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Competition is intrinsically wasteful

BMJ 2012; 344 doi: (Published 08 May 2012) Cite this as: BMJ 2012;344:e3199
  1. S Michael Crawford, consultant medical oncologist, honorary senior lecturer in Oncology and Clinical Research, Airedale General Hospital, West Yorkshire BD20 6TD, UK
  1. Michael.Crawford{at}

Some months ago I read a remarkable newspaper story. There is a push for restaurants to reduce waste ( This is enthusiastically welcomed in some quarters but is causing consternation in others. Apparently, excessive portion size and careless kitchen habits lead to a third of all wasted food coming from diners’ plates—600 000 tonnes of food each year, or 22 tonnes per eatery.

In the NHS we are taught to regard waste as anathema. Some are of the view that making healthcare provider organisations compete with each other will force them to drive down their costs by cutting out waste. Those providers operated by the private sector are expected to be especially good at this. Competition between providers is an important point of the legislation recently passed by parliament.

If any commercial organisations know about competition, restaurants do. Business failures are extremely common …

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