss of function. So should we welcome healthcare reforms that offer more competition? Soon general practice consortiums will commission services from any “willing provider,” and foundation trust status will be given to all hospital trusts, willing or otherwise. All this will be overseen by a new economic regulator.

The government’s rationale on commissioning is simple. …

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