Intended for healthcare professionals

Observations Body Politic

The NHS must change or die

BMJ 2012; 345 doi: (Published 04 July 2012) Cite this as: BMJ 2012;345:e4478
  1. Nigel Hawkes, freelance journalist, London
  1. nigel.hawkes1{at}

The approach being taken to improve innovation in the NHS in England smacks strongly of business as usual

Ministers and managers keep telling us the NHS is serious about innovation. Take this from David Nicholson, chief executive of the NHS in England, in his 2011 report Innovation, Health and Wealth. “Simply doing more of what we have always done is no longer an option. We need to do things differently. We need to radically transform the way we deliver services. Innovation is the way—the only way—we can meet these challenges. Innovation must become core business for the NHS.”

Amen to that. The only change I would make would be to unsplit the infinitive, but that’s mere pedantry. But despite the torrent of words expended on the issue, in Nicholson’s report and elsewhere, I still wonder whether the NHS really gets it. The solutions advanced are many and various, but few mention the unpalatable fact that in life outside the NHS innovation is often driven by failure. Organisations that do not win market share or make the best use of their capital go to the wall. Their assets are taken over by others who either make better use of …

View Full Text

Log in

Log in through your institution


* For online subscription